Initial Post

The population health concern that I have selected in the opioid crisis.  The opioid crisis affects all people regardless of socio-economic class.  Addiction to opioids, especially illegal, can occur with as little as one dose.  According to Berman (2018), factors that contribute to the opioid crisis include “short-term effectiveness, lack of education and the unavailability of prescription medications”.

Administration Agenda

President Bush’s agenda was largely focused on stopping drug use before it started, healing America’s drug dealers and disrupting the illegal drug market (“The President’s National Drug Control Strategy” (n.d.).  President Bush was also an advocate for securing the countries borders to discourage illegal drugs from entering the country.

President Obama’s agenda focus was through the Affordable Care Act (ACA), commonly called “ObamaCare” which label substance abuse .  One of the main goals of the ACA was to improve access to health care.  Other key Agenda items were monitoring of prescription drugs, enabling safe disposal of needles, increasing access to naloxone and accelerating research on pain management.  President Obama was able to get the Comprehensive Addiction and Recovery Act passed.  The Bill was aimed at improving prevention and education, expanding naloxone availability, launching evidence-based opioid and heroin education and treatment programs (“Comprehensive Addiction and Recovery Act” (CARA) (n.d)) Presidential Healthcare Agendas.

President Trump has a three part plan to address the opioid epidemic.  Part one of the plan is aimed at reducing the demand for opioids and targeting over prescriptive practices.  Part two of the plan is aimed at reducing the amount of drugs that enter the country illegally as well as addressing illegal drugs domestically.  Part three of the plan focuses on evidenced-based treatment for addiction (“Ending America’s Opioid Crisis, The White House”, 2020).

The opioid crisis is a complex problem.  I believe that all of the approaches previous presidents have had can be effective.  Unfortunately, as with most problems there is a political divide that limits the effectiveness of the programs established.  I think one measure that could be effective is improving low income communities and creating jobs that allow for improved self-esteem.  I feel that uplifting communities as well as individuals could be an effective tactic for reducing illegal opioid use.  Prescriptive practices still need to be monitored.  In Michigan we have the Michigan Automated Prescription Service (MAPS), which monitors the amount of drug that is being prescribed and filled for the patient.  One of the causes listed by Berman (2020) was short-term effectiveness of the medication.  With that in mind, it may be a good idea to research non-opioid medications that have longer half-lives

References

Berman, D.,(2020). https://www.pharmacentra.com/three-factors-led-opioid-epidemic-america/. [Blog].

“Comprehensive Addiction and Recovery Act” (CARA).  (n.d.).  Retrieved June 2, 2020, from https://cadca.org/comprehensive-addiction-and-recovery-act-cara

“Ending America’s Opioid Crisis, The White House”, (2020). The White House. Retrieved June 1, 2020, from https://www.whitehouse.gov/opioids/

Response

Based on your discussion post it sounds like Bush, Obama, and Trump have all addressed the seriousness of the opioid epidemic during their presidential term(s).  As the new presidential election approaches, I think it is important for health care providers to review and understand what our current president has implemented in response to this ongoing issue.  As you mentioned in your post, the Trump Administration’s Strategy to fight the opioid epidemic consists of three elements: prevention, treatment and recovery, and reducing the availability of drugs.

Two ways health care providers can help prevent the opioid epidemic from growing are by utilizing safe prescribing practices and expanding the use of prescription drug monitoring programs (Office of Nation Drug Control Policy, 2019, pp. 5-6).  Following clinical guidelines and best practices when prescribing opioids is one way to ensure safe prescribing practices are being utilized by providers (Office of National Drug Control Policy, 2019, pp. 5).  Developing a universal drug monitoring program for the United States would be another beneficial way of preventing over-prescribing of opioids.  Some of the issues with the current Prescription Drug Monitoring Programs (PDMP) are that not all states require this tool to be used, certain electronic health records (EHR) are not able to be integrated into the PDMPs, and some providers feel their patient’s confidentiality will be compromised if they use PDMPs (Office of National Drug Control Policy, 2019, pp. 6).

I think it is important for all advanced care providers with prescribing rights to be educated and up to date on the national and state recommendations for opioid prescribing.  “The Minnesota Prescription Monitoring Program (PMP) was established to promote public health and safety by detecting diversion and misuse of prescriptions for controlled substances” (Minnesota Department of Health, n.d.).  In 2017, enrollment into the PMP was made mandatory for all prescribing providers (Minnesota Department of Health, n.d.).

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Resources

Minnesota Department of Health. (n.d.). Prescribing practices: Prescription monitoring program. Retrieved June 4, 2020, from https://www.health.state.mn.us/communities/opioids/mn

response/pmp.html

Office of National Drug Control Policy. (2019, January). National Drug Control Policy. Retrieved June 4, 2020, from https://www.whitehouse.gov/wp-content/uploads/2019/01/

NDCS-Final.pdf Presidential Healthcare Agendas.

Discussion: Presidential Agendas

Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.

Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?

To Prepare:

• Review the Resources and reflect on the importance of agenda setting.
• Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities.

By Day 3 of Week 1

Post your response to the discussion question: Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?

By Day 6 of Week 1

Respond to at least two of your colleagues* on two different days by expanding on their response and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.

Teenage Pregnancy

The United States has one of the most pregnancy rates of all industrialized countries (Solomon-Fears, 2015). Nonetheless, there have been improvements in the way this public issue is being handled to lead to a significant reduced rate. Scholars have been divided on the approach to tackle this health issue with no compromise on either side. One group prefers the abstinence-only education program, while the other favors the comprehensive approach to sex education.

The Bush Administration leaned toward the abstinence-only method, which led to increased federal money allocated for this approach to reduce and or prevent teenage pregnancy. This administration favored education to stop teenage sex as opposed to teaching safe sex which aides in encouraging teenagers and or giving them a sense of false security. An eight-point federal definition of abstinence education was established as the Welfare Reform Act of 1996 by this administration (Ballaro and Ginsburg, 2019).

The Obama Administration favored evidence-based approaches to broaden the interventions to reduce teenage pregnancy. This administration used rigorous evaluation strategies to choose from numerous interventions available. The Department of Health and Human Services was given the responsibilities to come up with as many as possible educational remedies to the plague of teenage pregnancy irrespective of opinions of the two groups earlier discussed. The culmination of using this approach led to the isolation of teenage pregnancy as a separate issue from adult women which led to the creation of Teen Pregnancy Prevention Initiative (TPPI) by this administration.

The Trump Administration favored the abstinence-only education method to reduce teenage pregnancy. This led to the significant cut of funding for the Teen Pregnancy Prevention Initiative of the Obama Administration. An amendment was approved in 2015 that allowed insurers to opt out of covering preventive services for women such as birth control in favor of abstinence. The funding cut was a $216 million savings for the government. On the other hand, it has been estimated that in 2010, expense from the government towards teen pregnancy and childbirth cost U.S. tax payers $9.4 billion (Teen Pregnancy Prevention, 2017). This however by no means is meant to undermine the stand of this administration, but to analyze the cost and effects of different approaches on this health concern.

References

Ballaro, B., & Ginsburg, J. (2019). Abstinence education. Salem Press Encyclopedia.

Pam Belluck. (2018). Trump Administration Pushes Abstinence in Teen Pregnancy Programs.

Solomon-Fears, C. (2015). Federal Strategies to Reduce Teen Pregnancy. Congressional Research Service: Report, 7–20.

Teen Pregnancy Prevention. (2017). Congressional Digest, 96(7), 30.