Week 4 Project

Opioid abuse

Yordanka Milanes

South University

Health Policy and Health Promotion in Advance Nursing Practice

February 13, 2019

Introduction Comment by Author: The heading introduction is not used in APA see page 63 APA manual 6th ed Recommend paper title instead

Opioid abuse is a primary problem in the United States. Opioid abuse has raised concern among stakeholders in the healthcare industry. There is an underlying problem of opioid misuse by the public as indicated by the increasing opioid addiction. Increased addiction to opioid impacts the social and economic welfare of the society. According to the 2015 report, there were 33,000 opioid-related deaths (Dart, 2015). Deaths resulting from opioid overdose were almost equal to the accidental deaths number. Reports show that about two million people in the United States have opioid use disorders. Opioid abuse has devastated society, as well as the growing addiction rates, reveals that the problem might continue to spread. There is a connection between increasing heroin abuse and the abuse of prescribed opioids. Despite the adverse effects of the opioid epidemic, little attention has been offered (Rudd, 2016). No signs showing that opioid epidemic will decrease.

How the policy is intended Comment by Author: First level headings capitalize first letter key words see page 62 APA manual 6th ed.

The Center for Disease Control (CDC) has stepped to discuss the opioid abuse issue due to the rising concern of this epidemic in a healthcare setting. CDC developed a health policy aiming at directing opioids use in healthcare organizations. This policy stated the guidelines for opioid pain drugs prescription by healthcare professional for chronic pain in non-cancer related cases. These guidelines concentrated on the appropriate long-term usage of opioid pain relievers (Dowell, 2016). The policy was established through a comprehensive evidence review available as well as healthcare expert input.

The policy aimed at ensuring that patients and healthcare staff use a safer and effective treatment methods. This helps to improve patients’ results like improved function. The policy is intended to decrease the number of individual having the disorders or even experience of negative impacts related to the drugs. Healthcare organization decision making is supposed to be made based on the relationship between healthcare professionals, patient’s health condition and patient. The recommendation made through policy depends on healthcare evidence like clinical trials (Dowell, 2016). When the physician provides care should consider patient care and circumstances of the case.

The policy concentrates on three major areas. First, determine if it is appropriate to begin or even continue prescribing opioids to manage pain. It includes selecting the best therapy to be used in an offered condition. Some therapies to be considered by a physician are opioid therapy and non- opioid therapy. Selecting therapy help to establish the treatment goal as well as discuss the benefits and risk of the selected therapy with the patient.

Secondly, selecting the opioid drug to be prescribed, identifying drug-intake duration and dosage, discontinuation of the prescription and follow-up the client. The physician selects the appropriate opioid depending on the needs of the patient and considers the dosage of the drug as well as treatment duration to be given (Dowell, 2016). Clinicians also consider follow-up and opioid therapy termination. Therapy termination is done once the treatment goals have been realized.

Thirdly, evaluation of risk and handling risks of opioid usage. The physician should evaluate risk factors opioid-related injuries as well as identify methods of mitigating health risk. Prescription drug monitoring program data should be reviewed as well as conduct urine drug test (Dowell, 2016). Physicians should organize treatment for opioid use disorders.

Legislators involved in policy development and dissemination Comment by Author: Format please see page 62 APA manual 6th ed. Should capitalize first letter key words

The legislators supporting CDC policy are Ohio Attorney General Mike DeWine, Ryan Smith, and Robert Sprague. They have advocated counties to adopt the policy as well as encourages the local law enforcement officials to support CDC. The legislators know opioid has impacted many people in society. Therefore, the community needs to support the execution of the policy. The Attorney General supported this policy since it was a key in combating addiction of heroin (Representatives, 2016). CDC policy assisted in fighting against the heroin epidemic, according to the legislators.

Role of APRN in assisting the policy

APRN involves drug prescription involve regulated substances like opioids. The nurses may play a significant role to combat epidemic through adopting a policy in their practice. APRNs adopting the policy focuses on delivering evidence-based care that is aligned with the needs of the patient as well as may enhance patient results. Currently, they are offering authority to prescribe different controlled medications (Rounds, 2013). APRNs role in chronic management shows improvement in reducing the opioid epidemic. Comment by Author: Please explain all acronyms see page 107 APA manual 6th ed.

In the healthcare setting, APRNs might integrate guidelines in the policy in order to guide their practices. This includes conduction of a comprehensive physical examination to identify patient pain severity score to determine if opioid is an appropriate treatment method. APRNs operating in HIV care may incorporate the policy into their practice to decrease opioid-related disorders (Manworren, 2015). In other settings like emergency care, or primary care, APRNs may adopt some aspects of this policy in their practices to improve patient results as well as mitigate opioid use disorders.

How the policy influences clinical practice and promotes best outcomes Comment by Author: See page 62 APA manual 6th ed and directions for first level headings

Clinical practices related to opioid treatment have changed significantly due to CDC policy. Non-pharmacologic therapies like non- opioid therapies and physical therapy are the most preferred treatment methods for chronic pain. The clinician needs to identify when to use opioid for treating chronic pain. Before administering opioid drugs, clinicians consider the expected benefits and the risks of opioids. Clinicians use a low dosage of opioids to reduce the risk of overdose. Low dose is utilized to reduce the risks which are associated with opioid usage because acute pain treatment involves long-term opioids use. After initiating the treatment, clinician focus on assessment of the harms as well as benefits of opioid therapy within a month. Once they determine that harm outweigh benefits, the therapy is discontinued.

When clinician evaluates risks factors of a patient for opioids like drug abuse history and identifies the risk, mitigation strategy is developed and incorporated in treatment plan (Winter, 2014). Patient having opioid use disorder are given evidence-based treatment with behavioral therapies to prevent risks of opioid disorders.

How the policy may be used to ensure coordinated and comprehensive care Comment by Author: Format see page 62 APA manual 6th ed.

The CDC policy promotes multidisciplinary therapies use to manage chronic pain. These therapies involve a healthcare professional coordinating team to offer appropriate care based on the patient’s needs. Healthcare professionals operate together to combine related therapies to minimize long-term pain. They coordinate the medical as well as social aspects of care to enhance patient results. The policy encourages a patient-centered treatment approach that involves patient engagement. This involves different health care professional team who evaluates a patient and discussed treatment methods to be applied (Prevention, 2015). In order to engage with the patient, physicians normally listen to the concerns of the patient and collaborate with the patient to get a solution. Healthcare staff with cognitive behavioral therapy experts operate together to assure patient of the effectiveness of the treatment method since many believe opioids are the only pain reliever. Under the CDC policy, the treatment plan involves the interplay of various healthcare aspects that need various healthcare staff to meet the needs of the patient and enhance the patient’s outcomes.

Conclusion

The opioid epidemic is a primary health problem which might negatively impact society. Opioid use disorders and heroin addiction are still inclining as it has been observed. Execution of CDC policy was developed to reduce the trend of opioid use disorder and heroin addiction increase. This is done through promoting the usage of an appropriate prescription of opioid drugs to decrease addiction. This policy tends to regulate the prescription of opioid in an outpatient setting outside cancer care, palliative care, and end-of-life care. CDC policy has performed a crucial role to change healthcare practice to minimize usage of opioid through encouraging the use of non-opioid therapies. The policy has acquired much attraction in various states in the country due to much support from various legislators. Execution of the policy involves various healthcare professionals’ collaboration to deliver coordinated care which is centered on the needs of the patient.

References Comment by Author: Do not bold font Names of journals and volume numbers should be in italics see pages 198-199 APA manual 6th ed.

Dart, R. C. (2015). Trends in opioid analgesic abuse and mortality in the United States. New England Journal of Medicine, 372(3), 241-248. Dowell, D. H. (2016). CDC guideline for prescribing opioids for chronic pain. Jama, 315(15), 1624-1645. Manworren, R. C. (2015). CE: Nurses’ Role in Preventing Prescription Opioid Diversion. AJN The American Journal of Nursing, 115(8), 34-40. Prevention, C. f. (2015). CDC grand rounds: prescription drug overdoses-a US epidemic. MMWR. Morbidity and mortality weekly report, 61(1), 10. Representatives, O. H. (2016). State Rep. Sprague Announces Support For CDC Opioid Prescription Guidelines. Retrieved from http://www.ohiohouse.gov/robert-sprague/press/state-rep-sprague-announces-support-for-cdc-opioid-prescription-guidelines. Rounds, L. R. (2013). The consensus model for regulation of APRNs: Implications for nurse practitioners. Journal of the American Association of Nurse Practitioners, 25(4), 180-185. Rudd, R. A. (2016). Increases in drug and opioid overdose deaths—United States. American Journal of Transplantation, 16(4), 1323-1327. Winter, M. B. (2014). Collaborative care of opioid-addicted patients in primary care using buprenorphine: five-year experience. Archives of internal medicine, 171(5), 425-431.