Identification of a Health Policy Issue/Concern
The ever-growing rapid lifestyle of Americans causes migraines and various pain symptoms, while people with oncologic and chronic diseases also need painkillers. To address pain, people visit doctors who, in turn, prescribe painkillers containing opiates and other addictive drugs. When drugs no longer work, doctors tend to prescribe fentanyl or other opioids, which are hundreds of times stronger than heroin. The described situation is one of the leading reasons for opioid epidemic that was officially declared by President Trump. The American healthcare is still in need of a relevant and effective policy to address such an adverse situation by reducing the number of drug prescription abuse cases and creating alternative solutions to treat pain syndromes.
Evidence-Based Literature Review and Documents
Researchers attribute the spread of opioid dependence primarily to the prescription painkillers such as Oxycontin and Vicodin (Kominek, 2018). Since the early 1990s, a medical practice to help patients with chronic pain and prescribe strong painkillers with opioids has been established in the United States (Kominek, 2018). Doctors, following that recommendations for chronic pain, often prescribed them to people who did not actually need any pills.
According to a preliminary estimate by the American Health Policy Institute (2018), in 2016, 59 thousand people became overdose victims, which is more than death associated with car accidents. Approximately two-thirds of all overdose deaths are associated with heroin and other opioids (American Health Policy Institute, 2018). In the past ten years, the number of heavy drug-taking deaths has been increasing exponentially.
In the United States, the number of visits to emergency departments for suspected opioid overdose rose by 30 percent from 2016 to 2017 in 45 states (Marie, Arnstein, & Zimmer, 2018). Opiate overdose rates have increased in both men and women of all age groups and all regions, varying in rural and urban areas. Studies show that people with one overdose are more likely to get a second one in the short-term period. Proper preparation of emergency departments and patient management protocols after an overdose, including the introduction of naloxone and grouping for treatment, are critical (Kominek, 2018). Obtaining data on the treatment of patients after an opioid overdose in emergency rooms is necessary for timely, strategic, and coordinated community responses.
Recently, the US Senate was assigned to find ways of eliminating the drug epidemic that was recognized as a national emergency. Recent changes in the budget for 2018 require about $ 18 billion for a drug control policy implemented by a federal agency responsible for the US combat against drug overdose (Marie et al., 2018). The letter was addressed to the republican and democratic leaders of the Senate, as well as to the heads of the Senate Committee on Appropriations. In 2016, the Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Act were implemented to provide grants for programs targeting the prevention of opioid drug abuse.
Analysis of the Issue/Concern Using a Chosen Analysis Model
The key health policy that aims at addressing prescription drug abuse focuses on improved pain management, reduction of pills, and public education. In order to understand the specified health concern in an in-depth manner, it is essential to consider it in terms of model elaborated by Hewison (2007). The first step identified by the mentioned author is to clarify sufficiency of authority. One may note that some organizational changes may be required to implement the target policy since many nurses do not have the authority to prescribe drugs, while patient education and proper drug administration are among their responsibilities.
As for adequate support step, change nurses should be equipped with resources such as clear guidelines and change plan to strictly follow its prescriptions (Hewison, 2007). Change resistance issues and patient dissatisfaction should also be anticipated and elaborated by nurses in advance. Even though the proposed policy is consistent with the overall workforce development, nurses’ skill mix needs to be supplemented by such competences as conflict management, patient education techniques, and relationship building.
The clinical governance dimension implies that the target policy is consistent and balanced so that change nurses may achieve the initial goal and address the concern (Hewison, 2007). In this case, it is evident that public education and reduction of prescribed pills would encounter negative attitudes of patients since many of them are used to taking opioids to eliminate pain. Therefore, additional measures to communicate change and allow patients alternatives to opioids should be suggested.
Strong leadership is critical in addressing the specified epidemics in order to formulate relevant goals, milestones, analyze results, and monitor the process and consequences of the policy. There are no specific education points that were clearly explained to nurses, which demonstrates the necessity to elaborate on the health policy.
Clear Statement of Personal Position/View on the Issue/Concern Chosen
In my point of view, the reduction of prescribed opioids cannot be reduced without offering some alternative means to address pain syndromes. Since no one should live with pain, the health policy should assume useful options to ensure that people who have pain may comfortably and safely use it. At the same time, I consider that patient education is a rather significant aspect of the proposed health policy as it focuses on eliminating health illiteracy and increasing awareness of people regarding their own health condition and the ways of enhancing it. In my opinion, both individual and group educational sessions should be developed with the emphasis on the specific needs of patients, be it migraine or oncology.
Alternatives to the Current Policy Issue/Concern
The review of the scholarly literature provides an opportunity to pay attention to alternative strategies aimed at combating with opioid epidemic. Consistent with Holton, White, and McCarty (2018), I suppose that public health should consider improving access to naloxone rescue as a means to eliminate the impact of opioids. The connection between opioids and immune receptors causes addiction, which can be blocked by naloxone that completely eliminates the addiction, changing not only the behavior but also the neurochemical processes in the brain by stopping dopamine responses (Holton et al., 2018). Personally, I propose that opioids for pain relief should be prescribed in combination with naloxone. At the same, it is essential to building public awareness of naloxone-related treatment and overdose prevention options.
Nursing Specific Leadership Impact
The alterative discussed in the previous section of the paper requires significant efforts of nursing leaders and nurses as new practice guidelines should be developed and implemented. One may anticipate that some challenges such as misunderstanding of drug administration or medical errors may occur in the process of introducing the proposed health policy. In this regard, nurse leaders should carefully explore the problem and the offered solution, thus learning every aspect to be taken into account.
Furthermore, leaders should act as motivators to nurses and change stimulators, answering all questions and addressing difficult situations. Special training should be provided by leaders to nurses with the aim of ensuring they properly understand what exactly should be done, including goals, timeframe, expected outcomes, and potential barriers.
References
American Health Policy Institute. (2018). Opioid crisis prevention, strategy and treatment. Web.
Hewison, A. (2007). Policy analysis: A framework for nurse managers. Journal of Nursing Management, 15(7), 693-699.
Holton, D., White, E., & McCarty, D. (2018). Public health policy strategies to address the opioid epidemic. Clinical Pharmacology & Therapeutics, 103(6), 959-962.
Kominek, C. (2018). Current and emerging options to combat the opioid epidemic. The American Journal of Managed Care, 24(10), 207-214.
Marie, B. S., Arnstein, P., & Zimmer, P. A. (2018). Pain and opioids: Call for policy action. The Journal for Nurse Practitioners, 14(1), 40-44.