Introduction
Substance abuse has been one of the major public health concerns for decades, and the most recent trends are rather alarming as an increasing number of people start misusing prescribed opioids. It has been estimated that the rates of drug treatment admissions grew 236% between 2002 and 2012 (Saha et al., 2016). The rate of drug poisoning deaths tripled during the same period, while the increase in opioid analgesics dispensed by American pharmacies is now unprecedented (248 million in 2012 compared to 142 million in 2002) (Saha et al., 2016). Patients tend to be reluctant to use nonopioid alternatives, and healthcare practitioners often fail to encourage patients to reduce their use of these drugs. The prevalence of prescription drug misuse is similar across different age groups.
Young adults are found to be at the highest risk as the rate of misusers in this age category reaches 15%. Approximately 5% of adolescents reported nonmedical use of prescription drugs in 2017 (Perlmutter et al., 2018). Another vulnerable group is older adults who tend to use up to five types of medication daily and often take over-the-counter drugs, which poses considerable threats (Schepis & McCabe, 2016). Saha et al. (2016) note that the annual societal costs of this health issue reach up to over $72 billion. The high prevalence of the health concern and significant negative impact on the development of the society has been acknowledged, which led to the inclusion of the corresponding objective in Healthy People 2020. This paper deals with a policy aimed at addressing the issue and the associated outcomes for certain groups and the clinical setting.
Literature Review
The high incidence of the health issue, as well as its potential threats to public health and significant economic burden, the problem has attracted researchers’ substantial attention. The prevalence of the health concern under study across different populations and periods is one of the topics of investigation. Saha et al. (2016) explore the rate of nonmedical use of prescribed opioids in the USA and note that the rate of prescription opioid misuse has been increasing considerably. Schepis and McCabe (2016) concentrate on older adults and the period between 2002 and 2012. The researchers also trace the growth of prescribed drug abuse in this cohort.
Perlmutter et al. (2018) examine the nonmedical use of prescribed drugs among adolescents. The researchers claim that the increase in prescription opioid misuse is apparent and highlight some peculiarities of prevention, assessment, and treatment related to the health issue in question. The role interprofessional teams can play in addressing the problem has also been investigated (Hagemeier et al., 2018). It is noted that healthcare practitioners working in such teams often face certain challenges associated with miscommunication and different role perceptions. These issues are specifically evident in low-income communities, which makes serving underprivileged populations more complex.
The Policy Under Consideration and Legislators Involved
The policy in question is the general bill under the title HB 743: Nonopioid Alternatives introduced by Rep. Scott Placon and enacted in June 2020 (The Florida Senate, 2020). The co-sponsors of this bill are Senators Dennis Baxley and Keith Perry. The bill revises the requirements for the medical staff to provide information about nonopioid alternatives to patients and their representatives. The major changes are as follows:
- Patient representatives and patients rather than patients alone will be informed;
- Healthcare professionals prescribing and ordering drugs should provide the information while those dispensing and administering the drugs are not required to do so according to the changed policy;
- The medical staff of emergency or critical units and those providing hospice care are not required to discuss the alternative of opioid drugs but will provide a print copy of a pamphlet containing the corresponding information.
Most Affected Population and Program
Patients and the general population, as well as healthcare professionals, are the most affected people. On the one hand, the policy is consistent with Healthy People 2020 objective SA-19 Reduce the past-year nonmedical use of prescription drugs (Office of Disease Prevention and Health Promotion, 2020). Patient education is one of the primary targets of the policy that regulates this process. The policy ensures that people receive detailed information about possible alternatives and are encouraged to reduce their use of opioids. This effort can result in people’s responsible use of prescription drugs. It is noteworthy that the involvement of patient representatives is an essential addition to the existing legislation and guidelines. The deeper engagement of patients’ representatives can be instrumental in reaching better patient outcomes (Perlmutter et al., 2018). Patients’ close ones can help them find sufficient resources to resort to alternatives to opioid use.
However, the policy is more concerned with the requirements given to the healthcare professionals concerning the appropriate methods of patient education on nonopioid alternatives. The policy relates to different groups of healthcare practitioners dealing with opioids, and the emphasis is placed on those prescribing this type of medication (The Florida Senate, 2020). The practitioners dispensing and administering drugs are not required to discuss non-opioid alternatives, which make the provision of care more efficient.
Policy, Practice, and Outcomes
The bill in question has a considerable influence on clinical practice as it contributes to the creation of a more effective healthcare system. In some settings, such as emergency departments and hospice care facilities, the discussion of the use of drugs is largely disruptive due to the specifics of health issues patients have. Healthcare professionals have little time to discuss such topics as they have to make quick decisions in acute cases. Hospice care is often associated with mental illness, which makes discussions less relevant due to memory issues or other illnesses patients may have. The discussion of nonopioid alternatives becomes a waste of time and resources in some cases. Therefore, the current changes introduced to the existing guidelines aimed at reducing the prescribed drug misuse make care more efficient.
Importantly, patient education is not reduced but transformed and made more effective. According to the bill, all patients receive a printed pamphlet containing the relevant data about nonopioid alternatives (The Florida Senate, 2020). In addition to the discussion with the authorized healthcare practitioner, the patient receives materials that can help them revise the most important points whenever it may be necessary. As for the healthcare professionals administering and dispensing these drugs, they also provide the pamphlet as a reminder to the patient. Without investing time, which is an important resource, in oral discussions, the medical staff provides a set of comprehensive guidelines patients can use whenever needed. All healthcare professionals can refer to the pamphlet during every encounter with their patients to remind them of alternatives, which can be beneficial for patient outcomes.
Policy, Practice, and Interprofessional Team
The bill under consideration is related to the development of interprofessional collaboration. Interprofessional teams can operate more effectively as their roles linked to informing patients about nonopioid alternatives are well-described (Hagemeier et al., 2018; Perlmutter et al., 2018). This policy minimizes confusion and the improper use of resources (mainly time that is critical for healthcare professionals due to work overload and often inappropriate patient-doctor ratio). Interprofessional teams can also develop additional materials for some patients based on the pamphlet and the patient’s history. Healthcare facilities can develop guidelines for specific groups of people, and interprofessional teams can be at the forefront of this process. Healthcare practitioners in such teams will create clear and concise recommendations for the specific groups that are common for their community, based on age, linguistic and cultural peculiarities.
Conclusion
In conclusion, it is necessary to note that the bill HB 743: Nonopioid Alternatives can be instrumental in addressing the abuse of prescribed opioids. The policy improves the quality of care provided to patients and enables healthcare professionals to manage their time more effectively. The bill regulates the use of discussions or the provision of print materials based on the setting, as well as patients’ needs. Importantly, the bill under consideration fosters a deeper involvement of patient representatives, which can play a favorable role in achieving positive patient outcomes. The bill can facilitate the development of more specific guidelines for particular populations based on their community needs. It is possible to note that the legislation understudy can have a positive impact on the development of the healthcare system in Florida and, potentially, the entire USA.
References
Hagemeier, N. E., Tudiver, F., Brewster, S., Hagy, E. J., Ratliff, B., Hagaman, A., & Pack, R. P. (2018). Interprofessional prescription opioid abuse communication among prescribers and pharmacists: A qualitative analysis. Substance Abuse, 39(1), 89-94.
Office of Disease Prevention and Health Promotion. (2020). Substance abuse.
Perlmutter, A. S., Bauman, M., Mantha, S., Segura, L E., Ghandour, L., & Martins, S. S. (2018). Nonmedical prescription drug use among adolescents: global epidemiological evidence for prevention, assessment, diagnosis, and treatment. Current Addiction Reports, 5(2), 120-127.
Saha, T. D., Kerridge, B. T., Goldstein, R. B., Chou, S. P., Zhang, H., Jung, J., Pickering, R. P., Ruan, W. J., Smith, S. M., Hang, B., Hasin, D. S., & Grant, B. F. (2016). Nonmedical prescription opioid use and DSM-5 nonmedical prescription opioid use disorder in the United States. The Journal of Clinical Psychiatry, 77(06), 772-780.
Schepis, T. S., & McCabe, S. E. (2016). Trends in older adult nonmedical prescription drug use prevalence: Results from the 2002–2003 and 2012–2013 National Survey on Drug Use and Health. Addictive Behaviors, 60, 219-222.
The Florida Senate. (2020). HB 743: Nonopioid alternatives.