531 Dis Re1

2-3 paragraphs and 2 sources. This is a reply explaining how the topic in this passage affects impacts your work setting and what (if anything) is being done to address the national healthcare issue/stressor. 


Employed at a mental health and chemical detox hospital in Phoenix, the writer witnesses the continuing struggles of healthcare providers making positive headway in reducing substance abuse in patients and in particular, the use of opioids. In 2017, an average of 141 people per day sought opioid-related services at Arizona hospitals (Arizona Department of Health Services, 2018). Deaths related to opioid use increased 76 percent in Arizona since 2013, a majority coming from fentanyl overdose (National Institute on Drug Abuse, 2019). This post will discuss the healthcare issue of substance abuse among the population and the workplace impact of caring for this patient subset. Moreover, the discussion will highlight implemented changes by the organization to help educate staff and reduce re-encounters from substance abuse patients.

  Addiction has a profound impact on society, from individuals battling drug dependence, to family members struggling with loved ones suffering from drug abuse, to healthcare personnel providing necessary care to help people through withdrawal and counseling. Illicit drugs are easily available in Arizona, particularly various types of Mexican heroin and fentanyl (Arizona Health Care Cost Containment System [AHCCCS], 2016). Also, the number of prescriptions for opioids has skyrocketed in Arizona. In 2015, providers gave opioid prescriptions totaling 570 million pills of controlled scheduled II-IV substances, or 90 pills for every person and child in Arizona (AHCCCS, 2016). Moreover, the continuing cycle of new or reoccurring patients seeking inpatient drug treatment leads to greater levels of anxiety, stress, and burnout among nursing staff (Homer et al., 2019).  

To address the level of repeat substance abuse patient encounters and employee morale, the writer’s organization has implemented several tactics for healthcare staff. First, doctors are highly encouraged to use non-addictive medications to help control pain and anxiety. Nurses at the writer’s employment are obligated to hand-write on a broadsheet each narcotic pulled from a narcotic medication drawer. At times early on in the writer’s employment, nurses pulled upwards of 80 narcotics a day for a 36-person unit, not all of whom sought drug treatment. Now, the number of prescribed narcotics has dropped dramatically. Moreover, psychiatrists have been provided education on evidence-based guidelines to safely wean patients off substances such as Subutex and Ativan for opioid and alcohol withdrawal respectively. Also, hospital administrators provide ongoing education about substance abuse, the physical and chemical changes occurring from continued substance abuse, and the use of suggested terminology. The goals are to limit the stigma associated with drug addiction, medically treat substance abuse patients fairly and appropriately, minimize burnout and stress from staff, and share substance abuse information with the community.

To help substance abuse patients after discharge and avoid rapid readmission, the writer’s employment has implemented specific teaching protocols to encourage patients to download smartphone applications to help curtail the use of drugs and alcohol. For example, for people wanting to avoid alcohol, nurses provide education to patients about free or low-cost apps such as I Am Sober, SoberTool, and Nomo. These applications are designed to help motivate people to stay sober through inspirational messages, chat rooms, and online learning tools. Also, for patients with opiate addictions, smartphone applications such as Addicaid and Squirrel Smart Recovery may offer help by using behavioral therapy techniques, daily registrations, and a patient’s social contacts to overcome cravings and draw-in more support. While the writer’s organization has implemented education about smartphone app usage, the evidence is still murky about the effectiveness of smartphone apps for patients with drug addictions. Indeed, Tofighi et al. (2019) suggest many free or low-cost smartphone applications designed to help drug and alcohol abusers encouraged the activity from which the app was designed to limit.  

Reducing substance addictions in the community is a monumental challenge for healthcare providers. The writer’s organization has implemented protocols designed to discourage and limit narcotic dispensing, educate staff and patients about substance use disorders, and teach ways to encourage prevention techniques while avoiding the stigmatization of patients. More resources need to be implemented to help improve patient outcomes, such as tailored, patient-driven discharge planning, coordinated follow-up care, and partnerships between hospitals and outpatient drug treatment services. Individuals discharged from inpatient care must receive continual support to help ensure success for the patient’s substance recovery.

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