Letter to the Editor: Population Health Policy Advocacy Paper

Letter to the Editor: Population Health Policy Advocacy Paper

The Current State of Opioid Addiction Treatment for Veterans

According to Oas (2019), approximately 20 percent of veterans suffer from opioid addiction or addiction to other drugs. This is further worsened by the fact that a larger percentage of veterans from Vietnam and Afghanistan/Iraq suffer from post-traumatic stress disorder (PTSD) (Oas, 2019). Opioids are among the most prescribed analgesics for managing both physical and psychological pain commonly associated with battlefield conditions and experienced by war veterans. The combination of PTSD and opioid treatment makes veterans susceptible to opioid addiction to relieve their pain completely. This has raised concern about better training for physicians on the management and prescription of opioids for veterans to avoid possible addiction. The rise in suicide cases among veterans daily has not been directly linked to opioid use. However, opioid-related suicides in the general population can be implicated as a cause of suicide amongst veterans (Dembek et al., 2020).

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Opioid Addiction and the Need for Health Policy Development

The drafting and implementation of policies to help curb the unnecessary and unmonitored dispensation of opioids to patients, especially veterans, is critical to ensure unwanted addiction is experienced by this population group (Rogal et al., 2020). The policies that have been currently enforced include those that deal with the prescription of opioids to veterans. These policies include the one that stipulates the maximum dosages of opioids that can be given at a time to veterans requiring opioid analgesics and the state prescription drug monitoring programs that require verification of any refill of certain vital drugs, including opioids. There are also voluntary guidelines that advise primary care clinicians treating veterans with chronic pain to consider alternatives to prescription medicines like hydrocodone and oxycodone, limit treatment duration, and evaluate their patients to see if opioids are the best option for them. As Rogal et al. (2020) note, all these guidelines and policies function to limit cases of chronic usage that may lead to addiction.

Treatment of Opioid Addiction Patients: Improving the Quality of Care

Evidence-based practice in the prescription of opioids and other analgesics to patients with chronic and psychological conditions will play an essential role in improving the quality of care for war veterans and other specific populations (Hagedorn et al., 2018). This will enable the development of alternatives to opioids, in addition to oxycodone and hydrocodone, for the relief of such pain. These alternatives reduce the duration of treatment and hence the risk of addiction associated with opioid usage. Education of the public will also play a significant role in ensuring improved quality of care for patients requiring opioid intervention. Through education, the public gets informed, eliminating myths and misconceptions regarding opioid usage and pain management, such as the usage of strong opioids to relieve stress and pain, which acts as a short-term solution but in turn sinks an individual into addiction (Hagedorn et al., 2018).

Establishment of drug prescription programs with well-organized management that ensures centralized dispensation of opioids and other sensitive drugs will help reduce cases of opioid addiction among the general population, including veterans (Weimer et al., 2019). Monitored decentralized opioid prescription and dispensation will reduce instances of wrongful and illegal prescription of opioids to individuals. Additionally, qualified and competent specialists in pain management, including specialists, counselors, psychiatric consultants, and senior advanced nurses in these programs, will ensure the correct administration of care for patients with chronic pain and psychological problems. This holistic care of patients reduces the chances of unnecessary prescription of opioids to patients who would rather have psychological evaluation and therapy (Weimer et al., 2019).

How the Policy will Support Achievement of Desired Outcomes

The “desired outcome” in managing opioid prescriptions and dispensations is to increase the usage of alternative pain medication and reduce related addiction. Implementing the suggested policies and guidelines will play an important role in ensuring favorable outcomes are achieved (Rogal et al., 2020). This, however, will require significant monetary and human resources. The rationale for implementing the suggested policies is based on the fact that studies have indicated that every dollar spent towards the prevention of drug abuse and treatment results in significant savings at the national level. Implementation of the suggested policies and guidelines is expected to significantly reduce the number of cases of opioid addiction and ensure quality care for specific populations, such as war veterans who are susceptible to drug addiction (Rogal et al., 2020).

Policy Development Advocacy and the Importance of Interprofessional Involvement

Application of the proposed policy outside the hospital setting is essential in ensuring holistic care of addiction patients and those susceptible to opioid addictions. Veterans interact with a variety of individuals outside the medical field. This essentially means that their care does not come from health personnel in its entirety. Other areas, such as surrounding communities, family/relatives, and potential places of work, require an understanding of the state of the individuals, their predilection for opioid abuse, and how to assist such individuals in avoiding possible addictions (Barglow, 2018).

Additionally, interprofessional involvement is essential in ensuring the effective implementation of such policies. The involvement of different levels of health personnel, including psychiatric specialists, senior nurses, counselors, community health providers, etc., will ensure efficient implementation of these policies from the top level to the grassroots with significant success. Interprofessional collaboration significantly improves the holistic approach to opioid abuse and addiction prevention in vulnerable populations (Weimer et al., 2019).

Letter to the Editor: Population Health Policy Advocacy Paper References

Barglow, P. (2018). Commentary: The opioid overdose epidemic: Evidence-based interventions: The Opioid Overdose Epidemic. The American Journal on Addictions27(8), 605–607. https://doi.org/10.1111/ajad.12823

Dembek, Z. F., Chekol, T., & Wu, A. (2020). The opioid epidemic: Challenge to military medicine and national security. Military Medicine185(5–6), e662–e667. https://doi.org/10.1093/milmed/usz487

Hagedorn, H., Kenny, M., Gordon, A. J., Ackland, P. E., Noorbaloochi, S., Yu, W., & Harris, A. H. S. (2018). Advancing pharmacological treatments for opioid use disorder (ADaPT-OUD): protocol for testing a novel strategy to improve implementation of medication-assisted treatment for veterans with opioid use disorders in low-performing facilities. Addiction Science & Clinical Practice13(1), 25. https://doi.org/10.1186/s13722-018-0127-z

Rogal, S. S., Chinman, M., Gellad, W. F., Mor, M. K., Zhang, H., McCarthy, S. A., Mauro, G. T., Hale, J. A., Lewis, E. T., Oliva, E. M., Trafton, J. A., Yakovchenko, V., Gordon, A. J., & Hausmann, L. R. M. (2020). Tracking implementation strategies in the randomized rollout of a Veterans Affairs national opioid risk management initiative. Implementation Science: IS15(1), 48. https://doi.org/10.1186/s13012-020-01005-y

Weimer, M. B., Tetrault, J. M., & Fiellin, D. A. (2019). Patients with opioid use disorder deserve trained providers. Annals of Internal Medicine171(12), 931. https://doi.org/10.7326/m19-2303