Translating Evidence Into Practice: The Opioid Crisis Essay

Translating Evidence Into Practice: The Opioid Crisis Essay

NR706

The purpose of this paper is to explore opioid abuse as a burden of disease. Substance abuse has become a national disease burden, with addiction to opioids the most significant concern. Persons abusing substances also experience emotional trauma and discrimination from persons who have stereotypes about them. They are, therefore, unable to recognize that they have health issues that need to be addressed by healthcare professionals and end up not receiving the services they need to uphold their health. Addiction to opioids requires immediate interventions before the abusers develop serious complications. Healthcare providers have provided the individuals abusing opioids with opioid antagonists, raising moral uproar about whether healthcare encourages more people to use these drugs. The DNP nurse is expected to utilize technology to obtain and analyze data and ultimately disseminate data that will lead to the adoption of effective interventions to solve problems troubling the healthcare sector.

Practice Problem and Question

Approximately 500,000 opioid-related deaths have been reported in the US from 1999 to 2019, projected to increase (Ciccarone, 2021). There were over 49860 deaths reported in 2019 from opioid use (Ciccarone, 2021). This epidemic has been on the rise because of healthcare providers’ overprescription of these drugs. Statistics indicated an average of 51 prescriptions per 100 persons in the United States (Ciccarone, 2021). The increased efforts in awareness of the issue have seen a decrease in the number of prescriptions, and relevant policies have also helped regulate the prescriptions.

Statistics indicate that over 9.9 million persons in 2019 in the United States were abusing opioids. The Centers for Disease Control and Prevention (CDC) published that over 10.1 million persons over 12 misused opioids in 2018, with 9.7 million abusing pain reliever prescriptions. An average of 128 people in the US succumb to death due to the abuse of opioids (National Institute on Drug Abuse, 2023). These statistics show that opioid abuse is a severe problem in the US that should be given much attention.

The US has an average of $78 billion annually to cater for lost productivity, legal expenses, and healthcare costs (Lyden & Binswanger, 2019). In 2018, the US incurred around $696 billion, and more than $2.5 trillion between 2015 to 2018 (Lyden & Binswanger, 2019). These figures differ from one source to another, but all indicate that the opioid epidemic is crippling the economy. The individual states where the abuse of opioids is prevalent have been financially affected; for instance, it cost Arizona a massive $1.3 billion in costs related to this abuse (Lyden & Binswanger, 2019). The economic costs of opioid abuse affect individuals, their families, and the entire nation.

Medication Assisted Treatment (MAT) is effective for individuals abusing opioids. It entails using naltrexone, buprenorphine, methadone, behavioral therapy, and counseling to aid persons abusing opioids to achieve and maintain their recovery (Moore et al., 2019). Evidence has indicated that MAT can help to decrease mortalities from opioid abuse and transmission of disease, reduction in the abuse of other drugs, and reduce criminal activities (Moore et al., 2019). Persons adhering to MAT are likely to improve their social life and collaborate with healthcare workers to regain control of their lives. Stigmatization, lack of healthcare providers, and lack of financial aid have all been barriers to accessing MAT services.

PICOT question

P – Individuals abusing opioids

I – Medication Assisted Treatment (MAT)

C – No Medication Assisted Treatment (MAT)

O – decreased abuse of opioids, decreased relapse and readmission rates

T – 5 months

Picot Question: In individuals abusing opioids, does the use of Medication Assisted Treatment (MAT) compared to no Medication Assisted Treatment (MAT) lead to decreased abuse of opioids and decreased relapse and readmission rates over a period of 5 months?

Scope of the Evidence

The databases used to search for the literature were Cochrane Library, CINAHL and PubMed. The main keywords used were “opioid use disorder,” “opioid crisis,” “Medication Assisted Treatment,” “MAT,” “naltrexone,” “methadone,” “buprenorphine,” and “opioid treatment programs.” Only articles published in the last five years were considered. Across the databases, around 978 articles were yielded. After applying the exclusion and inclusion criteria, 32 articles relevant to the review were identified. They covered the prevention, epidemiology, and treatment of opioid abuse. The commonest themes were about the use of Medication Assisted Treatment (MAT) in its management, the role of healthcare providers in fighting this epidemic, and the utilization of telehealth to help these individuals to access the services they need to maintain recovery.

Evidence Synthesis of the Literature

Volkow and Blanco (2020) assert that significant efforts should be placed on preventing the opioid crisis rather than on treatment. However, the government and the healthcare sector should focus on the treatment of abusers of opioids and ensure that they prevent complications long before they occur. They suggest that a combined approach utilizing MAT and behavioral therapies must be employed to achieve positive health outcomes. They also concluded that increased access to naloxone could help to reverse opioid overdoses, subsequently reducing mortalities and morbidities associated with the abuse of these drugs. They propose that new drugs, vaccines, and non-opioid medications should be created to help address the crisis.

Deyo-Svendsen et al. (2020) conducted a study on a rural family medicine practice to assess the effectiveness of MAT for opioid users. It included the use of methadone and buprenorphine. It concluded that using MAT for these individuals was effective and feasible as the patients achieved high-quality health outcomes and improved mental health (Deyo-Svendsen et al., 2020). There was a decreased craving for opioids associated with MAT and a decreased suffering of withdrawal symptoms. The authors also concluded that in rural settings where access to healthcare services was limited, the user of MAT was effective and feasible. They recommended adopting new policies to increase access to MAT services for individuals abusing opioids.

The review by Ghanem et al. (2022) concluded that the use of MAT was effective as it helps to decrease the number of individuals abusing the substance, mortalities due to the overdose of opioids, and a reduction in the transmission of infectious diseases such as HIV/AIDS. They also suggested that MAT should be considered the first-line therapy for individuals abusing opioids and that other behavioral interventions should also be used alongside the therapy to ensure improved healthcare outcomes (Ghanem et al., 2022). The article also concluded that the management of these patients should rely on personalized plans of treatment and the provision of holistic care that includes social and mental health services to help them to achieve long-term recovery.

Bell and Strang (2020) concluded that the use of MAT in treating patients abusing opioids was effective as it led to a decrease in the rates of drug overdose, transmission of infectious diseases, and criminal activities. They stress that continuous individualized care and psychosocial support are essential for positive health outcomes. The authors suggest that healthcare workers should be on the frontline in helping to create awareness about the use of opioids to decrease the stigma these individuals face so that they can come out and utilize these services. Bell and Strang (2020) insist that MAT is not a solution to opioid abuse but is a vital component of the multidisciplinary tactic in managing this prevalent problem.

Evidence-based MAT in managing the opioid crisis is widely accepted by this population worldwide. MAT helps people achieve recovery by helping mitigate the withdrawal symptoms experienced when they try to quit, making the recovery process less overwhelming. It also combines the use of behavioral therapies, which are non-pharmacological ways to help reinforce the positive behavior of the individuals in continuing with the treatment. Overall, the use of MAT has helped to decrease drug overdose, improve the general health of individuals, and increase adherence to treatment programs. The effectiveness and feasibility of adopting MAT make it the legible first-choice therapy for individuals abusing opioids.

Data-Driven Decision-Making

Readmission rates can be used as evidence to inform the healthcare institution that a practicum change is needed. The increased number of persons readmitted due to opioid use calls for adequate management of withdrawal symptoms and pain during admission to decrease readmission and relapse rates. It also signifies inadequate care coordination and transition of care between the institution and community-based treatment programs. These issues can be addressed if there are follow-up efforts in place to ensure that the individuals utilize these community-based programs. It may also highlight patient and staff education on MAT’s foundations, harm reduction, and the stigma these individuals face. Addressing these factors can help hospitals reduce rehospitalization rates and ensure that clients receive high-quality services.

Electronic Health Records (EHRs) can provide healthcare professionals with a detailed patient medical history, essential in making informed decisions about their condition and aversion to adverse drug events (Bayramzadeh & Aghaei, 2021). Data analysis using sophisticated technological solutions can help healthcare professionals establish patterns and trends in the abuse of opioids, creating opportunities for targeting at-risk populations to prevent misuse and dependence (Bayramzadeh & Aghaei, 2021). The use of telehealth in delivering information virtually to individuals without visiting the hospitals physically can also promote compliance and save time while preventing hospital overcrowding. Mobile health applications can also help patients to track their medications, helping with adherence to therapy. Technology use in managing the opioid crisis allows patients and healthcare providers to make informed decisions, ultimately leading to better health outcomes and management of the problem.

Conclusion

Misuse of opioids, overdose, increased mortalities, and addiction have been seen in the United States in recent years. The overprescription of opioids such as fentanyl, oxycodone, and hydrocodone has fueled the crisis. The number of deaths related to overdose of opioids has hit an all-time high and is forecasted to rise over the years steadily. The crisis has severely affected healthcare resources, individual health, and social and economic facets of the individual and the nation. There is a rise in criminal activities and a loss of productivity. There has been a breakdown in the social support systems of the individuals, the breakage of families, and the stigma against individuals abusing opioids. Even though the use of MAT in the management of opioids has been successful, more emphasis has to be placed on the prevention of opioid use through awareness and the adoption of policies on the use of opioids in the United States. The government also needs to address barriers to access to MAT services, such as stigmatization, increased insurance coverage, and adequate funding.

Medication Assisted Treatment (MAT) is essential in managing patients suffering from opioid abuse. It helps to decrease the withdrawal symptoms ensuring that patients adhere to the treatment regimen and maintain recovery for longer periods. It also antagonizes the activity of opioids, helping to decrease the risk of drug overdose. Similarly, it effectively reduces relapse rates and leads to enhanced patient outcomes and an overall improvement in the quality of life experienced by the patients. Issues revolving around stigma and lack of access to MAT should be addressed to encourage opioid users to utilize these services.

ORDER A PLAGIARISM-FREE PAPER HERE

References

Bayramzadeh, S., & Aghaei, P. (2021). Technology integration in complex healthcare environments: A systematic literature review. Applied Ergonomics, 92, 103351. https://doi.org/10.1016/j.apergo.2020.103351

Bell, J., & Strang, J. (2020). Medication treatment of opioid use disorder. Biological Psychiatry, 87(1), 82–88. https://doi.org/10.1016/j.biopsych.2019.06.020

Ciccarone, D. (2021). The epidemiology of the opioid overdose epidemic in the United States. The Opioid Epidemic and Infectious Diseases, 1–10. https://doi.org/10.1016/b978-0-323-68328-9.00001-1

Deyo-Svendsen, M., Cabrera Svendsen, M., Walker, J., Hodges, A., Oldfather, R., & Mansukhani, M. P. (2020). Medication-assisted treatment for opioid use disorder in a rural family medicine practice. Journal of Primary Care & Community Health, 11. https://doi.org/10.1177/2150132720931720

Ghanem, N., Dromgoole, D., Hussein, A., & Jermyn, R. T. (2022). Review of medication-assisted treatment for opioid use disorder. Journal of Osteopathic Medicine, 0(0). https://doi.org/10.1515/jom-2021-0163

Lyden, J., & Binswanger, I. A. (2019). The United States opioid epidemic. Seminars in Perinatology, 43(3), 123–131. https://doi.org/10.1053/j.semperi.2019.01.001

Moore, K. E., Roberts, W., Reid, H. H., Smith, K. M. Z., Oberleitner, L. M. S., & McKee, S. A. (2019). Effectiveness of medication assisted treatment for opioid use in prison and jail settings: A meta-analysis and systematic review. Journal of Substance Abuse Treatment, 99, 32–43. https://doi.org/10.1016/j.jsat.2018.12.003

National Institute on Drug Abuse. (2023, February 9). Overdose Death Rates. Accessed on May 3^rd from https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates

Volkow, N. D., & Blanco, C. (2020). The changing opioid crisis: development, challenges and opportunities. Molecular Psychiatry, 26(1), 1–16. https://doi.org/10.1038/s41380-020-0661-4

 

Assignment

Purpose

The purpose of this assignment is to identify a practice problem idea and an evidence-based intervention to address the practice problem idea. Data management is essential to drive actions and decisions to improve healthcare outcomes. The content will support the formulation of a literature synthesis related to your practice problem idea, which supports professional formulation, communication, and dissemination skills relevant to the DNP-prepared nurse.

Instructions

In order to create flexible options, we are providing you options on this assignment. Concept maps are an effective way to express complex ideas, especially for visual learners. For this assignment, each of the following sections may be presented either as a narrative or concept map:

Practice Problem and PICOT Question

Evidence Synthesis of Literature

Data Driven Decision Making

 

 

Please note you are not required to complete any or all of the sections identified as conceptual maps. If you choose to use a concept map for a section, it should be created in Microsoft Word using Smart Art and placed in that section of the paper under the associated first level heading. The concept map must meet all the requirements outlined in the assignment rubric for each section. The rubric and page length are unchanged.

 

 

Concept Map Resources

 

ORDER A PLAGIARISM-FREE PAPER HERE

If you need additional information on concept maps and how to create a concept map in Microsoft Word, review the following resources:

Link (article): Effects of Web-Based Concept Mapping Education on Students’ Concept Mapping and Critical Thinking Skills: A Double-Blind, Randomized, Controlled StudyLinks to an external site.

Concept Map (2:48)

 

Additionally, review the conceptual maps section in the current APA manual.

The assignment should include the following components. Contact course faculty for questions.

Introduction
Develop a focused one-sentence purpose statement.

Explain the selected practice problem idea in general terms (cited).

Practice Problem and Question (Narrative or Conceptual Map)

Discuss the significance of the practice problem idea (cited).

Discuss the prevalence of the practice problem idea (cited).

Discuss the economic ramifications of the practice problem idea (cited).

Identify an evidence-based intervention to address the selected practice problem idea (cited).

Construct the practice problem PICOT in question format.

 

 

Evidence Synthesis of the Literature (Narrative or Conceptual Map)

Discuss the scope of evidence including databases searched and keywords.

Compare and contrast main points from the evidence integrated in a cohesive manner (cited).

Provide objective rationale for the evidence-based intervention to address the practice problem idea. (cited).

Data-Driven Decision-Making (Narrative or Conceptual Map)

Describe the source of the evidence (i.e., internal data to support the need for change at practicum site to improve outcomes and/or nursing practice. Example: incident reports, readmission rates, infection rates, etc.).

Identify how the use of information technologies potentially influence data capture, process improvement, evaluation, and patient outcomes related to your practice problem idea.

Conclusion (Write one concise paragraph.)

Summarize the impact of the practice problem idea.

Summarize the role of the evidence-based intervention to address the practice problem idea.

References

Identify and list four scholarly sources used in evidence synthesis on the reference pages.

Identify and list other scholarly sources used in the paper on the reference pages.

List scholarly sources in alphabetical order.

Use correct hanging-indent format.

 

 

Appendix: Summary Table of the Evidence

Attach the completed John Hopkins Nursing Evidence-Based Practice Individual Evidence Summary Tool.

Link (Word doc): John Hopkins Nursing Evidence-Based Practice Individual Evidence Summary ToolLinks to an external site.

Provide a minimum of four research studies.

Complete all sections completely for the four sources of evidence.

Identify both the quality and level of evidence for each scholarly source on the table.

Level I Headings for the Assignment

Practice Problem and Question

Evidence Synthesis of the Literature

Data-Driven Decision Making

Conclusion

References

Appendix: Summary Table of the Evidence

 

 

Writing Requirements (APA format)

Length: 6-8 pages (not including title page or references page)

1-inch margins

Double-spaced pages

12-point Times New Roman or 11-point Arial font

Headings & subheadings

In-text citations

Title page

Reference page

Standard English usage and mechanics

 

 

Graduate Re-Purpose Policy

The late assignment policy and the reuse repurpose policy (located in the student handbook) apply to this assignment.

 

Program Competencies

 

This assignment enables the student to meet the following program competencies:

Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)

Appraises current information systems and technologies to improve health care. (POs 6, 7)

Course Outcomes

This assignment enables the student to meet the following course outcomes:

 

Use information technology to collect and analyze data to generate evidence-based nursing practice across healthcare settings. (PC 4; PO 7)

Design programs that monitor and evaluate outcomes of care, care systems, and quality improvement. (PC 4; PO7)

Evaluate the types of healthcare information systems, knowledge-based systems, and patient care technology and the imp act on patient safety, quality of care, and outcome measurement. (PC 4; PO 7)

Resolve ethical and legal issues related to the use of information, communication networks, and information and patient care technology. (PCs 2, 4; PO 6)

Due Date

By 11:59 p.m. MT on Sunday

Late Assignment Policy applies

 

 

Rubric

 

W4 Assignment Grading Rubric

 

 

 

W4 Assignment Grading Rubric

 

Criteria Ratings Pts
This criterion is linked to a Learning OutcomeIntroduction

Requirements:

1. Develop a focused one-sentence purpose statement.

2. Explain the selected practice problem idea in general terms (cited).

 

10 pts

Includes all requirements and provides an excellent introduction.

 

9 pts

Includes fewer than all requirements and/or provides a very good introduction.

 

8 pts

Includes fewer than all requirements and/or provides a basic introduction.

 

0 pts

Includes 1 or fewer requirements and/or provides a poor introduction.

 

10 pts

ORDER A PLAGIARISM-FREE PAPER HERE

This criterion is linked to a Learning OutcomePractice Problem and Question (Narrative or Conceptual Map)

Requirements:

1. Discuss the significance of the practice problem idea (cited).

2. Discuss the prevalence of the practice problem idea (cited).

3. Discuss the economic ramifications of the practice problem idea (cited).

4. Identify an evidence-based intervention to address the selected practice problem idea (cited).

5. Construct the practice problem PICOT in question format.

70 pts

Includes all requirements and provides an excellent description of the practice problem and question.

 

63 pts

Includes fewer than all requirements and/or provides a very good description of the practice problem and question.

 

56 pts

Includes fewer than all requirements and/or provides a basic description of the practice problem and question.

 

0 pts

Includes fewer than all requirements and/or provides a poor description of the practice problem and question.

70 pts

This criterion is linked to a Learning OutcomeEvidence Synthesis of the Literature (Narrative or Conceptual Map)

Requirements:

1. Discuss the scope of evidence including databases searched and keywords.

2. Compare and contrast main points from the evidence integrated in a cohesive manner (cited).

3. Provide objective rationale for the evidence-based intervention to address the practice problem.

70 pts

Includes all requirements and provides an excellent evidence synthesis of the literature.

 

63 pts

Includes fewer than all requirements and/or provides a very good evidence synthesis of the literature.

 

56 pts

Includes fewer than all requirements and/or provides a basic evidence synthesis of the literature.

 

0 pts

Includes fewer than all requirements and/or provides a poor evidence synthesis of the literature.

70 pts

This criterion is linked to a Learning OutcomeData-Driven Decision-Making (Narrative or Conceptual Map)

Requirements:

1. Describe the source of the evidence (i.e., internal data to support the need for change at practicum site to improve outcomes and/or nursing practice. Example: incident reports, readmission rates, infection rates, etc.).

2. Identify how the use of information technologies potentially influence data capture, process improvement, evaluation, and patient outcomes related to your practice problem idea.

 

70 pts

Includes all requirements and provides an excellent summary of data-driven decision-making.

 

63 pts

Includes fewer than all requirements and/or provides a very good summary of data-driven decision-making.

 

56 pts

Includes fewer than all requirements and/or provides a basic summary of data-driven decision-making.

 

0 pts

Includes fewer than all requirements and/or provides a poor summary of data-driven decision-making.

70 pts

 

ORDER A PLAGIARISM-FREE PAPER HERE

This criterion is linked to a Learning OutcomeConclusion (1 concise paragraph)

Requirements:

1. Summarize the impact of the practice problem idea.

2. Summarize the role of the evidence-based intervention to address the practice problem idea.

 

10 pts

Includes all the requirements and provides an excellent conclusion.

 

9 pts

Includes fewer than all requirements and/or provides a very good conclusion.

 

8 pts

Includes fewer than all requirements and/or provides a basic conclusion.

 

0 pts

Includes fewer than all requirements and/or provides a poor conclusion.

 

10 pts

 

This criterion is linked to a Learning OutcomeReferences

Requirements

1. Identify and list four scholarly sources used in evidence synthesis on the reference pages.

2. Identify and list other scholarly sources used in the paper on the reference pages.

3. List scholarly sources in alphabetical order.

4. Use correct hanging-indent format.

 

20 pts

Includes all requirements and provides excellent references.

 

18 pts

Includes fewer than all requirements and/or provides very good references.

 

16 pts

Includes fewer than all requirements and/or provides basic references.

 

0 pts

Includes one or fewer requirements and/or provides poor references.

 

20 pts

 

This criterion is linked to a Learning OutcomeAPA Style and Organization for Scholarly Papers

Requirements:

1. Uses Level I headers.

2.References and citations are proper APA (current version).

3.Length of APA formatted paper is 6-8 pages (excluding title page and references).

 

15 pts

Includes all requirements and presents excellent APA style and organization.

 

14 pts

Includes fewer than all requirements and/or very good APA style and organization.

 

12 pts

Includes fewer than all requirements and/or provides basic APA style and organization.

 

0 pts

Includes one or fewer requirements and/or provides poor APA style and organization.

 

15 pts

 

This criterion is linked to a Learning OutcomeClarity of Writing

Requirements:

1. Use of standard English grammar and sentence structure.

2. No spelling errors or typographical errors.

 

15 pts

Includes all requirements and demonstrates excellent clarity of writing.

 

14 pts

Includes fewer than all requirements and/or demonstrates very good clarity of writing.

 

12 pts

Includes fewer than all requirements and/or demonstrates basic clarity of writing.

 

0 pts

Includes 1 or fewer requirements and/or demonstrates poor clarity of writing.

 

15 pts

 

This criterion is linked to a Learning OutcomeAppendix: Summary Table of the Evidence

Requirements:

1. Attach the completed John Hopkins Nursing Evidence-Based Practice Individual Evidence Summary Tool.

2. Provide a minimum of four research studies.

3. Complete all sections completely for the four sources of evidence.

4. Identify both the quality and level of evidence for each scholarly source on the table.

 

20 pts

Includes all requirements and provides an excellently completed summary tool.

 

18 pts

Includes fewer than all requirements and/or provides a very well completed summary tool.

 

16 pts

Includes fewer than all requirements and/or a basically completed summary tool.

 

0 pts

Includes no requirements and/or provides a poorly completed summary tool.

 

20 pts

 

 

Total Points: 300