i need a response to these questions on nurs 5050

Identify the Population Health concern you selected.

Opioid Overdose Epidemic

Describe the Population Health concern you selected and the factors that contribute to it.

Deaths from drug overdoses are at their highest ever-recorded level since 2011, and have outnumbered deaths by firearms, motor vehicle crashes, suicide, and homicide respectively. Over 70,000 people died from drug overdoses in 2017. Opioids, particularly highly potent synthetic opioids like fentanyl are currently the main cause of these deaths. In 2015, the economic cost of the opioid crisis alone was more than $500 billion when considering the value of lives lost due to opioid-related overdoses (National Drug Control Strategy, 2019).

Opioids are psychoactive substances derived from opium poppy or synthetic analogues. Opioids are mainly prescribed for pain management but have the tendency to be abused due to their addictive tendency. Examples of prescribed opioids include Morphine, Oxycodone, Tramadol, Heroin, Methadone. Carfentanyl is an example of an illicit synthetic opioid. Those at higher risk for opioid overdose include people with a history of substance use disorders, those who have been prescribed opioids in high dosages (over 100mg of Morphine daily or equivalent), those who have had multiple prescriptions of opioids and benzodiazepines, people from lower socio-economic backgrounds. People with mental health conditions are more likely to become addicted to, and overdose on opioids. Opioid abuse is also more prevalent in males than in females (Wiss, 2019).

Administration (President Name)

President Trump

President Obama

President George W. Bush

Describe the administrative agenda focus related to this issue for the current and two previous presidents.

President Trump’s fight against drugs consists mostly of efforts to stem the flow of drugs coming into the US, for example, through Mexico by building a border wall. Other drug influx control efforts include making China agree to classify Fentanyl as a controlled substance, which has resulted in stricter control over Fentanyl’s export to the US (CNN Wire, 2020).

Federal drug control efforts under President Trump include prevention, treatment, interdiction, international operations, and law enforcement. Multiple federal agencies have ongoing efforts to respond to the opioid crisis, including efforts to reduce the supply and demand for illicit drugs, to prevent misuse of prescription drugs, and to treat substance use disorders (National Drug Control Strategy, 2019).

President Obama’s war on drugs focused on prevention and harm reduction. Prevention was mainly through education and fighting the influx of drugs from other countries. Harm reduction efforts implemented by some states included increased access to Naloxone an opioid antidote for overdose reversal treatments. President Obama set laws that prohibit law enforcement action against those seeking help for an overdose. He also promoted needle, or syringe, exchange programs; another harm reduction strategy aimed to prevent the spread of blood-borne diseases such as hepatitis B, hepatitis C, and HIV through needle sharing (Miller, 2016).

President Bush in 2001, set out a strategy that focuses on three primary elements: stopping drug use before it starts, healing drug users, and disrupting the market for illicit drugs. His focus was on illicit drug use in general, because of the statistics that came out at the time, stating that over the prior decade, drug use by young people had nearly doubled: in 2000, over half of all 12th graders in the United States had used an illicit drug at least once in their life before graduation (The White House, 2006).

Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.

Congress passed and President Trump signed into law the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT Act) for Patients and Communities. The SUPPORT act dedicated roughly $8 billion over five years to fight the opioid epidemic (CNN Wire, 2020). One strong aspect of the SUPPORT act is its promotion of Prescription drug monitoring programs (PDMPs) to share data across states. It helps reduce doctor- shopping for prescription opiate painkillers (Wiss, 2019).

According to President Trump’s fiscal year (FY) 2019 budget, federal drug control funding for the Fiscal Year 2017 was $28.8 billion, used by multiple federal agencies in ongoing efforts to respond to the opioid crisis (National Drug Control Strategy, 2019).

On February 2, 2016 President Obama’s white house released their response to the prescription opioid abuse and heroin use epidemic: a budget including mandatory new

funding of $1.1 billion to help ensure that all Americans who wanted treatment could get the help they needed (The White House, 2016).

The Department of State received authorization to spend $30 million in 2006 to buy and refurbish spray- aircraft for Colombia under the Critical Flight Safety Program for aerial eradication of opium poppy seed farms in Colombia (The White House, 2006).

President Bush empowered states by offering incentives to encourage states to provide a wider array of innovative treatment options by voluntarily using their Substance Abuse Block Grant funds for drug treatment and recovery support service vouchers (The White House, 2006)

Explain how each of the presidential administrations approached the issue.

Under President Trump, China, a major exporter of fentanyl to the US, agreed to classify fentanyl as a controlled substance. The Justice Department has increased the number of prosecutions it has brought against fentanyl traffickers. And the surgeon general

recommended prescribing or co-prescribing Naloxone (a drug designed to reverse an opioid overdose) alongside opioids (CNN Wire, 2020)

President Obama promoted medication-assisted treatment. He signed The Comprehensive Addiction and Recovery Act (CARA in July 2016 which expanded funding for the availability of medication-assisted treatment (MAT) for opioid use disorder (OUD). MAT consists of pharmacotherapy, ideally in conjunction with behavioral health intervention. Medications such as methadone and buprenorphine (Subutex) have proven effective in mitigating the negative side effects associated with OUD (Wiss, 2019).

President Obama’s strategy included advocating for greater access to naloxone, an opiate antidote that reverses the effects of an opiate overdose; endorsing state 911 Good Samaritan laws which provide immunity from arrests to people who call 911 to help someone who is overdosing; strongly supporting the expansion of syringe exchange programs to reduce the spread of HIV/AIDS, hepatitis C and other infectious diseases (States News Service, 2014).

President George W. Bush signed into law the Drug Addiction Treatment Act of 2000 (DATA 2000) that allowed office-based treatment with Schedule III-V drugs indicated for opioid dependence. However, the physician could only treat 30 patients maximum.

In 2006, he signed another law: the H.R. 6344, which raised from 30 to 100 the number of patients a physician could treat for opioid addiction with buprenorphine (Subutex) sublingual tablets or buprenorphine/naloxone (Suboxone) sublingual tablets (LoBuono, 2007).

President Bush supported aerial eradication of opium poppy seed farms in Columbia by spraying to destroy opium poppy cultivation. This was supported by the US State Department’s airwing, and inflicted substantial damage to the Colombian opium poppy cultivation sector, leading to a 68 percent reduction

in cultivation from 2001 to 2004. Upgraded security

screening at US airports also led to increased seizures of

Colombian heroin, from 15 percent of available heroin in

2001 to 23 percent of available heroin in 2002 (The White House, 2006).