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Melissa HinkhouseThe opioid crisis is a public health crisis that has been increasing and devastating lives for many years. Working as a Mental Health Registered Nurse I have seen many patients battle with addiction for one reason or another. Pharmacy companies told providers that pain relievers were not addictive, prescribers then prescribed them thinking they were safe and helping patients with pain. It was a sad when we learned, these medications had devastating consequences. I currently work both inpatient and outpatient and many of the life challenges don’t just end with the actual addiction.According to The White House’s web page president trump declared the opioid crisis a public health emergency in October 2017. President Trumps plan is as follows: “Part 1 is reducing demand and over-prescription, including educating Americans about the dangers of opioid misuse. Part 2 is cutting down on the supply of illicit drugs by cracking down on the international and domestic drug supply chains that devastate American communities. Part 3 is helping those struggling with addiction through evidence-based treatment and recovery support services (The White House). I work for a Grant part time called RCORP, we have been assessing the needs of the Western Upper Peninsula for Opioid addiction services availability. We just completed phase one, the need’s assessment. This grant is funding by an organization. I mention this because though some of the prescribing laws have changed, why is a private organization having to fund this grant I work for. Why is the government not assisting in analyzation of rural access to treatment for opioid addiction treatment? I feel as though that is something Trump could assist in implanting. In the UP we have very few inpatient treatment facilities. We have two mental health inpatient facilities for short term hospitalizations. The shortage and access to care is simply not enough.President Obama initiated the grant program for at HHS for Medication-assisted treatment (MAT) which began in 2015 with 11 states receiving a total of $12 million. More states were added in fiscal 2016 and 2017; the 2017 pot is $26 million, and five new states will be added (Barlas, 2017). At the very end of President Obama’s tenure in 2016, Congress passed the 21st Century Cures Act, which allocated $1 billion over two years to enhance states’ response to the epidemic. The Cures Act set up a new grant program within the HHS called the State Targeted Response (STR) to the Opioid Crisis Grants. A little less than $500 million in new money in both fiscal 2017 and fiscal 2018, over and above $53 million in opioid grants from HHS in fiscal 2016, will be distributed to all states and territories based on the degree of their opioid addiction problem. The grants will provide support to states for increasing access to treatment, reducing unmet treatment need, and reducing opioid-related overdose deaths (Barlas,2017). I would have made it mandatory that all MAT patient must also see a LMSW for counseling on a regular basis to receive services. I am a firm believer that cognitive therapy assists the MAT process for better outcomes.During Presidents Bush’s term prescription drug abuse was still a concern, with Oxycontin being the primary medication of choice. The drug epidemic was more adolescent focused. President Bush issued The National Drug Control Strategy in 2006, the goal of the strategy is to reduce drug us. His plan had three chapters, each build on the previous: “The first chapter, Stopping Drug Use Before It Starts, outlines the Administration’s work to prevent the initia­tion of drug use. The second chapter, Healing America’s Drug Users, high­lights initiatives that treat drug users. The third chapter, Disrupting Drug Markets, outlines the Administration’s work at home and abroad to disrupt the availability of illicit drugs, through source country efforts, interdiction programs, and investigative operations. (The White House, 2006). Bush’s plan focused on the largest city, I understands funds are limited and large cities are often the gateway but being from a rural community I feel as though the drug issues we have are high. I would have asked he have small task forces for rural communities that branch of from his large city plan.The opioid crisis did not occur overnight; it will not be corrected overnight. But with excellent leadership, we can improve access to care and beginning offering people the services they need when they are ready to utilize them.References:Barlas, S. (2017, September). U.S. and States Ramp Up Response to Opioid Crisis: Regulatory, Legislative, and Legal Tools Brought to Bear. P & T: a peer-reviewed journal for formulary management. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5565130/.The United States Government. Ending America’s Opioid Crisis. The White House. https://www.whitehouse.gov/opioids/.The White House (2006). Office of National Drug Control PolicyWashington,D.C.20503National Drug Control Strategy. Retrieved June 1, 2020, 2006, from: https://www.justice.gov/archive/olp/pdf/ndcs06.pdf.Cindy Salbino RE: Discussion – Week 1Discussion Board Post Wk1Cindy SalbinoI come from an area in California that has a high drug addiction rate. We see patients come in on a nightly basis that are struggling with an addiction to some form of drug. Some are street drugs and some are prescription medication. It’s clear that there is a never ending battle with opioids in our country.George W. Bush announced on February 12, 2002 that his plan was to reduce the limitations of the supply of drug, by reducing the demand available to addicts and provide them with drug treatments that are compassionate and effective. Both of these steps are to be handled together and funded with a submitted budget to Congress of $19 billion to fight the war on drugs.  He then started an organization called Parents Drug Corps and called on parents across the nation to do their job by being responsible, tell their children they are loved and of course, not to do drugs (U.S. Dept. of State Archives, 2002).  I absolutely agree with this strategy.  The fight starts at home. If our children had the family structure that it was intended to be, our country wouldn’t be faced with the incredible situation we are in now. George W. Bush is a God fearing man who has strong family ties and he absolutely believed the solution starts at home.When Barack Obama came along, opioid addiction was a national emergency already and despite the security of a solid funding plan, he enacted the Comprehensive Addiction and Recovery Act of 2016.  This act increased naloxone’s availability, set up a medication prescription monitoring and tracking drug diversion program and also helped with teens and adults prevention and education needs (Arlotta, CJ, 2016,para 4).  The bill often referred to as CARA, didn’t hold well with groups such as the Coalition to Stop Opioid Overdose, because regarding funding, they believed that the bill didn’t go far enough.  It authorized $181 million in funding, yet Obama asked for more than $1 billion in funding (Arlotta, CJ, 2016, para 6). I personally think that while he may have had good intentions, it was a ‘too little, too late’ effort on his part. While I may have that opinion, I don’t know what I would have done differently since I do not have the skill set or the advisors that a president has access too. He may have done what he thought was the best move with the information he had available to him. Unfortunately for him, “the worst of the epidemic happened on his watch, with deaths rising 71% a year from 2013-2017 when it claimed 130 lives each day” (Dinan, S., 2019).Donald Trump became president in 2017 and immediately began his initiative on drugs. His administration secured new funding in the amount of $6 billion over the next two years in order to fight drug abuse from opioids. It will also diminish or end the flow of drugs across the borders and within our own communities. His plan to increase education and awareness will reduce the drug demand with the help of more education. With the help of evidence-based treatments, and greater opportunities, the plan intends to save lives negatively affected by opioid addiction (President Bush announces drug control strategy, 2018)   Alex Azar, the secretary of the US Department of Health and Human Services was quoted saying “Thanks to President Trump’s leadership and the hard work of so many Americans in local communities, Our country is seeing the first drop in overdose deaths in more than two decades, and lives are being saved” (HHS.gov, 2019). I agree with President Trump’s aggressive action against drug abuse. If you work your way slowly, it will have no effect. However if you obtain your target and go for it, you will have a better success rate at knocking out your objective.Everyone knows that this isn’t a quick fix and will take years and even decades before we can say we have won the war on drug abuse. I believe that everything the past presidency’s have done, have done them with the Americans at heart and every bit plays a part in our future success against drugs.References:President Bush announces drug control strategy (February 12, 2002).  U.S. Department of State Archive. Retrieved from https://2001-2009.state.gov/p/inl/rls/rm/8451.htmArlotta, CJ (2016, July 23). Obama signs opioid legislation, despite funding concerns. Forbes magazine. Retrieved from https://www.forbes.com/sites/djarlotta/2016/07/23/Obama-signs-opioid=legislation-despite-funding-concerns/#3e7e5cae6806Dinan, S. (2019, October). Washington Times.  Retrieved from https://www.washingtontimes.com/news/2019/oct/1/Obama-administration-bungled-opioid-crisis-respons/President Donald J. Trump’s initiative to stop opioid abuse and reduce drug supply and demand (2018). Retrieved from https://www.whitehouse.gove/briefings-statements/president-donald-j-trump-initiative-stop-opioid-abuse-reduce-drug-supply-deman-2/Trump administration announces $1.8 billion in funding to states to continue combating opioid crisis (2019, September 11). HHS.gov. Retrieved from https://www.hhs.gov/about/news/2019/09/04/trump-administration-annunces-1-8-billion-funding-states-combating-opioid.html

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