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Evaluating Social Policies: Opioid Use among Adolescents

Pamela D. Easter

Policy II: Social Policy and Social Justice

Dr. Kiana Battle

April 03, 2022

Evaluating Social Policies

Opioids are medications used for pain relief among patients, especially after surgery. The paper focuses on the opioid epidemic as a social problem in the United States. Opioids are prescribed for medical purposes; the primary clinical concerns from using opioids are physical dependence and addiction. Many opioids users have become addicted to the drugs, leading to the opioid crisis. Severe dependence on opioids among adolescents can cause social problems such as school truancy and increased crime rates. Short-term opioids side effects are dizziness, constipation, sedation, nausea, and vomiting.

Researchers have published several studies on the effects of opioid use and the presenting crisis that results from its clinical side effects of physical dependence and addiction. Deveza et al., (2018) acknowledge the existing opioid epidemic. Researchers found that 66.5 opioid prescriptions were issued per every 100 people in 2016 in the United States. These figures are startling and point to the glaring problem of the opioids epidemic in the country. Researchers also noted that despite the prescriptions, there were around 53,000 nonfatal hospitalizations and 33,000 deaths from abuse of prescription or illicit opioids in 2014 and 2015 (Deveza et al., 2018). Data shows that the opioid crisis increases the cost of healthcare in the United States while also causing the death of thousands in the U.S. According to the research, one challenge that makes the opioid problem continuous is the lack of another alternative to treat the patients. Furthermore, doctors underestimate the side effects of opioid use, which contributes to the epidemic (Deveza et al., 2018).

As the prescription rates for the drugs increase, the risks worsen. Pergolizzi et al., (2020) also acknowledge the current opioid epidemic characterized by unprecedented levels. Many Americans access the drugs legitimately for pain management, but likewise, many people misuse the prescriptions or access opioids illegally (Pergolizzi et al., 2020). Illegal access and abuses of drugs are critical contributors to the opioid crisis reported in the United States. Continuous opioid use leads to tolerance and physical dependence, which are predictable, physiological responses to repeated opioid exposure (Pergolizzi et al., 2020). Opioid Use Disorder (OUD) resulting from tolerance and physical dependence and the behavioral outcomes of using opioids cause complex neurobiological adaptations in several major brain systems (Pergolizzi et al., 2020). In particular, opioid use disorder results in the distressing withdrawal symptoms individuals experience upon abrupt cessation or rapid dose reduction of opioids (Pergolizzi et al., 2020).

Additional studies support the adverse effects of opioid use, making it a social problem in the United States. Urman et al., (2021) studied opioid-related adverse drug events. Their study assesses the prevalence of opioid-related adverse drug events, risk factors, and impacts. They used various data collected retrospectively from observation, cohort studies, and medical bills. A total of 13 389 hospitalizations on patients who had undergone surgery were investigated. Of the total hospitalizations, 91% of the patients were subjected to opioid use after surgery for pain relief (Urmanet al., 2021). Their findings showed that introducing opioid-free patients to opioids after surgery had negative consequences for the users. The social issue problem identified in the overview section is the opioid epidemic in the United States.

The targeted population is adolescents. Adolescence is a development stage between childhood and adulthood. Annual data show that at least 300,000 youth between the ages of 12 and 17 and nearly 2 million young adults between 18 and 25 misuse opioids (Pike et al., 2021). Further, according to the figures in 2018, 70% of the reported death cases resulted from an opioid overdose. Federal data showed a 268% increase in pediatric mortality resulting from opioid poisoning, with adolescents increasing at 88% (Pike et al., 2021). The data shows that the opioid epidemic among adolescents is pervasive.

The opioid epidemic is widespread among adolescents in the United States. According to CDC, the Centers for Disease Control and Prevention reports, 14% of the students have reported abusing opioid prescriptions (Youth high-risk drug use is linked to risky health behaviors and experiences, 2020). Further, the agency notes that high-risk drug use among adolescents increases their chances of participating in risky behaviors with detrimental effects on health and school performance (Youth high-risk drug use is linked to risky health behaviors and experiences, 2020). Some of the adverse outcomes of drug use among adolescents are loss of life, injuries, crimes, risky sexual behaviors, violence, and mental problems.

Adolescents in the United States abuse opioids for different reasons. One of the leading reasons for opioid prescription misuse among the population is physical pain relief and getting high (Groenewald et al., 2019). Barnett et al. (2019) investigated the risk factors associated with non-medical opioid use among adolescents. They analyzed a data survey involving 10175 adolescents. A cohort study involved 1060 adolescents from different high schools in southern California for two years. The mean age for the adolescents was 17.5 years (Barnett et al., 2019, (Groenewald et al., 2019), Pike et al., (2021) found that exposure to illegal drugs increased the odds of nonprescription opioid use among adolescents.

According to research and the Center for Disease Control and Prevention (CDC), opioid misuse among adolescents has negative consequences. One of the consequences is sexual behaviors which could lead to early unwanted pregnancies or the spread of sexually transmitted diseases. Another negative outcome of opioid use relates to the mental wellness of adolescents. Continuous opioid use may deform memory and concentration. Furthermore, opioid misuse among adolescents increases the chances of low academic performance, school dropout, physical injuries, and crimes.

Policy Overview

Amid the growing epidemic, state and federal governments have focused on implementing different policies to address the crisis. Social policies aim to provide a roadmap for solving social-related issues. This section focuses on two federal policies enacted to address the opioid epidemic among adolescents.

The first federal policy for discussion is the Opioid Prescription Verification Act, introduced in Congress by Davis Rodney and was passed on December 08, 2021. The objective of implementing the Opioid Prescription Verification Act was to "reduce prescription shopping and curb sales of illegally obtained opioids" (Davis' Opioid Prescription Verification Act to combat opioid epidemic passes the house, n.d). The policy was supported by the National Council for Behavioral Health, Shatterproof, the U.S First Responders Association, the National Association of State EMS Officials, and the International Association of Fire Fighters. They backed the policy because they are all on the frontline of fighting the opioids epidemic in the U.S. The policy will be implemented through the (HHS) Department of Health and Human Services, (FDA) Food and Drug Administration, and the Centers for Disease Control and Prevention (CDC) using budgets allocated by the federal government. The policy was mostly opposed by synthetic opioid manufacturers because of business interests, mainly financial. Some members of Congress rejected the policy due to political reasons. The policy seeks to encourage the state governments to execute protocols for opioid prescriptions through incentives. Further, the policy was enacted to advance electronic processes in prescribing opioids to facilitate easy record-keeping and tracking of information. Prescriptions under Medicare Part D and Medicare Advantage need to be electronically prescribed. Through electronic prescription, the state and the federal government will be able to prevent overdose and illegal access to opioids. Consequently, tracking adolescents accessing opioids will become easier.

The second federal policy that addresses is opioid use among adolescents is the Synthetic Opioid Danger Awareness Act. The policy was introduced by Andy Ki and passed on December 08, 2021. It aims to mandate government health care agencies to conduct public education to create awareness of the dangers of synthetic opioids. The policy was enacted after CDC reported opioid overdose deaths that exceeded 100,000, with synthetic opioids accounting for most of the reported death cases (House passes Congressman Kim's bill to highlight the dangers of synthetic opioids, 2021). Additionally, (NIOSH) the National Institute for Occupational Safety and Health, has the task of publishing training materials for first responders and other personnel at high risk of opioid exposure.

Policy Analysis

Synthetic Opioid Danger Awareness Act and the Opioid Prescription Verification Act have unique advantages and disadvantages. One advantage of the Opioid Verification Act is that it will offer training opportunities to pharmacists to enable them to verify identities and prevent pharmacy shopping. Therefore, it would be difficult for adolescents to shop for drugs. The second benefit of the act is that it will encourage electronic prescription. It will be easy to track opioid misuse among different users with an electronic prescription. The other advantage is that the policy would provide incentives to states for implementing electronic prescriptions for opioid drugs.

Therefore, many states will be willing to implement the policy. Lastly, the policy will facilitate the responsibly and informed dispensing of controlled substances to mitigate the risk. The only limitation in the policy is the challenge of identifying whether prescriptions are legitimate or illegal. For instance, while electronic prescriptions can be tracked easily, it is difficult to identify whether they are unauthorized.

Synthetic Opioid Danger Awareness Act also has its merits and demerits. The policy will raise awareness of the dangers of fentanyl synthetic opioid use through public education regarding its benefits. Thus, individuals will make better decisions regarding opioid use through increased awareness and educational support. Secondly, the policy will lower opioid risks by communicating treatment options available for opioid abuse because it requires health care agencies to publicize the available treatment options. Under the Policy, CDC has the duty of working collaboratively with healthcare facilities by disseminating information on different types of opioids (House passes congressman Kim's bill to highlight dangers of synthetic opioids, 2021). However, the policy's limitation is that it does not contain methods that directly limit opioid use. It is assumed that people who know the dangers of synthetic opioids will stop using them.

Policy Evaluation

The CDC evaluation framework for The Synthetic Opioid Danger Awareness Act is to determine if the policies are accomplishing their goal. In evaluating the policy, the CDC framework is used. During the formulation process, various Congress committees were engaged. The public also offered their views on the policy's implementation before it was passed. Regarding objectives, the primary goal of the Synthetic Opioid Awareness Act is to educate and protect high-risk providers through public education campaigns and training materials on the dangers of synthetic opioids.

On the other hand, the Opioid Prescription Verification Act was supported by National Council for Behavioral Health due to the organization's interest in ending the opioid epidemic in the United States. Like the Synthetic Opioid Danger Awareness Act, it received opposition from some Congress members and pharmaceutical companies due to their special interests, such as funding. The policy will be funded through the Medicare program. Thus, the public and special interests goals were engaged in formulating the policy. CDC evaluation framework will identify the objectives of the policy. The Opioid Prescription Verification Act seeks to develop and maintain prescription drug monitoring programs, mandate opioid dispensers to include certain purchase information in the state's opioid prescription monitoring system, and enforce electronic prescription. The Policy Analysis Table below contains information on both policies.

The policy that I think would be best for the target population that I have chosen would be the Opioid Verification Act would have a greater effect on the opioid epidemic amongst adolescents; the feasibility is high and more likely to reverse this epidemic.

Role of Social Media in Promoting the Social Policy

Advancement in technology has revolutionized social work and policymaking processes. Social media play fundamental roles in promoting and increasing the reach of social policies. The first role of social media platforms is to create awareness (Bou-Karroum et al., 2017). Social workers can use media avenues such as Twitter and, Facebook, Instagram to inform different groups about particular policies. The dual role of social media in promoting social policy is advocacy. Social workers use social media to advocate for various programs (Bou-Karroum et al., 2017).

On the other hand, the targeted audience can also contribute their ideas to improve the policies. Social media can increase policymakers' awareness (Bou-Karroum et al., 2017). Such awareness may include understanding an existing problem, interventions, or obtaining information about policies proposed by other professionals. The Rx Awareness Campaign Social Media Kit offers graphics from the campaign and personalized posts that you can use to distribute and promote the Rx Awareness campaign on your social media channels, including Facebook, Instagram, and Twitter.

Social media can also be used to mobilize resources that can assist in implementing a policy. Social media and social networks are key drivers of public debate and perceptions of marijuana, opioids, and other drugs, including for the youth, and there are numerous messages promoting the acceptability of substance use in these digital networks. This emphasizes the need for new interventions that use digital prevention tactics and offer a counternarrative or counterargument. Current studies have examined exposure to antidrug communications and found that counternarrative strategies may partially explain positive campaign outcomes.

For instance, policymakers can seek financial support through social media avenues to assist them in advocating or executing their policies. Lastly, social media can be utilized as an awareness tool to increase the adoption of a particular policy or facilitate compliance with laws and regulations on a specific policy (Bou-Karroum et al., 2017). Thus, social media is significant in publicizing any policy contemporarily. Rx Awareness Campaign Resources Digital 30-second testimonial videos, Web banner ads,Online search ads , 5-second bumper digital video ads Social media ads.

Conclusion

In summary, the social problem discussed in the paper is the opioid epidemic in the United States. The targeted population is adolescents. Opioid misuse among adolescents increases the risk of illicit drug use. It may also lead to mental problems, violence, and increased crime rates. The federal government, has developed various policies to deal with opioid abuse and this epidemic in the United States. The two analyzed policies are the Synthetic Opioid Danger Awareness Act and the Opioid Prescription Verification Act. After analyzing the federal policies using the CDC framework, the paper identifies the Opioid Prescription Verification Act as the best because it is easy to implement and sustain.

During the promotion and implementation process, the social media platforms can increase awareness, mobilize resources, enhance adoption, and comply with regulations within the policies. The The Rx Awareness Campaign Social Media Kit offers graphics from the campaign and personalized posts that you can use to distribute and promote the Rx Awareness campaign on your social media channels, including Facebook, Instagram, and Twitter.

References

Barnett, T. E., Thompson, E. L., Litt, D. M., Lewis, M. A. (2019). Correlating non-medical prescription opioid use among U.S. adolescents. American Journal of Preventive Medicine, 57(5).

Bou-Karroum, L., El-Jardali, F., Hemadi, N., Faraj, Y., Ojha, U., Shahrour, M., Darzi, A., Ali, M., Doumit, C., Langlois, E. V., Melki, J., AbouHaidar, G. H., & Akl, E. A. (2017). Using media to impact health policymaking: An integrative systematic review. Implementation Science, 12(1).

Centers for Disease Control and Prevention. (2015, July 6). Policy evaluation. Centers for Disease Control and Prevention. Retrieved March 31, 2022, from

Centers for Disease Control and Prevention. (2020, November 6). Youth high-risk drug use is linked to risky health behaviors and experiences. Centers for Disease Control and Prevention. Retrieved March 31, 2022, from

Davis' Opioid Prescription Verification Act to combat the opioid epidemic passes house. Congressman Rodney Davis. (n.d.). Retrieved March 31, 2022, from

Deveza, L. A., Hunter, D. J., & Van Spil, W. E. (2018). Too much opioid, too much harm. Osteoarthritis and Cartilage, 26(3), 293–295.

Groenewald, C. B., Patel, K. V., Rabbitts, J. A., & Palermo, T. M. (2019). Correlates and motivations of prescription opioid usage among adolescents 12 to 17 years in the United States. Pain, 161(4), 742–748.

House passes congressman Kim's bill to highlight the dangers of synthetic opioids. Representative Andy Kim. (2021, December 9). Retrieved March 31, 2022, from

Pergolizzi, J. V., Raffa, R. B., & Rosenblatt, M. H. (2020). Opioid withdrawal symptoms, a consequence, and chronic opioid use and opioid use disorder: understanding and approaches management. Journal Clinical Pharmacy and Therapeutics, 45(5), 892–903.

Pike, J. R., Fadardi, J. S., Stacy, A. W., & Xie, B. (2021). The prospective and association between illicit drug use and nonprescription opioids among vulnerable adolescents. Preventive Medicine, 143, 106383.

Pike, J. R., Fadardi, J. S., Stacy, A. W., & Xie, B. (2021). The prospective association between illicit drugs and nonprescription opioid use among vulnerable adolescents. Preventive Medicine, 143, 106383.

Schulte, E., Spies, C., Denke, C., Meerpohl, J. J., Donner‐Banzhoff, N., Petzke, F., Hertwig, R., Schäfer, M., & Wegwarth, O. (2021). Patients' self‐reported physical and psychological effects of opioid use in chronic noncancer pain—a retrospective cross‐sectional analysis. European Journal of Pain, 26(2), 417–427.

Urman, R. D., Seger, D. L., Fiskio, J. M., Neville, B. A., Harry, E. M., Weiner, S. G., Lovelace, B., Fain, R., Cirillo, J., & Schnipper, J. L. (2020). The burden of opioid-related adverse drug events on hospitalized opioid-free surgical patients previously. Journal of Patient Safety, 17(2).