Opioids Are Effective Pain Relievers: Advocacy through Legislation

Problem

Opioids are effective pain relievers that, however, have the capacity for becoming extraordinarily addictive and building tolerance in users. The primary effect of opioid use stems from the drug’s interaction with opioid receptors located on nerve cells in the human body and brain. Thus, opioids are prescribed for treating persistent and severe pain, provided the limited period of consumption and strict compliance with the doctor’s recommendations. In the 20th century, opioids were marketed aggressively by pharmaceutical companies and state agencies, which lowered the American public’s cautiousness and made them a staple for pain management (Volkow & McLellan, 2016). Today, opioid addiction takes the lives of 128 people every day (The National Institute on Drug Abuse, 2020). Florida providers prescribe more opioids than the average US provider (53.7 opioid prescriptions per 100 people vs 51.4 prescriptions per 100 people nationwide) (“Florida: Opioid-Involved Deaths”, 2020). In 2018, more than two-thirds of reported drug overdose deaths in Florida involved opioids (“Florida: Opioid-Involved Deaths”, 2020), If not addressed, the opioid crisis will continue causing economic losses and harm Florida residents’ quality of life.

Idea for Addressing Solution

Because of its scale, the opioid epidemic cannot be tackled locally; it needs comprehensive legislation that would set new standards for prescription and help vulnerable communities. At the moment, there exist multiple legal initiatives aimed at combatting the opioid epidemic. The present paper proposes an Opioid Antagonist Program that would involve expanding the list of organizations eligible for storing and distributing opioid antagonists as well as improving patient education on opioid addiction and opioid antagonists.

Research the Issue

Evidence 1

Clark, Wilder, and Winstanley (2014) authored a systematic review in which they assessed the effectiveness of community-based opioid overdose prevention programs (OOPPs) that entail the distribution of naloxone (opioid antagonist). Naloxone is a medication approved by the Food and Drug Administration that has a reversing effect on opioid overdose and prevents opioid overdose deaths. Legislation regarding the bystander administration of naloxone varies from state to state. Generally, the distribution by non-medical people is illegal; however, some states make concessions because immediate access to medication saves lives. Clark et al. (2014) found that OOPPs were generally helpful with overdose reversals, better education, and the ability to provide an adequate response in case of an overdose.

Evidence 2

Straus, Ghitza, and Tai (2013) reviewed existing initiatives, with the most notable being (1) the 2010 Drug Enforcement Administration’s (DEA) National Take-Back Initiative; (2) the Prescription Drug Monitoring Programs (PDMPs); and (3) the naloxone community-based rescue programs. Straus et al. (2013) discovered that take-home and community-based opioid antidote programs alone were responsible for 10,171 overdose reversals.

Stakeholder Support

Stakeholder(s) Supporting 1

The Substance Abuse & Mental Health Services Administration (SAMHSA) is part of the Department of Health and Human Services. It is tasked with preventing and treating addictive and mental disorders through allocating grants to various bodies and agencies. The SAMHSA already expressed its support for community-based opioid overdose prevention programs (American Society of Addiction Medicine, 2015).

Stakeholder(s) Supporting 2

American Society of Addiction Medicine is the US leading addiction medicine society. It published a statement in which it wholeheartedly supported the use of naloxone to prevent opioid overdose deaths (American Society of Addiction Medicine, 2015).

Stakeholder Opposition

Stakeholder(s) Opposed 1

Pharmaceutical companies, such as Purdue Pharma, are not interested in reducing opioid consumption because it means fewer profits. Conversing about this consideration may include mentioning the many lawsuits that opioid manufacturers have had to settle in recent years and reminding that the state will set stricter standards for opioid prescriptions.

Stakeholder(s) Opposed 2

Certain government officials see the bystander administration of opioid antagonists as illegal. Their reluctance may stem from the desire for more control over medication distribution. Reasoning with them would require showcasing evidence that suggests that community-based opioid overdose prevention programs are effective in tackling the issue.

Financial Incentives/Costs

The US opioid crisis creates an economic burden whose social costs (healthcare, criminal justice, and workplace) were estimated at 77.8 billion in 2018 (an almost sevenfold increase compared to 2001) (Leslie et al., 2019). Fifteen percent of opioid use disorder patients require medication, and the full treatment plan can cost anywhere between $5874 and $15,183 (Leslie et al., 2019). Such patients use medical services frequently, putting a workload on the system, and typically have other comorbidities, translating into additional costs. A successful intervention program could break the cycle of opioid abuse and lighten the economic burden.

Legislature: Information Needed and Process for Proposal

Provide the name and complete contact information for the legislator: Florida Senate President Joe Negron.

Describe the steps for how you would present this to your legislator: The information would be presented in a personal meeting, using various media and utilizing scientific resources. Given that Negron already supports opioid use restrictions, the presentation can focus precisely on community-based programs.

Outline the process if your legislator chooses to introduce your idea as a bill to congress:

1. The bill is drafted and sponsored by a representative;
2. The bill is assigned to a committee for a review;
3. If approved, the bill is scheduled for a vote, debate, or amendment;
4. If successful, the bill is passed to the Senate;
5. Step 4 is repeated;
6. The bill is reviewed by both the House and the Senate and then passed to President who has the right to veto it.

Christian Principles and Nursing Advocacy

One of the cornerstones of Christian faith is selflessness and altruism, which is reflected in Scripture: “Now we who are strong ought to bear the weaknesses of those without strength and not just please ourselves” (Romans 15:1). Nurses and doctors are in the unique position to give voice to those who underserved and neglected, regardless of their origins, background, and status. Though the Bible never directly addresses the issues of healthcare, it emphasizes the value of preventing disasters: “A prudent person foresees danger and takes precautions” (Proverbs 27:12). Therefore, the Christian worldview can and does inform preventive efforts.

References

American Society of Addiction Medicine. (2015). Public policy statement on the use of naloxone for the prevention of opioid overdose deaths. Web.

Clark, A. K., Wilder, C. M., & Winstanley, E. L. (2014). A systematic review of community opioid overdose prevention and naloxone distribution programs. Journal of Addiction medicine, 8(3), 153-163.

Leslie, D.L., Ba, D.M., Agbese, E., Xing, X. & Liu, G. (2019). Deaths, Dollars, and Diverted Resources: Examining the Heavy Price of the Opioid Epidemic. American Journal of Managing Care, 25(13), 25-50.

Supplements and Featured Publications, Deaths, Dollars, and Diverted Resources: Examining the Heavy Price of the Opioid Epidemic, Volume 25, Issue 13

Florida: Opioid-involved deaths and related harms. (2020). Centers for Disease Control and Prevention. Web.

The National Institute on Drug Abuse. (2020). Opioid overdose crisis. Web.

Straus, M. M., Ghitza, U. E., & Tai, B. (2013). Preventing deaths from rising opioid overdose in the US–the promise of naloxone antidote in community-based naloxone take-home programs. Substance Abuse and Rehabilitation, 4, 65.

Volkow, N. D., & McLellan, T. (2016). Opioid abuse in chronic pain. Misconceptions and mitigation strategies. New England Journal of Medicine, 374(13), 1253-1263.