Physician Prescribing Practices

As we see the further progression of the opioid epidemic within the United States, pharmacists become the frontlines to recognizing and providing care for these patients. It is however difficult to provide care for a patient when even the professionals within the medical community have an associated stigma attached to the use of these drugs. Patients who have a need for these painkillers recognize this stigma, and by doing so decide to avoid consulting their doctors and do not seek the care which they need. They do this to avoid the discriminatory treatment they receive both within and on the outside of the healthcare system, and to avoid the legal repercussions associated with the misuse and abuse of these products1. It is therefore the pharmacists' job to avoid the stigmatization of these people and respect those who use these treatments for legitimate medical purposes.

In 2012, enough opioid prescriptions were written to cover every adult in America at least once , but that trend has already begun to be reversed. Last year, 17 million fewer opioid pain relievers were prescribed than in the year before. The concern is that the new guidelines and policies are blunt instruments that are denying patients who appropriately use their prescription opioids access to medications, rather then blocking access for the recreational, illicit user of opioids. There are reports of physicians who are wary about writing prescriptions for opioid pain relievers, those who blindly follow guidelines without considering the nuances of an individuals’ needs, and those who have

According to the Department of Health and Human services, over 650,000 opioid prescriptions are dispensed in one day. This translates to around 230 million prescriptions each year. This amount just barely falls short of being high enough to give every adult in the United States their own bottle of opioid pills. The loose prescribing habits of medical professionals are to blame for these absurdly high numbers. Current doctors will prescribe an opiate-based painkiller for anything from a backache, toothache, to even headaches. To give patients “highly addictive” drugs for low scale chronic pain over the three-days recommended max incurs high risk for tolerance, dependence, and potential addiction to opioids. Some would argue that doctors are simply doing their job by solving their patient’s pain problem and that people should not intrude upon a medical professional’s expertise. However, while doctors should be unbiased pillars of medical advice and treatment, they should also take into account the risks involved with their treatment for their patient’s sake. Particularly for opioid prescriptions, doctors should have to abide by dosing criteria, receive guidance on when to seek consultation, and know how to use their state’s prescription drug monitoring program (Alexander et al., 2015). According to Alexander et al., (2015) Prescription Drug Monitoring Programs (PDMPs) are underutilized by 81% of all prescribers.

The following assignment will discuss and analyse a prescribing episode, within practice, furthermore will outline safe prescribing from the Nurse Prescribing Formulary (NPF, 2013-2015).To be able to analyse and reflect on my new role as Community Practitioner Nurse Prescriber (CPNP) I will use Gibbs (1988) reflective model and a structure that will allow the use of a consultation model (Appendix1,Fig1).

While many drugs enjoyed a period of legalization, eventually most drugs have come to find a place as a scapegoat for many of society’s ills, from poverty, unemployment and homelessness, to rape, murder, and reasons to discriminate certain races based on a stereotypical link to a certain drug. (Steiker, C. S., 2011) At one time even alcohol was a major scapegoat for societal problems, but its strong history and presence in Euro-ethnic culture made

Social conflicts and struggles are an inevitable part of any society in any country. These struggles can include an increased rate in crime, unemployment, domestic/general violence, and overall civilian depression. When governments cannot seem to find a means to an end, they often turn and look for something to blame for their struggles, and that thing is more often than not, drugs. For many years, several opiates and drugs were primarily used for medicinal purposes, were seen to have an abundance of health benefits and was widely accepted among communities. Although, with the increasing social conflicts and economic conditions, authorities turned to and targeted many different forms of once accepted drugs, and made them the scapegoat for the problems they were facing.

Incarceration of individuals is rapidly rising and the “war on drugs” has targeted opioid addicted users with no other ways of treatment other than jail time. Opioids are widely used for people with legitimate problems and they're easy accessibility is making it possible for people of all ages and race to get a hold of. The crisis of opioid epidemic is only getting bigger along with the jail population. Anything from Xanax to Codeine can be easily attainable for the purposes of getting high. Another that is illegal however is heroin. Anyone and their addiction to opiates can lead them to being incarcerated possibly in the future. And this is a problem that needs to be addressed because these our the next generations we are talking about.

The recommendations of the article are therefore useful in concluding a study or exploring future areas of research. 4. Jafari, S. (2014). Prescription medication abuse. BC Medical journal, 56(2), 92-93. Jafari (2014) specifically focuses on the issue of misuse of prescription painkillers. Terming it as an urgent issue, the author systematically accounts for the total number of fatalities in Ontario, noting that drug abuse killed more individuals than HIV. Jafari uses data from the Centre for Disease Control and Prevention in presenting statistics to show the significance of the issue. In addition, Opioid abuses as well as other emerging addictions specifically in the young population are also expounded. The author cites the process of obtaining the drugs as a plethora of activities by unscrupulous individuals in the society. In the conclusion, the author proposes for a dedicated system to counter prescription drug abuse among individuals; as well as additional mechanisms to monitor the chief distributors of the drugs. This is therefore a relevant article in our research. 5. Jena,

Drug abuse and misuse are prominent problems in the United States, whether the issue is with trafficking, overdoses causing death, illegal recreational use in adolescents, or even improper prescriptions by medical professionals leading to physiological dependence. The formerly listed problems stem from outdated, yet current, classification system of drugs in the Controlled Substances Act (CSA). The “Heroin Epidemic” is an example of a problem concerning improper prescribing in medical practice; this issue began when many medical professionals began to prescribe potent painkillers to their patients early in their treatments. Over time and with consistent use, the patients grew to psychologically and physiologically depend on the painkillers. Eventually, the prescribed painkillers became unaffordable and patients began to depend on a cheaper drug with similar, yet more dangerous, effects: heroin. As a result, many are addicted to heroin as compared to prescription drugs. There is also an issue concerning qualified medical professionals that “pill mill,” meaning they prescribe Schedule II drugs such as oxycodone with the sole purpose to make more money; this puts the patient in danger in exchange for the doctor’s personal benefit. As a student pursuing a career in the medical field, I find that the proper implementation and use of medicine and drugs is vital to providing quality health care, so that events like the heroin

Our criminal justice system has undoubtedly failed to effectively deal with the issue of illegal drugs use, and to address the underlying issues of problematic drug users. Surely, the use of illegal drugs does not belong in the criminal justice system, but is a matter that needs to be dealt with from a public health perspective. As Toby Seddon Articulates:

If the United States is serious about winning the war on drugs, it will have to face some hard facts about the failure of its drug policy to date. Since Reagan introduced the war on drugs in the early 1980s, the focus of anti-drug legislation has been on incarceration and eradication, not on drug education and treatment. Drug use is viewed as a crimethe same way that burglary and murder are viewed as crimeswithout examining the social and economic causes behind drug use. This categorization of drug use as criminal misrepresents the nature of addiction. Drug addicts do not abuse drugs because they are deviant or even because they consciously desire to cause harm to themselves or to those around them, they abuse drugs because they are

In the United States of America, there is prescription drug abuse epidemic that continues to be a growing concern. Prescription drugs cause a large amount of overdoses and result in an abundant amount of deaths each year. A government study conducted shows this epidemic is scarily on the rise, “A recent government study found a 400% increase in prescription drug abuse between 1998 and 2008” (Schreiner 531). The excessive use of prescription drug abuse is leading to nonmedical use of the drugs, and creating addiction. Furthermore society is paying an extreme amount of money in this battle. With this drug abuse on the rise, legislators must create a law preventing doctors and pharmacists from over prescribing prescription medications as well a law to require they both participate in drug monitoring programs to prevent drug abuse. Now is the time that doctors and the pharmaceutical industry must be held accountable for their role in causing one of America’s worst addictions. The over medication of prescription drugs in the United States must be brought to an end by legislators creating laws to stop

Drug legalization is an enduring question that presently faces our scholars. This issue embraces two positions: drugs should not be legalized and drugs should be legalized. These two positions contain an array of angles that supports each issue. This brief of the issues enables one to consider the strengths and weakness of each argument, become aware of the grounds of disagreement and agreement and ultimately form an opinion based upon the positions stated within the articles. In the article “Against the Legalization of Drugs”, by James Q. Wilson, the current status of drugs is supported. Wilson believes if a drug such as heroin were legalized there would be no financial or medical reason to avoid heroin usage;

A multibillion dollar industry, with a consumer population of about 125 to 203 million people; the drug industry affects lives of all racial, ethnic, economic , social background, including participants in the drug industry, addicts, teenagers, parents, families, and officers of the law. Many people have encountered an experience with drugs and or drug education; the shared experience regarding the discussion of this topic or illegal experience brings importance to this current issue and validates the proposal for change. How much change, what change and how long will the change take place. Although this issue has many perspectives and opinions on how the war on drugs could be “won”, I will focus on two perspectives: drug criminalization and drug legalization. In a Human Rights lens, I will discuss the limitations and strengths of both methods. In the opinion of some and with hindsight the status quo regarding drugs requires reform in order to reverse the unintended consequences of drug prohibition. In the opinion of others criminalizing participants in the drug trade should be penalized under the law.

It’s easy to lose track of the chaos that happens in the world on a day to day basis when your main priority is deciding what to eat for lunch tomorrow, or even dreading your next shift; yet we can turn on the news and hear about the most recent overdose and not even blink an eye. The blatant disregard for drug addicts today is at an ultimate high. In the past two years alone, more people have died from opiate addiction than they have in the entire Vietnam War. The fact that drug users are seen as lower class members of society as only aided in the increase of addiction and death, killing more Americans than HIV/AIDS did at its peak. Though the epidemic did not occur overnight, it has recently become one of America’s biggest health confrontations. Although there is no absolute solution, in order to decelerate the prevailing wave of usage and overdose/death, decriminalization in correlation to government funded programs could give ease to the definition of the word “epidemic”.