opioid abuse response

Please respond to this student post
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 Opioid abuse disorder prevention, treatment, and
recovery are at the forefront of all political agendas, and
current president Joe Biden has submitted a proposal to
the U.S. Department of Health & Human Services
(HHS) (2021) for $11.2 billion. The amount is 54%
higher than the proposed amount in 2021 (HHS, 2021).
The main goal of the funding is to strengthen the HHS
5-point plan strategy to combat opioid abuse (HHS,
2021). The strategy prevents opioid abuse or misuse,
treatment, reduction of harm, and support with and after
recovery.
Now, let us break down the policy utilizing
Bardach's eightfold steps. While there is no precise
science to Bardach's, it allows the writer flexibility
(Engleman et al., 2019). While there are currently only
eight steps, there is a possible ninth step based upon
Bardach's writing: repeat steps one through eight as
necessary (Engleman et al., 2019).
Step one is defining the problem; in this
instance, the problem is since 1999, the overdose rates
from opioid abuse have increased to over 250% (HHS,
2021).

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Step two is to assemble the evidence (Engleman
et al., 2019). Substance abuse disorder has shown a
significant increase from 1990 till 2021; in 1990, the
United States was at 4.36 deaths per 100,000, and to
show how these figures have grown exponentially, in
the past year, we have lost 95,133 lives (Center for
Disease Control and Prevention [CDC], 2021; Ritchie &
Roser, 2019). In addition, statistics show, 19.4% of
individuals begin using opiates at the age of 12
(National Center for Drug Abuse Statistics [NCDAS],
2021). With these statistics, the government declared
drug abuse an epidemic (NCDAS, 2021).
Constructing the alternatives is step three
(Engleman et al., 2019). One alternative to the original
policy is to start with education in school. Since statistics
show most opioid abusers begin at the age of 12,
starting drug education in middle school is essential
(NCDAS, 2021). Allowing the student to participate in
learning and understanding the dangers of opioid abuse
will prevent the start of using them. The next alternative
would be initiating high-dose buprenorphine in the
emergency room (Herring et al., 2021). By doing this,
the patient can be titrated to a therapeutic dose within
three hours with little to no withdrawal symptoms
(Herring et al., 2021). The study by Herring et al. (2021)
shows the overall benefit to the patient, and while the
investigation is in its beginning stages, it would be most
cost-effective. The third alternative is an all-in-one
reporting system. Suppose there was one reporting
system for all providers across the nation. In that case,

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they could see what medications the patient is taking,
whether they had any drug or alcohol-related charges,
or emergency room visits for drug-related issues
(Whitmore et al., 2019).
The fourth step is selecting the criteria for
evaluations of the criteria (Engleman et al., 2019). All
three alternative criteria listed above put the patient and
their safety first. The first alternative is geared more
toward prevention. Prevention is key to combating
opioid issues (Whitmore et al., 2019). If we can find a
way to prevent young people from starting opioids or
any other addictive substances, we may be able to
show a decrease in the trend of addiction (Whitmore et
al., 2019). The second alternative offers a more
effective way of combating the issue. If the patient can
be regulated with minimal side effects, that drastically
cut down from outpatient medication-assisted treatment
programs (Whitmore et al., 2019). Also, if the patients
realize they are not experiencing withdrawal and the
process is easy, they will tend to continue with the
treatment program (Whitmore et al., 2019). Finally,
suppose there is an all-in-one reporting system. In that
case, it will aid in preventing the continuation of their
opioid abuse and allow them to assist the patient in
getting the true help or treatment they need (Whitmore
et al., 2019).
Next, the fifth step of Bardach's eightfold is
projecting the outcomes (Engleman et al., 2019).
Regarding the first one, there are no significant data to
support the outcome. However, in the medical field, we

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all know, prevention is the primary. If teenagers or
young adults are shown the dangers and their possible
futures, they may consider ever starting down that path
in life. The second alternative has limited data; with the
small sample size of 391, only 2.8%-6.8% had a
significant reaction to the treatment (Herring et al.,
2021). With those kinds of statistics, the alternative is
looking promising. Finally, there is no data to show if
this alternative would present any statistical significance
in combatting the opioid epidemic with the all-in-one
reporting system.
The sixth step, confront the trade-offs
(Engleman et al., 2019). As previously stated,
prevention is key, and this is why the education and all-
in-one system would be beneficial (Whitmore et al.,
2019). However, the cons are the amount of money it
would take to implement both systems nationwide or
adequately prepare the educators. Another con involves
the all-in-one system, the political agreement, and
pushing the agenda through the appropriate channels,
which could take months, if not years, for approval. The
pro with the Herring et al. (2019) buprenorphine
treatment is the early success the data shows and the
potential it holds with offering more effective treatment.
The biggest con is the time it will take to show its
efficacious, efficiency, and effectiveness to develop into
a standard of care (Whitmore et al., 2019).
Next, the seventh step is to decide (Engleman et
al., 2019). Out of the three alternatives we have
discussed, the high-dose buprenorphine treatment

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initiation in the emergency room (Herring et al., 2021).
Despite it still being in its initial phases, the data is
showing significant promise and warrants further clinical
trials and push through the political agenda (Herring et
al., 2021). If patients know they can be rapidly induced
on buprenorphine with little to no side effects and a
therapeutic dose within three hours, they will be more
than likely to be successful in completing treatment
(Herring et al., 2021).
Opioid abuse is a relevant health issue that has
plagued our community, and everyone in American
knows someone who this disease has afflicted. While it
is controversial if opioid abuse is considered a disease,
it is still a health issue that needs significant intervention
(CDC, 2021). The political aspect has seen the need for
intervention, and President Joe Biden has stepped in
budgeted $11.2 million towards prevention, treatment,
and support to combat the opioid epidemic (HHS, 2021).
While the government has not set any definitive plans to
combat the issue besides medication-assisted
treatment, there are alternatives possible.
As previously stated, educating our youth on the
dangers can prevent the start of opioid abuse. Also, if
there is a nationwide all-in-one system, it will allow
healthcare providers to recognize an issue early on and
offer alternative treatments and assistance to the patient
instead of allowing their addiction to continue due to
lack of information. Finally, the best alternative out of all
three is initiating high-dose buprenorphine treatment in
the emergency room. Again, the data is showing

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significant promise. Out of the 391 participants, only a
marginal percentage of 2.8%-6.8% of patients
experienced any side effects (Herring et al., 2021).
As you can tell by the data, intervention and
change are needed. However, with no guidance, it
makes it challenging to accomplish this task. For this
reason, this is why alternative methods are needed. Is
there going to be one gold standard plan? No, but there
needs to be proven clinical practice guidelines put into
place, other than medication-assisted treatments.