NR 506 Week 2 Discussion Policy-Priority Selection Identify your selected healthcare concern in your city or state that needs your advocacy with an elected official. What is the impetus and rationale for your selection? What is your solution to this concern? Describe the model of policy making that you feel would be best applied to your policy concern and the rationale for selecting this model. I have been having a difficult time choosing my healthcare policy priority, mainly because I am worried that it is one that is being talked about by everyone lately. However, with that being said, I have chosen the Opioid Epidemic or the Opioid Overdose Crisis. I have chosen this topic because it specifically has been a problem I have witnessed with patients, and people within surrounding communities. It also is something that could be reduced if laws were different.

NR 506 Week 2 Discussion Policy-Priority Selection Identify your selected healthcare concern in your city or state that needs your advocacy with an elected official. What is the impetus and rationale for your selection? What is your solution to this concern? Describe the model of policy making that you feel would be best applied to your policy concern and the rationale for selecting this model. I have been having a difficult time choosing my healthcare policy priority, mainly because I am worried that it is one that is being talked about by everyone lately. However, with that being said, I have chosen the Opioid Epidemic or the Opioid Overdose Crisis. I have chosen this topic because it specifically has been a problem I have witnessed with patients, and people within surrounding communities. It also is something that could be reduced if laws were different.

I think that there should be required follow up between the provider and patient once opiods are prescribed.  All too often a patient is discharged from the hospital with narcotics and the provider does not do any type of follow up other than refer them to follow up with their primary care provider. I think all providers whether it be inpatient/hospital setting or primary care providers, should be required to follow up with all of their patients who are on prescribed opioids. I  also think there should be documented non-opioid treatment attempts on all chronic opioid users as well.

With this being said, I do not think that opioids should not be used for acute patients. For example, if I came into the my physician’s office with a kidney stone or after I threw my back out, I would not expect them to attempt non-pharmacological treatment.  In instances like these, a small amount of narcotics should be able to be prescribed, but then the physician should be required to follow up within a given time frame, whether it be 24 hours or a week.  I think because the FDA is a federal agency, this should be done by everyone and not just by certain states. Of course, to make a change it’s not easily done at that level, so I think it would have to start slowly. I think I would first propose it to all hospital employed providers at my hospital. After that change was implemented and there was time for adequate data to be obtained, i would branch out to other facilities, and then eventually to the state level.

Many physicians will prescribe a patient a narcotic for an acute pain, but then continue to refill the medication for years “just because.” This contributes to the problem. I worked with a nurse years ago who had back pain and went to her PCP and was prescribed Norco. She became dependent on the Norco, and eventually  stole Dilaudid, Morphine, Norco, and many other drugs from the hospital. Of course she was caught and her license was disciplined, but the point is, this prescription started innocent, but due to a lack of follow up from her physician, the medication was continued to feed a habit, which could have been avoided had there been stricter follow up.

If the physicians were required to follow up and have documentation that was supportive of their reason for continuing the prescription, the numbers may decrease.  At a certain point, the physician could then potentially refer the patient to a pain specialist for some sort of treatment that was not an opioid.

I think the topic you picked is very important right now and the more people talking the more change there can hopefully be made.  I grew up and currently live in the suburbs of Cleveland, OH, and have worked at one of the major hospitals in inner city Cleveland.  There are a lot of drugs in this area, and not just in the city, but in the suburbs as well.  The Opioid Crisis has really taken this area and the state of Ohio by storm.  The CDC found Ohio to be the second leading state in drug overdose deaths in 2016.(CDC, 2017)  This number continues to climb and I am not sure when it will start to get better.  I do have a personal experience with this crisis in the fact that my oldest nephew died of a heroin overdose in 2015 at the age of 23.  We were close growing up because we were only 8 years apart and my sister, his mother was 15 years older than me.  This has been very hard on our family especially because we did not know what to do to help him when he was using, and so like so many families we had to experience the worst part of this epidemic.  Besides this I have also been a nurse to many young patients in the hospital who had endocarditis due to the use of opioids intravenously.  One patient on my floor was in their mid-twenties and was in because they needed a 2nd aortic valve replacement surgery due to IV heroin use.  Before the patient was placed on the unit I worked on the patient ad her boyfriend had been shooting up heroin in the other hospital room she was staying in, but left AMA because boyfriend was kicked out of the hospital.  I know a lot of people might disagree with me, the opioid addiction is a disease, and the death or addiction is preventable.

Since the passing of my nephew, my mom is very involved in different groups related working to fight the opioid epidemic, or have more successful outcomes.  In the area I live in my mom has helped police stations be introduced to a program called Safe Passages.  This program allows people to go to the police station and ask for help specifically for opioid addiction and they are found detox and treatment and it is paid for.  It started with just a few police stations in my area and is spreading rapidly and has had success stories.  The first person they had was a pregnant girl who turned her self in, no questions