Essay Example on Opioid Crisis in Canada: 2800 Deaths in 2016

Introduction

The opioid crisis in Canada has recently been on the rise. Both prescription and illegal opioids have driven this trend. In the year 2016, over 2800 deaths in the country resulted from the use of opioids (Lisa and Halverson 224). Doctors and other healthcare professionals may prescribe opioids for patients suffering from intense pain. These prescription opioids are used to relieve pain and are regarded as generally safe when used for a short time as prescribed by a doctor or physician. However, they can be misused in some ways. First, they can be taken in dose amounts or means other than prescribed. One can also abuse them by taking medicine prescribed for another person. The other way is by taking medicine for its effects, i.e., to get high. Misuse of prescribed opioids can happen through swallowing in the usual form, snorting crushed powder of the pills or capsules, or injecting the dissolved liquid of the powder into the veins.

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Patients can get hooked or addicted to the use of opioids. Due to the benefits and the effects that opioid causes, a patient may want to continue using the drug even after recovery. Patients who are forced to use opioids for a long time may also become used to the medicines and cannot do without them. When patients who have recovered or people who misuse opioids run out of supply, they may turn to other illicit drugs to get the fill. This is because they are used to getting high and cannot access the usual medicines, opioids (Drugabuse.Gov n.d.).

The misuse of opioids has a wide range of health effects. In older patients, the abuse can be accidental due to multiple prescriptions given for chronic illnesses. This increases the risk of drug-disease as well as drug-drug interactions. They also slow the metabolism process, affecting the breakdown of other drugs. Also, in non-patients, the symptoms of opioids misuse can be life-threatening. Fentanyl, for instance, can be illicitly manufactured or be diverted for abuse. The drug killed over 31000 people in the United States in 2018. The primary purpose of the drug is to treat severe pain in cancer patients (CDC.Gov n.d.).

Stakeholders

As indicated earlier, healthcare professionals play a significant role in the opioid crisis. They are therefore placed in the frontline of the policies, and efforts are taken to reduce the misuse of opioids, especially among patients. Other stakeholders include the people using opioids and families of the victims, the taxpayers, advocacy groups conducting community-based programs targeting opioid misuse, pharmaceutical companies engaged in the manufacture of opioids, and the community members. Each of these stakeholders plays a significant role in the opioid issue.

Policy options/solutions

The opioid crisis is deeply rooted in society and will require many years of coordinated, sustained, and vigilant efforts to contain it. These efforts will help contain the epidemic and improve its adverse effects on society. The number of people with opioid use disorders is likely to increase in the future. The overdose causes a heath complication affecting public health and also leads to premature death among those dependent on opioids such as heroin and fentanyl. These effects necessitate the need o come up with treatment approaches termed as policies that can be taken to help people with opioid use disorders and prevent others from becoming addicted. Some of these options are discussed below.

Safe injection sites, restrictions on big pharmacists and doctors for prescribing opioids, and limits on pharma lobbying.

Injections safety can be ensured by making safe injection equipment available in communities. The equipment is obtained directly from the pharmacists. Injection sites are places designated to offer communities with services tailored to meet their needs. These sites provide people suffering from opioid use disorders with access to first aid services related to injections, counseling for harm reduction, needs, and other drug paraphernalia, provision of condoms to reduce the risk of STI transmission. The sites also respond to opioid overdoses. The drug users can seek detoxification and treatment for addiction to opioid use. Safe injection sites are also called supervised injection sites (SIS). They are government jurisdiction and help in reducing mortality, hospitalization, disease transmission, and ambulance calls during emergencies. The caregivers at these sites offer assessment and referral services (Ng, Sutherland, and Kolber 866).

Aside from the safe injection sites, restricting the prescription of opioids by big pharma and doctors can help reduce illicit opioids in supply. This can be achieved through measures that regulate the types of drugs approved to be prescribed and dispensed for use by patients. Drugs at high risk of being misused or abused, e.g., fentanyl, must be only prescribed to patients with chronic pain due to cancer or other illnesses. It should not be made available over the counter for access to the public. Opioids are preferably cheap compared to other illicit drugs like heroin. Therefore, only restrictions can help reduce their supply.

Pharmaceutical lobbying is a significant challenge associated with the abuse of opioids and other drugs. The companies engaged in the manufacturing of opioids influence the provincial and federal policies that regard opioids. This influence is achieved through lobbying (Piper n.d.). Measures must be put in place to reduce pharma lobbying. Such strategies include campaigning against government laws that make prescription drugs cheaply available.

Harm reduction sites and clinics

These are centers set up to help patients with opioid use disorders. The sites and clinics utilize evidence-based approaches to reduce the health and social harm caused by addiction to and abuse of opioids. They are client-centered and do not require them to abstain from drug use necessarily. The features associated with harm reduction approaches include pragmatism, humanity, and focus on the harms. The strategies recognize that the use of opioids is inevitable in society and that measures should be public health-oriented. Humane values mean that individuals must be treated with dignity and respect. The approaches also focus primarily on the harms associated with drug use (Nelson, Juurlink, and Perrone 326).

Education programs

The use of education programs is one way of reducing demand for opioids. This measure can begin from provider education (Nelson et al. 320). It helps in shifting the expectations of patients concerning the treatment they are offered to manage chronic pain. This is achieved by raising awareness of the risks and benefits of the prescribed opioids. The programs can also target the public to discourage the abuse of opioids. Such measures will result in the safe and effective management of pain.

Testing stations

Testing stations refer to centers set up to conduct opioid testing. They can be in communities or within healthcare facilities. The test confirms the presence of opioids in the urine, hair, sweat, blood, or saliva. If opiates are detected present, the individual is counseled and then enrolled for available treatment or prevention programs. These stations are also used to monitor compliance with prescribed drugs by patients, screen for opioid diversion for abuse, monitor individuals with opioid use disorders or addiction, and to evaluate or detect the overdose of opioid medications (Nelson et al. 303).

Educate health care professionals on which medications to prescribe first & work up

Healthcare professionals can also be offered education to offer them with knowledge and skills on which drugs they can prescribe first before opioids. This will help reduce the risk of depending on opioids for too long. Such approaches help prevent dependency, hence prevent addiction. Some of the healthcare providers that can be offered primary education include nurses, doctors, pharmacists, dentists, psychologists, social workers, and physician assistants. The education may be provided by the state licensing board or any other professional society engaged in the fight against the opioid crisis (Nelson et al. 14). Drug prescription must go in line with the workup results. This means that patients will only be prescribed with opioids when in severe pain. Pain killers that are less intense can be used to treat low and mild strains.

Mandated pain-suppression intervention

These policies apply to the provincial or statutory and national contexts. For instance, state laws require drug manufacturers to ensure that their products are safe for use before releasing them into the market (Nelson et al. 32). This prevents illicit production and ensures that the drugs released to consumers are safe and not subject to abuse. Interventions by the public health department can involve the collection of epidemiologic data on the use and misuse of opioids as per the existing public health laws. Mandated community treatment approaches also fall under such interventions (Nelson et al. 435). Methadone-assisted withdrawal can also help assist patients. However, the approach may not be used on pregnant women due to the adverse effects of the drug (Nelson et al. 240).

Rehabilitation program

In rehabilitating the opioid crisis, all the above policies and measures can be incorporated into the rehabilitation program. This means that there is a need to bring all the stakeholders together in the fight against the abuse of prescribed opioids. This will helps ensure the accountability of all the players, increasing the effectiveness of such programs.

The policy

Every policy that is aimed at mitigating the opioid-related harms is vital in rehabilitation. The strategies aim to reduce access to opioids, e.g., through preventing over-prescription. The policies will cause potential therapeutic loss to patients suffering from pain. These patients usually have no alternatives that can replace opioid use. Some of the procedures that can be used in rehabilitation include restrictions, policies, and recommended practices (Nelson et al. 340).

Implementation: Focus, stages, and explanations

Restricting supply

One of the ways of mitigating the opioid problem is through the improvement of access to programs of the drug take-back. The provincial governments and the public health departments should seek to secure partnerships between the public and private sectors for the implementation of the medicine take-back programs. Opioids that have been overprescribed or remained after use should be returned to the pharmacy. Occasional take back events must be discouraged since they cause the risk of exposure to opioids (Nelson et al. 340).

Other policies that would restrict supply is offering education to physicians on the prescription of the drugs. They must be well educated to ensure that they do not prescribe the medications unnecessarily. This will prevent over-prescription and also prolonged dependency on opioids.

Influencing prescription practices

First, the policy will seek to provide comprehensive pain education materials as well as curricula for healthcare professionals. The provincial medical schools, together with other health professional institutions, need to coordinate with the respective health professional licensing boards and other agencies to come up with an evidence-based approach to pain education. The program will encompass both pharmacologic and non-pharmacologic treatment approaches as well as the opioid prescription materials. The education programs, as mentioned earlier, will influence the habits of prescription hence preventing over-prescription (Nelson et al. 341).

Secondly, the stakeholders should seek to facilitate reimbursement plans for comprehensive pain management. Both the public and the private payers need to come up with...