Analysis of Position Papers for Vulnerable Populations
Legalization of Illicit Substances – Marijuana
Illicit substances of abuse in the United States include but are not limited to marijuana, opioids, central nervous stimulants such as cocaine, methamphetamines, and lysergic acid diethylamide (LSD). Marijuana remains the commonest substance of abuse (Yu et al., 2020).
In the United States, the jurisdictional marijuana use has been classified as recreational, medicinal/medical, and illegal use of marijuana. The recreational use of marijuana has been legalized in 19 states, including Washington District of Columbia; medical marijuana use has been legalized in 38 states.
In other states, marijuana use of any kind remains illegal. National legalization of marijuana among adults and adolescents has been controversial for decades now, and the argument has been based on public health data relating to its use and safety among users and non-users and the possibility of nonusers having to use it in uncontrolled situations. The purpose of this paper is to support my stance on legalizing the medicinal use of marijuana and controlling the recreational use and possession of the drug.
Specific Healthcare Issue and My Stance
Marijuana has been used as a medicinal and recreational drug. Among adolescents, the effects can go beyond recreation. Permanent brain damage and impact on schooling are some of the feared consequences. Depression, anxiety, and sometimes suicidal ideations are the major psychological consequences of marijuana use among adolescents and young adults (Shen, 2020).
Because of their physiological and psychological vulnerability to uncontrolled marijuana use, this population remains relevant to the health issue. These are the vulnerable population for my issue – the national legalization of marijuana.
In October 2018, Canada legalized the recreational use of marijuana in the country. To prevent the health of the young and adults as a result of the legalization, Canada introduced various subsections into the cannabis act that ensured the access to this substance is limited. Currently, in the US, various states are moving towards legalizing marijuana for recreational and medical purposes.
With these state-level legalizations, there has been some pressure on the other states where marijuana is still illegal to initiate certain laws that will allow their citizens to use cannabis for medical or recreational purposes. The legalization has enabled free access to cannabis for youths and adolescents. The legalizations have allowed access to cannabis to adults of various age groups that vary from state to state.
My position on this health issue is that the government should decriminalize the use of marijuana but legalize its use for medicinal but not recreational purposes among adolescents and young adults. This would ease the efforts with which the adolescents go to acquire this substance.
This step would make it easier to control its access and use, thus regulating its use by killing the black market. Allowing recreational access to adults may not, however, prevent access to the use or reduce its use by the adolescents. This would support a partial probation approach to addressing marijuana use among adolescents.
Supporting Pieces of Evidence
An ecological study done by Yu et al. (2020) found that legalizing marijuana laws have led to a decline in the use of various age cohorts since these laws have been in place. The decrease has been consistent among older to younger cohorts of citizens. Whether it is the legalization of medical or recreational uses, there has been a historical decline in the use of marijuana among young Americans aged between 12 and 15 years.
Dutra et al. (2022) assessed the impacts of these legalizations on driving under the influence of cannabis. Their sources were from a national survey of current users. Their study reported a lower risk of driving under the influence of cannabis among users in states where legalizations for recreational and medical use compared with states where use is illegal.
In 2015, a study by Shi et al. reported that legalization would increase the odds of use of cannabis among adolescents in Canada. However, a reanalysis by Stevens (2019) using a larger sample size found no association between the legalizations and increased odds of cannabis use among adolescents.
Interprofessional Roles
This issue requires various professionals to enhance the proposed position plan. Effecting improvement in health outcomes of this vulnerable population would require legal and health professionals’ input. United States Drug Enforcement Administration, the US Department of Human and Health Services, and the Public Health Departments are the top relevant stakeholders in solving the issue.
However, the participation of specific health professionals such as nurses, physicians, psychiatrists, and pediatricians is also required for professional input. Epidemiologists are essential in this health issue because of the need to understand the effectiveness of the legislative interventions at the population level. The interprofessional approach will ensure proper coordination between the policy implementers and policymakers.
Contrary Evidence
A cross-sectional study by Zuckermann et al. (2021) assessed the impact of the national legalization of cannabis and reported that the national legalization is yet to improve cannabis use among youths. Various longitudinal cohorts were compared, but no significant differences were reported for the analysis of 2-year reported data.
Ziolkowski et al. (2021) also studied the impact of national legalization of marijuana use on delirium rates and opioid use among patients with acute burns. From their study, it can be concluded that the legalization ah instead threatened public safety because it was associated with an increase in burn injuries and increased delirium rates, and opioid consumption in the United States.
In Canada, 2 years after legalization, reported a decrease in cannabis prices from the legal sources but unfortunately, the was also a decrease in the percentage of consumers buying from the legal sources. This shows poor public reception and perception of this national step and thus lack of total control on the public consumption after national legalization.
Conclusion
National legalization of cannabis use impacts various aspects of the lives of a vulnerable population – adolescents. Whether legalized for medical or recreational use, the government needs to control and limit the access to the legally eligible parties and the adolescents. The sources that back my opinion are purely primary sources with statically valid findings.
However, the contrary evidence provided a newer dimension to national legalization that my supporting evidence sources did not address. Evidently, national legalization has impacts at the population health level, but at the individual level, there are issues such as consumer safety that the government must address before legalization. Nevertheless, my position still stands that there needs to be controlled legalization – be it for recreational or medical uses.
References
Dutra, L. M., Farrelly, M., Gourdet, C., & Bradfield, B. (2022). Cannabis legalization and driving under the influence of cannabis in a national U.S. sample. Preventive Medicine Reports, 27(101799), 101799. https://doi.org/10.1016/j.pmedr.2022.101799
Shen, H. (2020). Cannabis and the adolescent brain. Proceedings of the National Academy of Sciences of the United States of America, 117(1), 7–11. https://doi.org/10.1073/pnas.1920325116
Stevens, A. (2019). Is policy ‘liberalization’ associated with higher odds of adolescent cannabis use? A re-analysis of data from 38 countries. The International Journal on Drug Policy, 66, 94–99. https://doi.org/10.1016/j.drugpo.2019.01.013
Wadsworth, E., Driezen, P., Pacula, R. L., & Hammond, D. (2022). Cannabis flower prices and transitions to legal sources after legalization in Canada, 2019–2020. Drug and Alcohol Dependence, 231(109262), 109262. https://doi.org/10.1016/j.drugalcdep.2021.109262
Yu, B., Chen, X., Chen, X., & Yan, H. (2020). Marijuana legalization and historical trends in marijuana use among US residents aged 12–25: results from the 1979–2016 National Survey on drug use and health. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-8253-4
Ziolkowski, N., D’Abbondanza, J., Rehou, S., & Shahrohki, S. (2021). 52 impact of national marijuana legalization on delirium rates and opioid use in acute burns. Journal of Burn Care & Research: Official Publication of the American Burn Association, 42(Supplement_1), S38–S38. https://doi.org/10.1093/jbcr/irab032.056
Zuckermann, A. M. E., Battista, K. V., Bélanger, R. E., Haddad, S., Butler, A., Costello, M. J., & Leatherdale, S. T. (2021). Trends in youth cannabis use across cannabis legalization: Data from the COMPASS prospective cohort study. Preventive Medicine Reports, 22(101351), 101351. https://doi.org/10.1016/j.pmedr.2021.101351
Analysis of Position Papers for Vulnerable Populations Instructions
Scenario
For this assessment, pretend you are a member of an interprofessional team that is attempting to improve the quality and outcomes of health care in a vulnerable population. For the first step in your team’s work, you have decided to conduct an analysis of current position papers that address the issue and population you are considering.
In your analysis, you will note the team’s initial views on the issue in the population as well as the views across a variety of relevant position papers. You have been tasked with finding the most current standard of care or evidenced-based practice and evaluating both the pros and cons of the issue. For the opposing viewpoints, it is important to discuss how the team could respond to encourage support. This paper will be presented to a committee of relevant stakeholders from your care setting and the community. If it receives enough support, you will be asked to create a new policy that could be enacted to improve the outcomes related to your chosen issue and target population.
The care setting, population, and health care issue that you use for this assessment will be used in the other assessments in this course. Consider your choice carefully. There are two main approaches for you to take in selecting the scenario for this assessment:
- You may use one of the issues and populations presented in the Vila Health: Health Challenges in Different Populations media piece. For this approach, you may consider the population in the context of the Vila Health care setting, or translate it into the context in which you currently practice or have had recent experience.
- You may select a population and issue that is of interest to you and set them in the context of your current or desired future care setting. While you are free to choose any population of interest, the issue you choose should fall within one of the following broad categories:
- Genetics and genomics.
- Sickle cell, asthma, multiple sclerosis, myasthenia gravis.
- Immunity.
- Type 1 diabetes, systemic lupus erythematosus (SLE), congenital neutropenia syndrome.
- Chronicity.
- Arthritis, any type of cancer or lung or heart disease, obesity.
- Addiction.
- Abuse of alcohol, prescription drugs, tobacco, illegal substances.
- Emotion and mental health.
- Post-traumatic stress disorder (PTSD), depression, eating disorders, psychosis.
- Genetics and genomics.
Note: If you choose the second option, contact your faculty to make sure that your chosen issue and population will fit within the topic areas for this course.
Instructions
For this assessment, you will develop a position summary and an analysis of relevant position papers on a health care issue in a chosen population. The bullet points below correspond to the grading criteria in the scoring guide. Be sure that your assessment submission addresses all of them. You may also want to read the Analysis of Position Papers for Vulnerable Populations Scoring Guide and Guiding Questions: Analysis of Position Papers for Vulnerable Populations [DOC] to better understand how each grading criterion will be assessed.
- Explain a position with regard to health outcomes for a specific issue in a target population.
- Explain the role of the interprofessional team in facilitating improvements for a specific issue in a target population.
- Evaluate the evidence and positions of others that could support a team’s approach to improving the quality and outcomes of care for a specific issue in a target population.
- Evaluate the evidence and positions of others that are contrary to a team’s approach to improving the quality and outcomes of care for a specific issue in a target population.
- Communicate an initial viewpoint regarding a specific issue in a target population and a synthesis of existing positions in a logically structured and concise manner, writing content clearly with correct use of grammar, punctuation, and spelling.
- Integrate relevant sources to support assertions, correctly formatting citations and references using APA style.
Example assessment: You may use the Assessment 1 Example [PDF] to give you an idea of what a Proficient or higher rating on the scoring guide would look like.
Submission Requirements
- Length of submission: 4–6 double-spaced, typed pages, not including the title and reference pages. Your plan should be succinct yet substantive. No abstract is required.
- Number of references: Cite a minimum of 3–5 sources of scholarly or professional evidence that support your initial position on the issue, as well as a minimum of 2–3 sources of scholarly or professional evidence that express contrary views or opinions. Resources should be no more than five years old.
- APA formatting: Use the APA Style Paper Template [DOCX] and the APA Style Paper Tutorial [DOCX] to help you in writing and formatting your analysis.