NURS 6050 Presidential Agendas

The population health topic I am choosing is the opioid epidemic. I chose this because it affects such a large population in today’s world. According to the Centers for Disease Control and Prevention (2022), drug overdose deaths have increased by nearly 5% from 2018 to 2019 and quadrupled since 1999. Over 70% of the 70,630 deaths in 2019 involved an opioid. In 2020, 91,799 drug overdose deaths occurred in the United States. The number continues to rise, and drugs seem to be more accessible.

Regarding social determinants, people from low socio-economic classes have poorer health. They are more likely to use tobacco, drink alcohol at high risk, and use illicit drugs. Drug-dependent people are particularly likely to be unemployed and to experience marginalization, both of which can exacerbate their problems and prevent seeking or benefiting from treatment (Spooner,2017). Drug abuse is not shy when it comes to whom it affects. People in low socioeconomic classes happen to get slammed with drug abuse as we have not provided the right accessibility for them.

One of President Trump’s solutions was to build a wall. Theoretically, the wall would stop illegal drugs from coming in, and this wall was supposed to be built on the Mexican border. He also said he would enhance access to addiction services, end Medicaid policies that obstruct inpatient treatment, and expand incentives for state and local governments to use drug courts and mandated treatment to respond to the addiction crisis (Kaiser Family Foundation,2017). Although some think the wall may help, it is not the solution to the epidemic. In some cases, working from the outside inward works, but in this case, I think this epidemic needs to be approached from the inside out.

In this case, I would have started the solution on the inside. I would have targeted what we can control right now. Stopping Illegal drugs from coming in will help in the long run, but you must focus on what illegal drugs are happening in the US. Building a wall doesn’t stop the use, trading, selling, or buying we are currently dealing with. I would work to eliminate those issues, do more research on who this affects the most, and start there. We know people from low socio-economic classes struggle the most, so I start there and work my way out. Maybe we start focusing on getting these people out of this low-income rut. We provide schooling, daycare, and opportunities some people will never receive. Even starting there seems small, but I would further it with Trump’s plan to enhance access to drug addiction services like counselors. I would hold more doctors accountable and pharmaceutical companies pushing these opioids for money.

According to the Democrat National Committee (2020), President Biden’s solution includes holding people accountable such as big pharmaceutical companies, executives, and others, responsible for their role in triggering the opioid crisis. Biden will create effective prevention, treatment, and recovery services available to all through a $125 billion federal investment. Most importantly, we will stop overprescribing pain medication to citizens. I think Biden’s solutions to this epidemic were much better; these solutions start inward and target the people in the US struggling. I believe the solutions listed will help the country see a decline in opioid deaths, but they won’t solve the issue altogether.

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS NURS 6050 Presidential Agendas:

As much as I agree with this approach, I don’t think the primary producers of these drugs are being held accountable enough. I would figure out a way other than fines to serve these companies. Possibly suspending their production may be a helping solution. The problem is these companies are laced with money, so half the time, they don’t even blink at the request to hand over money due to fines. I wouldn’t change much to Biden’s policy otherwise. I think his approach gives people accessibility, and that’s truly what we need to end this epidemic.

Centers for Disease Control and Prevention (2022). Death Rate Maps & Graphs. Centers for Disease Control and Prevention. Retrieved August 30, 2022, from https://www.cdc.gov/drugoverdose/deaths/index.html

Democrat National Committee. (2020). The Biden plan to end the opioid crisis. Joe Biden for President: Official Campaign Website. Retrieved August 30, 2022, from https://joebiden.com/opioidcrisis/

Kaiser Family Foundation. (2017, January 9). President-elect Donald Trump stands on six health care issues – election 2016: The issues. KFF. Retrieved August 30, 2022, from https://www.kff.org/report-section/where-president-elect-donald-trump-stands-on-six-health-care-issues/#opioid

Spooner, C. (2017). SOCIAL DETERMINANTS OF DRUG USE. National Drug and Alcohol Research Centre (NDARC). Retrieved August 30, 2022, from https://ndarc.med.unsw.edu.au/

There has been an increase on Fentanyl related deaths as of lately. According to the CDC overdose deaths which includes fentanyl and fentanyl analogs increased over 56% from 2019 to 2020. (CDC, 2022). From what I have observed personally at work, there has also been a lot of cocaine overdose in much younger populations. In terms of drugs being accessible, I had a 23 yr old patient on the ICU who overdosed on cocaine because it was being shared at a party. I work in NYC, with a lot of minority populations, I deal with a lot of cases like this, most of which end up fatal, they result in cardiac arrest and end in death. I agree with your point Regarding the building of the wall during former President Trumps term. I believe the wall being built was to serve a different Agenda and not necessarily to prevent drugs from being brought across the border. A wall is not the answer, working from inside out to address the issue and hold the main culprits responsible will be a much better approach. In the USA, there have been recent legislative shifts towards less punitive policing, with the former President Obama’s bill expanding access to naloxone, the implementation in the Washington State of Good Samaritan Laws aimed at empowering community members to prevent overdose. (Vashishtha et al., 2017). I believe these are ways that we can continue to help combat these issues from the inside out like you mentioned.

References

Centers for Disease Control and Prevention. (2022, June 1). Fentanyl. Centers for Disease Control and Prevention. Retrieved August 30, 2022, from https://www.cdc.gov/opioids/basics/fentanyl.html

Vashishtha, D., Mittal, M. L., & Werb, D. (2017, May 12). The North American opioid epidemic: Current challenges and a call for treatment as prevention – harm reduction journal. BioMed Central. Retrieved August 30, 2022, from https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-017-0135-4

I agree that primary producers of opioids are not being held accountable enough. However, I disagreed with suspending their production. I believe there is a clinical need for short-term use of opioids. The Centers for Disease Control and Prevention provided an opioid prescribing guideline that helps determine when to initiate or continue opioids for chronic pain, opioid selection, dosage, duration, follow-up, and discontinuation, and assessing risk and addressing the harms of opioid use. Thus, delivering safe and effective pain treatment and reducing misuse or overdose of opioids (Centers for Disease Control and Prevention, n.d.). What if primary opioid producers had to pay a percentage of their profits to fund education programs about the danger of opioid use and recovery support and treatment programs for opioid addiction?

References

Centers for Disease Control and Prevention. About CDC’s Opioid Prescribing Guideline. Retrieved August 31, 2022, from https://www.cdc.gov/opioids/providers/prescribing/guideline.html

References

Centers for Disease Control and Prevention. About CDC’s Opioid Prescribing Guideline. Retrieved August 31, 2022, from https://www.cdc.gov/opioids/providers/prescribing/guideline.html

In 2017, a declaration was made by President Donald Trump stating there is a public health emergency related to opioid use in America. He estimated that there were about 64,000 drug-related deaths in 2016 (Houseman, 2020). Moreover, three-quarters of those deaths were related to the use of opioids. The President mentioned that this was the death rate recorded. The “Support Act” was started by President Trump to place restrictions on providers and their ability to write narcotic prescriptions. Narcotic prescriptions are now electronically monitored to prevent patients from obtaining multiple prescriptions from multiple providers (U.S. Department of Health and Human Services, 2022). A budget for education, targeting youth at risk, tighter control on illegal drug transportation, and funds were made available for those in need of rehabilitation and recovery. To me, this is the best attempt to resolve this crisis. President Trump went through all the steps to prevent addiction, including educating youth at a specific age and sending a message out before they become affected. President Trump restricted the source of illegal drug administration and prescriptions to make drugs less available. President Trump offered a recovery process to those already affected and still affected by addiction. This process was well thought out, in my opinion. The “Support Act” was firmly implemented into society, but over time it began to be maintained with less force.

References

Houseman, K. (2020, November 19). Prosecuting drug overdose cases: A paradigm shift. National Association of Attorneys General. Retrieved September 2, 2022, from https://www.naag.org/attorney-general-journal/prosecuting-drug-overdose-cases-a-paradigm-shift/

U.S. Department of Health and Human Services. (2022, July 21). Overdose death rates. National Institutes of Health. Retrieved September 2, 2022, from https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates

When I consider the medical industry in general and the concerns that have been on their agenda, the first thing that comes to me is medical reform and insurance difficulties in general; second, the opioid crisis that has been a problem throughout at least my entire nursing career. I’ve chosen to focus on the opioid crisis because it’s a

problem I deal with on a daily basis at work, and it will have a huge influence on my future work.

In the last two years, I’ve seen that physicians have been under growing

pressure to explain their prescriptions for narcotics in general; In Pennsylvania,

when a patient is given an opioid prescription, they also get prescribed a

Narcan kit with instructions on how to use it in an emergency. This helps to

reduce the number of people who die from opioid overdoses.

Former President Barack Obama was more famous because of his work

on the Affordable Care Act, also known as Obama Care, than for his attempts

to address the opioid issue. According to a Washington Times story, the opioid

problem was at its worst under Obama’s administration, with mortality rates

climbing by 71% since 2013 (Zuckerman, 2017). The study was done, and the

country was aware of the opioid epidemic consequences. The president, on the

other hand, had a different goal and the problem remained largely ignored

while he developed other programs that he may have believed would give

resources that would aid in the reduction of opioid usage through increasing

access to insurance and medical care, including rehabilitation for these

individuals. I believe that If I had been in his shoes, I would have worked to

only execute the Affordable Care Act, which he is enthusiastic about, but also

to establish unique programs for individuals in need of mental health or recovery.

President Donald Trump announced a public health emergency in the

United States in 2017, estimating that there were around 64,000 drug-related

occurred in 2016, with three-quarters of those deaths being clearly linked to

opioid use (Salmond & Allread, 2019). This was the greatest mortality rate

ever recorded, according to the president. President Trump signed the “Support

Act,” which restricted physicians’ authority to provide opioid prescriptions and

imposed other limitations. Because narcotic prescriptions are electronically

tracked now, it is more difficult for patients to receive numerous narcotic

prescriptions from different practitioners. There was a budget for education

that was implemented, with a focus on at-risk adolescents. Illegal drug transit is

being closely monitored, and resources are being made available to those who

require therapy and recovery. When I consider the evolution of the crisis of

opioids, I believe this is the finest attempt to date at resolving the problem.

President Trump considered all of the options for preventing addiction,

including youth education at an early age to convey a message before drugs

had a chance to impact our kids. To make the drugs less accessible, President

Trump imposed limits on the sources of illicit drug prescription and

administration. He provided individuals who have been or are now being

afflicted by addiction a way to rehabilitate. I believe that this process was well

thought out and implemented; the support act was forcefully brought into

society; However, over time, the support act, which continues to provide the

same resources, is being sustained with less force than when it was first

introduced. If we stuck to this legislation, we’d be able to witness a more

significant drop in the number of persons harmed by opioids.

Our Current President Joe Biden stated that latest data in 2018 indicated

that about 68,000 American died from an opioid overdose. President Biden’s

plan is to basically build on Obamacare. Biden’s plan includes holding big

pharmaceutical corporations, and CEOs accountable for their part in the opioid

epidemic onset, providing effective preventive, treatment, and rehabilitation.

programs to everyone through a $125 billion government investment, stop

overprescribing and increase access to appropriate and necessary pain

management, reforming the criminal justice system so that no one is

imprisoned solely for their drug usage, and stopping the flow of narcotics like

heroin and fentanyl into the U.S. particularly from Mexico and China (Wen &

Sadeghi, 2020). If I were in the president’s shoes, knowing what I know today,

I believe I would have pursued President Trump’s proposal of clamping down

and monitoring prescription drugs distribution as well as early childhood

education for the many young people who have died as a result of opioid usage.

It is impossible to determine if opioid addiction takes precedence over

everything else that is happening in the world, but it needs more attention than

it is currently getting.

As a politician, I would make it possible for American to reach a

bipartisan agreement on the subject, which would include both government

officials and individuals. Following the increasing mortality rates caused by

opioid epidemic, I would place a high focus on the major effect and path to

resolution. In addition, to help contribute to the current opioid crisis, I would

join the healthcare professionals who are providing primary care to patients by

obtaining advanced clinical skills and knowledge in the early stages of their

mental illness or when first start abusing drugs. This will enable me to provide

better care and raise awareness about opioid crisis, removing any stigma that

may be associated with it.

References

Zuckerman, D. M. (2017). A major shortcoming in the public health legacy of the

Obama Administration. American Journal of Public Health, 107(1), 29-30.

https://doi.org/10.2105/ajph.2016.303559

Wen, L. S., & Sadeghi, N. B. (2020). The opioid crisis and the 2020 US election:

Crossroads for a national epidemic. The Lancet, 396(102), 1316-1318.

https://doi.org/10.1016/S0140-6736(20)32113-9

Salmond, S., & Allread, V. (2019). A population health approach to america’s opioid

epidemic. Orthopaedic Nursing, 38(2), 95-108.

https://doi.org/10.1097/nor.0000000000000521

Various health issues come to mind when deciding on a topic for discussion. I choose mental health, which has got the plan on the presidential level several times and continues to grow. The COVID-19 pandemic has increased mental health needs in the population. President Obama made progress in mental health by expanding health care coverage with the Affordable Care Act (ACA). The ACA restricted insurance companies from discriminating care for pre-existing diagnoses and gave coverage for substance use and mental health-related services. President Obama extended services with a hundred million US dollars through the ACA by building behavioral health centers. Obama indicated the nation’s responsibility by helping those in uniform with mental health and their families requiring support, and he announced May 2016 as a Mental health awareness month (The White House, 2016).

President Trump had positive and negative progress in the field of mental health. He focused on ruining the ACA and lowering Medicaid; many low-income people who relied on substance abuse and mental health treatment coverage would not have coverage. President Trump executed the first American health care by signing an administrative order on October 5, 2020. It was positive due to improved access to mental health for people who suffered from mental health conditions aggravated by the current COVID-19 pandemic. President Trump said that his government is committed to controlling the disaster of suicide, stopping the crisis of opioids, and enhancing behavioral and mental health (DeVylder, 2017). The COVID-19 pandemic also worsened behavioral and mental health because of anxiety and stress from social isolation, lost unemployment, and extended lockdown (Sim, 2012). It demonstrated the clear focus the Trump government executed.

I praise our presidents for creating recent modifications and concentrating on mental and behavioral health because it was overdue. I would execute additional mental and psychological training for health care staff because they need good mental health. I noticed people in need waiting for specialized facilities for their needs and spending hours and days waiting to see the doctor. For example, most of these patients go to the emergency department, and options for specialized treatment are unavailable at some locations. With increasing need, providers cannot accept many patients, and these patients do not get help on time and raised trauma occurs because of the wrong approach in areas that cannot deliver specialized care. I will also raise the mental health research budget because of the need for effective treatments.

References

DeVylder, J. E. (2017). Donald Trump, the police, and Mental Health in US cities. American Journal of Public Health, 107(7), 1042–1043. https://doi.org/10.2105/ajph.2017.303827

Sim, F. (2012). Health and Wellbeing: The 21st century agenda. Public Health, 126. https://doi.org/10.1016/j.puhe.2012.05.012

The White House. (2016, April 28). Presidential Proclamation-National Mental Health Awareness Month. https://www.counseling.org/news/updates/2020/10/06/president-trump-issues-executive-order-on-behavioralhealth

A public health topic which needs more attention is the opioid abuse epidemic. As a registered nurse in a large city, I often see the unfortunate effects of opioid addiction. According to Centers for Disease Control and Prevention (n.d.) nearly 69,000 overdose deaths involved opioids in 2020. The number of opioid overdoses has increased 8.5 times since year 1999 (Centers for Disease Control and Prevention, n.d.). Although all social determinants affect the opioid epidemic, most recently the most prevalent social determinant is social environment. Social environment plays a huge role in the opioid epidemic, the dramatic increase in opioid overdoses correlates with the timeline of the COVID-19 pandemic. There is a correlation between mental illnesses and drug addiction. Because of various reasons such as social isolation or workplace stress for front line personnel the pandemic caused or exacerbated many people’s mental illnesses which in response worsened the opioid crisis.

President Trump declared the opioid epidemic as a nationwide public health emergency (National Archives and Records Administration, n.d.). This was essential for the country and government officials to recognize the colossal problem the opioid epidemic had become in the United States. President Trump’s primary initiative against the opioid epidemic was stopping drug trafficking across the borders. In 2019 Mexico’s heroin production decreased by 27%, which is the largest decrease in history (National Archives and Records Administration, n.d.). Although this statistic shows that President Trump’s actions decreased heroin production in Mexico, heroin is only one type of many opioids contributing to the opioid epidemic.

President Biden also implemented changes to address the opioid epidemic. President Biden’s focus is meeting people where they are, increasing access to harm reduction such as naloxone and safe syringe access (The White House, 2022). President Biden initiative also includes disrupting transnational drug producing and trafficking criminal organizations’ finances to stop the smuggling of drugs into the United States, as well as stopping drugs from entering the United States from across the borders (The White House, 2022). Although the two presidents have a different focus on interventions to stop the opioid epidemic, they both have initiatives to stop drugs from crossing the borders.

Although it is important to decrease the availability of illicit drugs on the street and provide access to harm reduction interventions, I believe the focus should be on preventing addiction in the first place. Primary preventative measures of opioid abuse include using evidence-based guidelines when prescribing medications, increasing school-based prevention education programs, and increased access to behavioral health supports (Livingston et al., 2022). Education programs should be implemented in schools to prevent drug abuse. Also access to mental health care providers needs to be more readily available and interventions should be done to decrease the stigma around mental health care.

References

Centers for Disease Control and Prevention. (n.d). Opioid data analysis and resources. https://www.cdc.gov/opioids/data/analysis-resources.html

Livingston, C. J., Berenji, M., Titus, T. M., Caplan, L. S., Freeman, R. J., Sherin, K. M., Mohammad, A., & Salisbury-Afshar, E. M. (2022). American college of preventive medicine: Addressing the opioid epidemic through a prevention framework. American Journal of Preventive Medicine, 63(3), 454–465. https://doi.org/10.1016/j.amepre.2022.04.021

National Archives and Records Administration. (n.d.). Healthcare. https://trumpwhitehouse.archives.gov/issues/healthcare/

The White House. (2022, April 21). Fact Sheet: White house releases 2022 national drug control strategy that outlines comprehensive path forward to address addiction and overdose epidemic. https://www.whitehouse.gov/briefing-room/statements-releases/2022/04/21/fact-sheet-white-house-releases-2022-national-drug-control-strategy-that-outlines-comprehensive-path-forward-to-address-addiction-and-the-overdose-epidemic/

NURS 6050 Presidential Agendas