Bureaucratic Injection: Government in Hoosier Medicine

Opioids on Campuses

College is where to specialize your skillset to compete in this globalized market. Unfortunately, the reputations of United States colleges are being disturbed by the opioid crisis. Young adults are more likely to overdose now than in any recorded time. This graph shows the number of opioid-related overdose deaths in Indiana from 1999-2016. In 2016, there were 794 opioid-related overdose deaths: 304 involved synthetic opioids, 297 involved heroin, and 262 involved prescription opioids. Categories are not mutually exclusive because deaths may involve more than one drug.] In 2017, Indiana ranked thirteenth state for drug overdose death rate and its neighboring states: West Virginia, Ohio, Pennsylvania, and Kentucky, were ranked first to fourth respectively in the same list (Center for Disease Control and Prevention, para 2). According to the National Institute on Drug Abuse (NIDA), the Midwestern region saw a 70% incline in overdoses from July 2016 through September 2017 (2018, para 3). To combat the crisis, Hoosiers and institutions need to be informed to make better decisions and become part of the solution. My research is to motivate Indiana’s state government to inform its Hoosiers of the patient’s three R’s, alternative pain treatments, and institution of grants for combating the crisis.

The Jewels in the Crown

Opioid addiction has always existed. The 1990’s is where occurred the real footwork. Pharmaceutical companies were putting more opioids in their painkillers for a quicker, more potent, and longer-lasting effect (National Institute on Drug Abuse, 2019, para 2). They had convinced physicians in chronic pain management that their patients would not become addicted to their new formula. The subsequent boom in prescriptions was the boom in patients wanting more of what their doctors were promised they would not become addicted. In an interview, registered nurse Kenneth G. Stavitzke, stated that medically incompetent people in charge of chronic pain management.

The problem also stems from the people suffering chronic pain. The path of least resistance is what most people prefer. Prescribed opioids come as easy-to-swallow pills that have quick results, and do not requiring long-term commitment. It is why exercise and physical therapy are underutilized and regarded with derision.

Being a college student today has its problems. Balancing assignments, extracurriculars, internships, and having a job will certainly create anxiety and headaches. “Unique invulnerability” is when an individual thinks they will succeed where others have failed. This is prevalent in young adults which is why they tend to experiment with substances, not thinking they will become addicted junkies.

Not Prescribing the Last Resort

To begin, Indiana state government needs to inform Hoosiers of clinically-proven alternatives to opioids. It needs to pass legislation that requires doctors to recommend physical therapies first before prescribing opioids. Doctors get cash from the pharmaceutical company they prescribe medicine from (Ornstein et al. para 1). The American Academy of Family Physicians deems acupuncture as relatively cheaper than prescription opioids and is less likely to become addicted to (2019, para. 13). A once-in-a-week appointment may be a lot more time-consuming than swallowing pills every morning. However, alternatives like exercise programs, acupuncture, deep-muscle massage and hot tubs could make one look forward to something and meet new people. A study concluded that people are indeed happier spending money on experiences than objects. Indiana should sponsor these alternatives with tax deductibles and subsidies.

Indiana should pass legislation requiring patients watch an informercial from the Allied Against Opioid Abuse (AAOA). Their mission is to educate the nation, bring about awareness help prevent the abuse and misuse of opioid prescriptions. This act will be force people who still choose to take prescription opioids and to ensure they know the three R’s. First to be known is you rights as a patient. You have the right to ask your doctor how your prescription is being filled and if it is “weak” or “strong” (AAFP, 2019, para 2). The American Academy of Family Physicians split opioids as “weak” opioids such as tramadol, codeine, and pentazocine are easier to find than “strong” opioids like morphine, oxycodone and fentanyl (2019, para 2). The next thing to make sure the patients know of are the risks of dependence, addiction, overdose from prolonged use without planning to transition to a better alternative. Finally, their responsibility of taking opioids by storing their prescription opioids in a secure place and then safely disposing of any used medication. (AAOA, 2019, para 5).

Grants

Finally, Indiana needs to better inform its institutions of grants against the opioid crisis. President Trump’s administration has been taking great strides against the opioid crisis (White House, 2019, para 1). Indiana’s state government needs to follow suit and continue offering grants to colleges that are showing efforts in opioid counseling and education. In 2018, the Substance Abuse and Mental Health Services (SAMHSA) offered $930 million for states that combatted the opioid crisis (U.S. Department of Health & Human Services, para. 1) President Trump has garnered $1.5 billion for state opioid response grants as part of the State Opioid Response campaign. The administration is informing citizens of the dangers of opioid misuse and is working to curb over-prescription.

The reason why institutions will not pursue opioid-crisis grants is because of their reputation. For example, if Purdue Northwest received a grant for opening a counseling clinic, then the publics will conclude that there is an opioid problem on the campus. Hesitant parents will not let their children apply to their institution and the school will go under. Less students will pay for dorms because college students have been found overdosed in their dorms where they are privately alone to get high.

According to Christopher Freedman, community recovery supervisor at the College of New Jersey, “college were able to sweep it under the carpet better” (Field, 2018, para. 8). It’s no surprise that fraternities, alcohol is used to lighten the mood for parities and marijuana does less damage than alcohol and students are only drug checked if they wish to join an extracurricular like sports. Also, denial is common among college that there is a drug problem. According to registered nurse, Kenneth Stavitzke, drug addicts deny having a problem which is a common trait for people who do not want to be in the spotlight of an intervention.

President Donald Trump endorsed the U.S. Department of Health & Human Services’ five-pronged Opioid Strategy. HHS has invested over $4 billion in opioid specific funding to support treatment and recovery services, availability of overdose-reversing drugs, train first responders. (U.S. Department of Health & Human Services, 2018, para 5) Trump’s administration partnerships with the truth initiative and ad council, “58% of young americans and 1.4 billion viewers have seen ads highlighting dangers of opioids. (White House, 2018, para 3). Indiana needs to take advantage and gets some grants headed our way. Indiana could claw back the money the opioid crisis has costed in rehabilitation, hospitalization, prison for crimes to steal opioids, and foster care for children with parents of addiction.

The problem with the opioid epidemic towards college campuses are, according to Christopher Freedman, community recovery supervisor at the College of New Jersey, “Before opioids, college were able to sweep it under the carpet better.” It’s no surprise that fraternities, alcohol is used to lighten the mood for parities and marijuana does less damage than alcohol and students are only drug checked if they wish to join an extracurricular like sports.

Conclusion

To conclude, Indiana’s state government needs to better inform Hoosiers and institutions of becoming the solution. The government cannot rely on the citizens to inform themselves to make ration decisions. It is similar to the problem of uninformed voters having power over who gets elected. The medical field does not care. They just care about money. By preventing opioids from falling in the wrong hands, the crime to get the money to get more opioids will go down. Registered nurse, Kenneth G. Stavitzke stated that addicts do crimes to get money to feel better.

References

1. Allied Against Opioid Abuse. (2019). Education can help prevent prescription opioid misuse. Retrieved from https://againstopioidabuse.org/learn/
2. American Academy of Family Physicians. (2019 February). Study: fp’s who learn acupuncture prescribe fewer opioids. Retrieved from https://www.aafp.org/news/health-of-the public/20190221acupuncture-opioids.html
3. American Society of Anesthesiologists. (2018). Non-opioid treatment. Retrieved from https://www.asahq.org/whensecondscount/pain-management/non-opioid-treatment/
4. Field, Kelly. (2018 September). A new challenge for colleges: opioid-addicted students. Retrieved from https://hechingerreport.org/a-new-challenge-for-colleges-opioid-addicted students/
5. Centers for Disease Control and Prevention. (2018, April). National center for health statistics. [Web page]. Retrieved from https://www.cdc.gov/nchs/pressroom/states/indiana/indiana.htm
6. National Institute on Drug Abuse. (2019, January). Opioid overdose crisis. [Web page].
7. Retrieved from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis
8. Opioid Overdoses Treated in Emergency Departments (2018, March 16). In Centers for disease control and Prevention. Retrieved from https://www.cdc.gov/mmwr/volumes/67/wr/mm6709e1.htm
9. Opiod Overdose Crisis (2019, January). In National Institute on Drug Abuse. Retrieved from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis
10. Ornstein, Charles., Tigas Mike., Grochowski Jones, Ryan. (2016 March). Now there’s proof: docs who get company cash tend to prescribe more brand-name meds. Retrieved from https://www.propublica.org/article/doctors-who-take-company-cash-tend-to-prescribe more-brand-name-drugs
11. U.S. Department of Health & Human Services (2018 June). SAMSHA announces $930 million funding opportunity to combat the opioid crisis. Retrieved from https://www.hhs.gov/about/news/2018/06/15/samhsa-announces-930-million-funding opportunity-to-combat-opioid-crisis.html
12. White House. (2019 March). President Donald j. Trump’s fight against the opioid epidemic continues to help Americans around the country. Retrieved from https://www.whitehouse.gov/briefings-statements/president-donald-j-trumps-fight - opioid-epidemic-continues-help-americans-around-country/

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