Question

Please write a Policy Brief and a White Paper over a specific policy on the topic of Opioid overdoses (it can be whatever policy you choose on the subject but be specific). The papers must hace; Executive Summary, Problem Statement, Identifiy Different Stakeholders, 4 Policy Recommendations/solutions INCLUDING the first solution that is yout 'pie in the sky' dream solution.

Answer 1

Prescription opioids (e.g., oxycodone, hydrocodone, methadone) are used to treat moderate to severe pain, and can provide effective pain management when prescribed and taken as directed. However, prescription opioids can also be misused and lead to addiction, death, job loss and a host of other problems, taking a significant human and financial toll on individuals, families, communities and states.

State lawmakers are crafting innovative policies—engaging health, criminal justice, human services and other sectors—to address this public health crisis while also ensuring appropriate access to pain management. This report provides an overview of state legislation setting guidelines for, or limits on, opioid prescriptions.

• Background
• State Action
• Table: Legislation

The opioid epidemic is fueled by misuse of prescription and illicit opioids (e.g., heroin and fentanyl). Research indicates that the majority of illicit users first misused prescription opioids. According to the Centers for Disease Control and Prevention (CDC), there has been a significant increase in opioid prescriptions for pain since 1999, while the amount of pain that Americans report has not changed much overall. While new research found that the amount of opioids prescribed decreased between 2010 and 2015, it remains about three times higher than in 1999.

In response to the epidemic, the CDC released the “Guideline for Prescribing Opioids for Chronic Pain” in March 2016. The guideline offers primary care providers a set of voluntary, evidence-based recommendations for prescribing opioids to patients 18 years or older in primary care settings. It focuses on chronic pain treatment, and does not apply to patients in active cancer treatment, palliative care or end-of-life care. The recommendations are based on existing scientific evidence. For example, higher doses of opioids are associated with higher risk of overdose and death. Even relatively low dosages—considered to be 20 to 50 morphine milligram equivalents (MME) per day—increase risk. As such, the guideline recommends starting with the lowest effective dosage, and carefully considering dosages above 50 or 90 MMEs per day. For treating acute pain, the guideline recommends a quantity no greater than what is needed for the expected duration of pain severe enough to require opioids, specifying that three days or less will often be sufficient and more than seven days will rarely be needed.

Using opioids to treat acute pain can lead to long-term use. The likelihood of long-term use increases based on the length of the initial prescription, according to the CDC. In fact, the likelihood of long-term use increases sharply after the third and fifth days of taking a prescription, and spikes again after the 31st day. According to the CDC, long- term use also increases with a second prescription or refill, a 700 morphine milligram equivalents (MME) cumulative dose, and an initial 10- or 30-day supply.

Improving prescribing practices and the way pain is treated is one avenue to help prevent misuse, addiction and overdose, while ensuring legitimate access to pain management. In recent years, a number of states have enacted policies related to prescribing opioids, some of which align with certain recommendations in the CDC Guideline.