Patient Awareness in Opioid and Heroin Abuse
Evidence Base Paper
“The opioid epidemic has been called the worst drug crisis in American history. Death rates now rival those of AIDS during the 1990s, and with overdoses from heroin and other opioids now killing more than 27,000 people a year, the crisis has led to urgent calls for action.
The epidemic didn’t happen overnight. Over the course of more than a decade, it has grown into a problem destroying lives across the nation, regardless of age, race, wealth or location.” (Retrieved 2/28/2017) http://www.pbs.org/wgbh/frontline/article/how-bad-is-the-opioid-epidemic/).
Our neighborhoods, communities, counties, cities, states, and country are in an opioid epidemic. The question many people ask is how this opioid epidemic got out of hand, become so bad, who can we blame, etc. After considerable research into the topic, we need to know the history and maybe we can develop an awareness, because after all the research, I couldn’t really uncover information regarding awareness related to opioids. How do we as registered nurses bring awareness related to opioid abuse and now heroin abuse? Or does it really matter if there is awareness. Listed below are the questions I would like for you to consider for your evidence base paper for NURS 309.
15 % Evidence base paper, APA format, rubric. No more than 1000 words (does not include characters, etc.), does not include the cover page, reference page, and addendum.
Questions to be answered:
1. What is the history of opioid and heroin abuse? If you want you can choose one or the other or both.
2. In your current nursing practice have you observed opioid or heroin abuse? For example, if you practice in mother infant or pediatrics you may have observed neonate substance withdraw. OR the ED, or on a surgical unit; is there awareness provided to the patients upon discharge.
3. How would you bring awareness to this epidemic? The Gov. of VA states we have an epidemic; this is a very critical element of population health within our state.
4. What social determinants can lead to this type of abuse?
5. How does Healthy People 2020, CDC, National Survey on Drug Use and Health:
https://nsduhweb.rti.org/respweb/homepage.cfm. Or any data base suggest we bring awareness.
6. Lastly, within your EBP, please create a page which is not included in the 1000 words an awareness document/poster that reflects how YOU believe we could provide information to the patients you serve as a nurse. This would consider being an addendum. If you are inclined to use graphs, etc. please use this as an addendum. Resource: APA-https://owl.english.purdue.edu/owl/resource/560/01/
Patient Awareness in Opioid and Heroin Abuse
From its inception to this day, society has been faced with a great challenge in striking a balance between the medical properties of opioids in the management of pain, and the euphoric effects associated with its abuse. Nations around the globe find the addiction to and abuse of opioids including morphine, heroin, and other pain relieving prescriptions as a critical problem that affects the economic, social, and health welfare of their people. Currently, close to 2.1 million individuals across the United States are substance abusers, with disorders associated with opioid use. This is a clear indication that there is a need to put in place proper measures to ensure that individuals are well aware of the detrimental impact that abuse of opioid prescription may have on their health, their families, and society at large.
The History of Opioid and Heroin Abuse
The introduction of opioids including opium and Morphine was aimed at providing an alternative to the treatment of pain among individuals. Nevertheless, as the years moved by, the side effects of the use of these drugs including euphoria lead to an increase in the number of non-medical usage (Quinones, 2016). An increased number of individuals became addicted to the drugs and started abusing them. In a bid to help individuals with the addiction to morphine, the US Saint James Society championed for the introduction of yet another destructive drug, Heroin, through their campaign advocating for the supplying of morphine addicts who wanted to mend their habits with free samples of the drug early in the 1900s. Governmental efforts to fight the abuse of opioids became evident in 1909 when the Opium Exclusion Act was successfully passed by Congress to bar any opium importation for smoking purposes (Quinones, 2016). Nevertheless, the health system provided loopholes through which individuals could still access opioids, an aspect that continued to provide increased cases of addiction. In response to this problem, the government in 1914 passed the Harrison Narcotics Tax Act, laying a foundation for the prohibition of opioids (Quinones, 2016). The Act required pharmacists and physicians to register for them to distribute opiates. The fight against opioids and heroin has ever since grown. As much as the government has made tremendous efforts in barring the distribution of the drugs, it is evident that lack of awareness among the users has become the major barrier towards reducing the abuse of these drugs with more than 2.1 million people being current abusers of opioids (Quinones, 2016).
Current Practice Reflection
In my current Nursing practice, I have come across two exclusive cases of individuals admitted due to heroin abuse. Both patients presented with slowed breathing and a reduced heart-rate. One of the persons was admitted due to Lung abscess resulting from the excessive use of heroin. The other patient was diagnosed with widened and scarred air passages. Both patients had a history of heroin abuse. From the initiated communication between the nurse and the patients, it was clear that both payments were only aware that heroin is a banned substance, but lacked awareness of the ramifications that it had on their health. One of the patients was keen to observe that heroin had led to the loss of her family and home and she had moved back into her parents’ house after five years of marriage. Upon discharge, the patients were properly educated on the implications of heroin abuse on their physiological, mental, social, and economic health. The nurse used charts and pamphlets with descriptive images to show the patients the effects of heroin abuse on their health. The patients were also provided with similar pamphlets to take with them hoe for further reference. In addition, the nurse was keen to inform the patients of the available community resources including the rehabilitation center that can assist them to stop using heroin.
Evidence-Based Awareness Creation
To effectively reduce the prevalence of abuse of opioids and heroin, it is important to create awareness of the problem and ensure a dep understanding of the impact that such abuse has both on the individual and the society at large. School-based prevention is one of the most effective approach that health care providers can use. Efforts that target schools are more efficient as they allow individuals to access students in large numbers, who are more vulnerable to substance use. Initial attempts to create awareness of drug abuse among students have been heavily reliant on arousing fear based on the consequences of drug use, without addressing the etiological factors that contribute to drug abuse (Savage, Kub, & Groves, 2015). By designing approaches that would allow students to understand the social and development factors that are likely to lead to drug abuse, health care providers and other stakeholders would be able to address the underlying factors of drug abuse. Students should also be imparted with social resistance skills to allow them to overcome the influence that may come from different sources including their peers or the media in relation to drug use. Such skills could be developed through allowing students to engage in practical community surveys relating to drug usage in order to understand the practicability of the theorized consequences of drug abuse (Griffin & Botvin, 2010). Community health education approaches should also be introduced to allow for education of members of the community on the factors that predispose individuals to the use of drugs and the role of the community in reducing substance abuse.
Social Determinants of Opioid and Heroin Abuse
There are various social factors that contribute to the increased abuse of opioids and heroin. One such factor is the increased availability of these products as medication in the health care system. This allows individuals to access them from healthcare providers creating loopholes for abuse, especially among self-administered users (Savage, Kub, & Groves, 2015). Due to the euphoric effect of both Heroin and Opioids, they are more likely to be abused by individuals to whom they have been prescribed for medication purposes. Another contributing social factor involves the positive social attitudes relating to the abuse of prescription drugs, which has made it easier for individuals to experiment. The portrayal of the abuse of opioids and heroin by an individual’s important ones also increases the risk of initiation of use. Media portrayal of heroin and opioid abuse through the use of celebrities in movies and television shows also has an impact on the perception of the implications of these drugs, increasing the risk of abuse (Whitesell, Bachand, Peel, & Brown, 2013).
Healthy People 2020
According to Healthy People 2020, awareness can be created through community-Based Programs which may be targeted at schools, health care facilities, Worksites, and communities. These settings allow health care providers an opportunity to communicate to large populations of people concerning the substance abuse using the social structures that already exist within the community (Healthy People 2020, 2017). As a result, the resources required to develop intervention programs are reduced while the impact is maximized. Through community-based programs, health care providers can be able to initiate new practices, policies, and programs or facilitate the change of organizational or physical aspects of the infrastructure or change the social, norms, beliefs, and attitudes of individuals towards substance abuse initiatives (Healthy People 2020, 2017).
The Screening, Brief Intervention and Referral to Treatment (SBIRT) screening tool can provide an effective tool in providing patients with evidence-based knowledge concerning substance abuse. The tool would allow in screening individuals to identify those having problems with the abuse of heroin or opioids. By understanding the factors contributing to the abuse of these drugs among individuals, including the social factors, one can be able to effectively identify the knowledge gaps of the involved individuals and effectively establish a plan that would allow for the sharing of such knowledge (Borus, Parhami, & Levy, 2016). This approach is highly effective in establishing individual-based interventions. Nevertheless, it can be used to establish patterns in terms of the factors that contribute to the abuse of prescription drugs and facilitate the establishment of effective measures that would be used to prevent the increasing rates of prevalence of drug abuse.
It is evident that the rate of prescription drug
abuse has increased despite policy based and clinical interventions being
established to counter such prevalence. This could be attributed to lack of proper
awareness among individuals concerning the medical implications of abusing such
drugs. Establishment of effective avenues for educating individuals using
community-based programs would allow for the addressing of not only the
immediate but also the underlying risk factors including social and environmental
Borus, J., Parhami, I., & Levy, S. (2016). Screening, Brief Intervention, and Referral to Treatment. Child and Adolescent Psychiatric Clinics of North America, 25(4), 579-601.
Griffin, K. W., & Botvin, G. J. (2010). Evidence-Based Interventions for Preventing Substance Use Disorders in Adolescents. Child & Adolescent Psychiatric Clinics of North America, 19(3), 505–526.
Healthy People 2020. (2017). Educational and Community-Based Programs. Retrieved from Healthy People.gov: https://www.healthypeople.gov/2020/topics-objectives/topic/educational-and-community-based-programs
Quinones, S. (2016). Dreamland: The True Tale of America’s Opiate Epidemic. London: Bloomsbury USA.
Savage, C., Kub, J., & Groves, S. (2015). Public Health Science and Nursing Practice – Caring for Populations. Philadelphia, Pennsylvania: F. A. Davis Company.
Whitesell, M., Bachand, A., Peel, J., & Brown, M. (2013). Familial, Social, and Individual Factors Contributing to Risk for Adolescent Substance Use. Journal of Addiction, 1-9.