NURS-FPX6026Biopsychosocial Population Health Policy Proposa, Lecture notes of Accounting

Download NURS-FPX6026Biopsychosocial Population Health Policy Proposa and more Lecture notes Accounting in PDF only on Docsity! NURS-FPX6026 Biopsychosocial Population Health Policy Proposal NURS-FPX6026: Biopsychosocial Concepts for Advanced Nursing Practice II Biopsychosocial Population Health Policy Proposal The health care industry has come to acknowledge the rise of the opioid crisis over the past two decades. However, this does not take away from the necessity of pain relief for patients suffering from chronic pain, who are most often prescribed opioid treatment. Opioid treatment does show promise in short-term trials (Sehgal et al., 2013), but long-term treatments carry with them significant risk of addiction, adverse side effects, and prescription drug abuse (Franklin, 2014). The issue of opioid abuse and addiction is further complicated by the comorbidity of mental health problems in patients. In this context, veterans are a particularly vulnerable population because they often present with chronic noncancer pain while being comorbid with mental health issues such as post-traumatic stress disorder or substance abuse disorder (Sullivan & Howe, 2013). Given this vulnerability, it is necessary to take steps to prevent or reduce the potential for addiction or medication abuse among veterans who are prescribed long-term opioid treatment. Substance Abuse among U.S. Veterans: A Brief Retrospective Opioids came to be used in the treatment of chronic pain in cancer patients as a result of two WHO guidelines that were issued in 1985 and 1996 (Sullivan & Howe, 2013). Eventually, the treatment was extended to chronic noncancer pain and suggested as a safe, non-addictive method of treating pain. However, this claim was extrapolated from short-term opioid treatment studies. The issue then becomes primarily about the lack of evidence to support the safe long- term use of opioids. Opioids carry a significant risk of addiction and an array of unpleasant side effects (Franklin, 2014). Further, opioids also complicate matters of mental health. Opioids can relieve pain and produce a feeling of euphoria in patients. This physical relief could inadvertently soothe the psychological or emotional pain that a patient is experiencing. However, this leads to the patient doubly associating the opioid drug with both physical and psychological relief, potentially resulting in drug abuse and drug-seeking behavior. In this context, veterans’ health becomes a particularly complicated and layered issue to tackle. Many of them suffer from chronic pain because of injuries and exposure to hazards during their military career and often present with behavioral issues such as post-traumatic stress disorder or substance abuse disorder. Veterans are seven times more likely to abuse prescription opioids than civilians (Snow & Wynn, 2018). Further, Newhouse states that opioid medications were prescribed to over 400,000 veterans for pain relief and that approximately 1.7 million opioid medications were prescribed to them in 2014 (as cited in Snow & Wynn, 2018), indicating that opioid treatments are quite widespread. Several institutes, including the American Osteopathic Academy of Addiction Medicine, the American Society of Addiction Medicine, and the American Academy of Neurology, have stated publicly that opioids present a significant challenge in the health care industry. These institutes encourage raising awareness of the adverse side effects of opioid treatments, the use of naloxone (an opioid antagonist), and proper procedure in case of an opioid overdose (The American Osteopathic Academy of Addiction Medicine, n.d.; American Society of Addiction Medicine, 2016; Franklin, 2014). Given how widespread the prescription of opioids is among veterans suffering from chronic pain, it would be necessary to reevaluate the guidelines associated with would then be required to keep the attending physician informed about the state of the patient’s mental health and whether any further action would be required while still maintaining the confidentiality of the conversations the patient has had with the psychiatrist. Further, during the initial diagnosis, physicians would be required to screen patients for histories of behavioral issues, including post-traumatic stress disorder and substance abuse disorders. Certain populations such as veterans are likely to be at a higher risk of opioid addiction and misuse. To improve patient care, it would be necessary for physicians and nurses to sensitize themselves to these at-risk populations to better serve their health care needs. For example, veteran populations are known to present with both behavioral issues and chronic pain resulting from their time in the military; it would be the responsibility of the physicians and the nurses attending to a patient to familiarize themselves with the context of the patient so as to develop a nurturing relationship in such a situation. To enable this, human patient simulators will be made available to health care providers to train them through simulations that would provide knowledge that can be used in real situations. References American Society of Addiction Medicine. (2016). Use of naloxone for the prevention of opioid overdose deaths. https://www.asam.org/advocacy/find-a-policy-statement/view-policy- statement/public-policy-statements/2014/08/28/use-of-naloxone-for-the-prevention-of- drug- overdose- deaths#:~:text=Naloxone%20is%20a%20remarkably%20effective,at%20the %20proper %20low%20dosage. Crowley, R., Kirschner, N., Dunn, A. S., & Bornstein, S. S. (2017). Health and public policy to facilitate effective prevention and treatment of substance use disorders involving illicit and prescription drugs: An American College of Physicians position paper. Annals of Internal Medicine, 166(10), 733–736. https://doi.org/10.7326/M16-2953 Franklin, G. M. (2014). Opioids for chronic noncancer pain: A position paper of the American Academy of Neurology. Neurology, 83(14), 1277–1284. https://doi.org/10.1212/WNL.0000000000000839 Kolodny, A., Courtwright, D. T., Hwang, C. S., Kreiner, P., Eadie, J. L., Clark, T. W., & Alexander, G. C. (2015). The prescription opioid and heroin crisis: A public health approach to an epidemic of addiction. Annual Review of Public Health, 36(1), 559–574. https://doi.org/10.1146/annurev-publhealth-031914-122957 Sehgal, N., Colson, J., & Smith, H. S. (2013). Chronic pain treatment with opioid analgesics: Benefits versus harms of long-term therapy. Expert Review of Neurotherapeutics, 13(11), 1201– 1220. https://doi.org/10.1586/14737175.2013.846517 Snow, R., & Wynn, S. T. (2018). Managing opioid use disorder and co-occurring posttraumatic stress disorder among veterans. Journal of Psychosocial Nursing and Mental Health Services, 56(6), 36–42. https://doi.org/10.3928/02793695-20180212-03 Sullivan, M. D., & Howe, C. Q. (2013). Opioid therapy for chronic pain in the US: Promises and perils. Pain, 154(Suppl 1), S94–100. https://ncbi.nlm.nih.gov/pmc/articles/PMC4204477/ The American Osteopathic Academy of Addiction Medicine. (n.d.). Naloxone public policy statement: The use of naloxone for the prevention of opioid overdose deaths. https://www.aoaam.org/resources/Documents/AOAAM_NALOXONE_POLICY_2015.pd f