Substance Abuse Policy Analysis
Policy Introduction
The policy chosen for this analysis is the Washington Administrative Code, title 388, chapter 388-877B section 0400-50 substance use disorders services (WAC 388- 877B-0400-50). This policy applies to behavioral health agencies and any agencies that provide substance disorder opiate substitution and opiate treatment in Washington State (WAC, 2016). The Center for disease control and prevention (CDC) (2016) defines opioid addiction as a problematic pattern of opioid use that causes clinically significant impairment or distress.
This analysis has a special interest in the use of buprenorphine/naloxone and methadone in the treatment of opioid addiction. More research is being conducted as to
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The assumption of this policy is that the population most affected by opioid addiction qualifies for Medicare services. This assumption is in part justified as the population most affected by opioid addiction are non-Hispanic white and American Indian or Alaska native women ages 25-54 in 2015 a rise was seen in adolescents ages 12-17 years with 122,000 having an addiction to prescription pain medications (American Society of Addiction Medicine (ASAM), 2016). Stakeholders for this policy include Thurston-Mason RSN, Southwest Washington behavioral health RSN, Peninsula RSN, Washington State Legislature’s Association of Counties (WSAC), Tribal leaders, and Substance Abuse and Mental Health Services Administration …show more content…
Only a total of fifty percent of treatment can be spent on education such as abuse, nicotine addictions, and relapse prevention amongst other education. An individual can only be admitted to opiate substitution treatment detoxification services twice in a 12 month period. Research indicates that opioid addiction should be viewed as other disease processes are and that relapse is likely. According to the National Institute of health (NIH) (2014), opioid addiction has a physiological and behavioral component as does diabetes, hypertension, and asthma and relapse may indicate the need to adjust or try another
Opioid use in the US has increased over the years, and this has led to an increase in substance abuse. Substance abuse is not only associated with use of illicit drugs but also prescription drugs. In 2015, of the 20.5 million reported cases of substance abuse, 2 million had an abuse disorder related to prescription pain relievers and 591,000 associated with heroin.1 The increase in substance abuse disorder has led to an increase in opioid related death. In 2015 drug overdose was the leading cause of accidental death in the US with 52, 404 lethal drug overdoses.2
The drug misuse and dependence policy, aims to support people misusing drugs to live safe and free from a drug dependence life (Department of Health, 2015). With this policy in place drug treatments are becoming more successful with 18% of people staying in treatment and leaving drug free (Department of Health, 2015) this shows the policy is successful and works with people to reduce drug dependency (HM Government, 2012). 193,198 people aged 18 and over were in treatment for drug use during 2013 to 2014, 29,150 of these patients completed treatment and have overcome their drug dependency (Public Health England, 2014). From when the policy was first introduced, drug use is at its lowest since measurement began in 1996 (Featherstone, 2013).
The definitions have progressed from tolerance or withdrawal symptoms from a specific drug to chronic intoxication, continued use with increased dosage, dependence, and damaging effects to user (Reinarman 2005). Both of these definitions proved to be too restrictive because all drugs do not have the same effects on every user. The current definition used by physicians and the criminal justice system is based on seven criteria (Reinarman 2005). The constant evolution of how the professional world views drug dependence mirrors society’s change in the understanding of addiction. Historically, “the drink” was viewed as the devil and drugs were often thought to be the cause of many criminal acts (Schneider 2003). After the medicalization of addiction and dawn of decriminalization of drug abuse, public opinion of deviant alcohol and drug use has changed. For the family unit, it is much simpler to accept and approach treatment for addiction if it is classified as a medical disease. In society, drug users can be framed as patients instead of criminals based on current standards. By looking at addiction as a treatable set of signs and symptoms instead of holding the individual accountable for actions they committed while intoxicated, the disease concept releases a lot of the stigma that goes along with
Various levels of governments in different communities across North America have initiated programs to deal with the opioid epidemic and its effect. Some of these initiatives will be examined in more details below.
The United States of America has had a war against drugs since the 37th president, Richard Nixon, declared more crimination on drug abuse in June 1971. From mid-1990s to today, a crisis challenges the health department and government on opioid regulation, as millions of Americans die due overdoses of painkillers. Opioids are substances used as painkillers, and they range from prescription medications to the illegal drug, heroin. Abusing these substances can cause a dependency or addiction, which can lead to overdoses, physical damages, emotional trauma, and death. To ease the crisis, physicians are asked to depend on alternatives to pain management. Law enforcement cracks down on profiting drug-dealers and heroin abusers. People are warned against misusing opioids. The controversy begins for those who suffer from chronic pain, because they depend on opioids. There’s so a correlation to the 1980s cocaine epidemic, and people are upset over racial discrimination. Nonetheless, the best way to avoid this crisis is to recover the people at risk, reduce inappropriate opioid description, and have a proper response.
Many people may not realize this but multiple states, including Michigan, are facing an epidemic. It is not a disease, however, it is a heroin epidemic. In a country where addictive opioid pain-killer prescriptions are handed out like candy, it not surprising heroin, also known as smack or thunder, has become a serious problem. The current heroin epidemic Michigan is facing, as are dozens of other states, has spiraled out of control in recent years. In Michigan, some of the areas hit hardest by this drug are in the southern portion of the state, like Wayne, Oakland, and Monroe Counties. The connection between painkillers and heroin may not be clear, but this is because both are classified as opioid drugs, and therefore cause many of the same positive and negative side effects. As a country, we are currently the largest consumer of opioids in the world; almost the entire world supply of hydrocodone (the opioid in Vicodin) and 81% of the world’s oxycodone (in Percocet and OxyContin) is used by the United States (Volkow). Along with consuming most of the world’s most common opioids, we have gone from 76 million of these prescriptions in 1991 to 207 million in 2013 – constantly increasing except for a small decrease starting in 2012 (Volkow). This widespread use has caused numerous consequences from increasing emergency room visits – for both painkillers and heroin – to sky-rocking overdose cases all over the country (Volkow). Michigan, unfortunately, currently has one of the
Addiction is has been around for a long time. The fear of people becoming addicted to certain substances has lead to policies changes. However, there has not been a major federal law passed that dealt with addiction in over forty years. In 2016, President Obama signed a law that covered all the major points of addiction and recovery. This topic this important to me because some of my loved ones are addicts. I may also have clients that are addicts.This paper will take a look at that law. First, we have to define a few key terms.
There is no question that the alarming rate of deaths related to opioid overdose needs to be addressed in this county, but the way to solve the problem seems to remain a trial and error approach at this point. A patient is injured, undergoes surgery, experiences normal wear and tear on a hip, knee or back and has to live with that pain for the rest of their life or take a narcotic pain medication in order to improve their quality of life and at least be able to move. The above patients are what narcotic pain medications were created for, a population of people that use narcotic pain medications for fun is what is creating a problem. Narcotics are addictive to both populations, however taking the narcotic for euphoric reasons is not the intention of the prescription that the physician is writing. The healthcare system needs to find a way to continue to provide patients that experience chronic pain with the narcotics that work for them while attempting to ensure the Drug Enforcement Agency (DEA) doesn’t have to worry about a flood of pain pills hitting the streets by granting access to the population with a substance abuse problem.
As previously discussed, the program the author would choose to evaluate is MAT treatment programs. This population consists of individuals that have been diagnosed with opiate use disorder, and receive opiate-substitution medications, such as Methadone or Suboxone. These program evaluations would be consumer-centered, performed in the clinics they receive services. Interested stakeholders would include the treatment center where the participants receive services, as well as other MAT service providers. Additionally, the funding sources for these individuals and program centers, such as county, state, and federal agencies, along with medical insurers, would also gain value from the program evaluation research.
Drug policy is a crucial topic in the country today. Substance abuse, as well as drug-related crime rates, are a huge problem. This is a fact. The way to fix the problem of substance abuse, however, is widely disagreed upon. Some think that stricter laws regarding drug possession and use would solve the problem, while others believe that loosening the restrictions would be a better option. The issue of legalizing drugs, especially marijuana, is one that is debated all the time. In fact, in 1995, a survey was conducted on the most important policy issues and eighty five percent of the country placed drugs at the top of the list (Falco 1996). Many states are actually beginning to decriminalize, and even
The United States currently faces an unprecedented epidemic of opioid addiction. This includes painkillers, heroin, and other drugs made from the same base chemical. In the couple of years, approximately one out of twenty Americans reported misuse or abuse of prescriptions painkillers. Heroin abuse and overdoses are on the rise and are the leading cause of injury deaths, surpassing car accidents and gun shots. The current problem differs from the opioid addiction outbreaks of the past in that it is also predominant in the middle and affluent classes. Ultimately, anyone can be fighting a battle with addiction and it is important for family members and loved ones to know the signs. The cause for this epidemic is that the current spike of opioid abuse can be traced to two decades of increased prescription rates for painkillers by well-meaning physicians.
behavioral therapies, to provide a whole-patient approach to the treatment of opioid use disorders" (p. 2). There are two types of medications commonly used in opioid use disorder MAT; Naltrexone and Buprenorphine. "Naltrexone is
If you watch the news it should come as no surprise that drug abuse and overdoses have increased dramatically in the United States. According to the National Institute on Drug Abuse, as many as 36 million people abuse opioids throughout the world with 2.1 million in the U.S. who currently suffer from opioid abuse disorders (National Institute on Drug Abuse, 2014). These astonishing numbers are only marginalized when comparing them to opioid related deaths in the United States. With an increase of 137 percent since 2000, deaths from drug overdoses now occur 1.5 times more often than deaths from motor vehicle accidents (Rudd Aleshire, Zibbell & Gladden, 2016). The opioid epidemic in the
America has a major problem with opioid addicts, and many facilities are helping the addicts by providing safer options to taking the drugs their bodies crave. Methadone clinics are places where people addicted to opioids can receive medicine-based therapy. Opioid use, drugs such as heroin, morphine, and prescribed painkillers, has increased in the US with all age groups and incomes. People become addicted to these drugs when they are prescribed, recreationally used with other addicts, or they are born addicted. Many health institutions are addressing this issue with an estimated 2.1 million people in the United States suffering from substance use disorders related to prescription opioid pain relievers in 2012 and an estimated 467,000 addicted
Nonmedical Prescription-Opioid abuse in the United States and Michigan has continued to rise, and with it, the devastating results that accompany it. Research has shown that increased opioid abuse leads to an increase in overdose and death, increases in crime and increased incidences of costly blood borne diseases like HIV, AIDS and Hepatitis. It also leads to increased societal costs, such as an increasing number of children in foster care and increased healthcare, workplace and criminal justice costs that can decimate communities and local budgets. Many communities were caught with their heads in the sand, as they were overwhelmed by the influx of prescription opioids into their communities. When policies were finally implemented to curb the amount of prescription opioids in their communities, rates of heroin use (also an opioid) began to skyrocket and people began realizing they had an opioid epidemic on their hands. How to combat this heroin epidemic has been the topic of many debates. This article will attempt to examine the relationship of nonmedical prescription-opioid abuse and its effects on heroin use.