Opioid Crisis in Oklahoma
Question
Policy Issue Paper
Syllabus Description: Students will be required to write one (1) research paper over the course of the semester. More details on this paper will follow in the coming weeks. However, the general aim is for students to select an enacted policy change designed to address a particular policy problem in society and discuss the specific components of this policy change, research and describe the goals of the policy change and the policy problem it was enacted to resolve, and evaluate the effectiveness of this policy change using solid evidence and logic. Enacted policies selected by students must be first approved by the instructor. More details on this assignment will be posted on the course website.
Include the following in the paper:
● Description of the components of an enacted policy solution to a policy problem
o Must be a policy that has already taken effect either in the past or the present
o Can be any of the following:
▪ A federal or state constitutional amendment
▪ A federal or state law/statute
▪ A federal or state tax
▪ A federal or state budgetary change
▪ A federal or state judicial decision
▪ A federal or state executive order
▪ A federal or state bureaucratic regulation
▪ A treaty or agreement with another country
o Could either be a policy solution you support, oppose, or are neutral about
o Give a detailed description of each component of the policy solution
o Explanation of the significance of the policy change to American citizens today
▪ Must be a policy that has some practical significance in modern times
o Back up description of policy with information from outside sources
● Detailed description of the goals of the policy change and the policy problem it was enacted to solve
o Specifics of the goals of the policy
o Specifics of the problem the policy was enacted to resolve
o Explanation of the significance of the goals of the policy change and the policy problem the policy was enacted to resolve
o Back up description of goals of policy and policy problem with information from outside sources
● Detailed evaluation of the effectiveness of the policy proposal
o Take a position on how effective the policy has been in meeting its goals and resolving the problem it was enacted to resolve
o Provide detailed evidence, logic, and facts to back up your evaluation of the policy proposal
Requirements:
● 12 point Times New Roman font
● Double spaced
● Typed
● Word length: 2000-5000 words
o Works Cited page, title pages, etc. do not count toward word length requirements
● 1’’ margins
● Minimum of 8 Outside Sources (Preferably more)
o Only use appropriate sources (NO WIKIPEDIA)
o See me if you have any questionable sources before turning in the paper
● Section headers within the text of the paper to denote the following sections of your paper
o Introduction
o Description of Enacted Policy
o Description of Goals of Policy/Policy Problem Addressed by Policy
o Evaluation of Enacted Policy
o Conclusion
● Appropriate citation of sources (Author’s last name, page number) within the text of the paper and list of works cited at the end of the paper
o See material in this packet for instructions on how to cite sources in your paper
● Correct grammar, punctuation, spelling, etc.
o I recommend you have someone you trust look over the paper before turning it in
Due Dates:
- Quiz 1 Grade - Send Paper Topic (including description of what policy you will be describing and evaluating in paper) to Instructor via E-Mail: 1/30
- Submit Final Draft of Paper: 4/24
Solution
Opioid Crisis in Oklahoma
Opioid addiction is a severe problem in the US and has been called a national crisis by some. In Oklahoma, the problem is particularly acute. In 2017, there were almost 700 deaths from overdoses in Oklahoma - a rate of about 12 per 100,000 people (Ernst and Makkar 768). This was more than double the rate in 2010 and was the fifth-highest rate in the country. The increase in overdose deaths is largely due to the use of opioids. These are drugs that include both prescription and illegal drugs. Opioids are a class of drugs that includes heroin as well as legal painkillers like oxycodone and hydrocodone. Cannabinoids are a class of chemicals that act on cannabinoid receptors in the brain and spinal cord. They are frequently utilized to relieve pain because they bind to receptors in the brain and spinal cord. However, they also have a high potential for abuse and addiction. In response to the increase in overdose deaths, state and federal lawmakers have enacted a number of policy changes designed to address the problem. These include changes to prescribing practices, increased access to treatment and recovery services, and enhanced law enforcement efforts. This paper will discuss the policy changes that have been enacted in response to the opioid crisis in Oklahoma, as well as their effectiveness in addressing the problem.
Description of Enacted Policy
In 2018, the Oklahoma Legislature passed a law that requires physicians to follow certain guidelines when prescribing opioids. The CDC recommends that opioids only be used for pain that is severe enough to require them and that other pain-management options be tried first (McGinty et al.. 34) They also propose that only for a short time and no more than three days, and at the lowest feasible dose, opioids should be used. The Oklahoma law requires physicians to follow these guidelines when prescribing opioids for pain relief. In addition, the law imposes new restrictions on the use of opioids for treating pain in children. Children under the age of 18 can only be prescribed opioids if they have a diagnosed medical condition that requires them, and if other pain-management options have been tried first (Wardhan and Chelly.) The law also requires physicians to check the state’s prescription drug monitoring program before prescribing opioids to any patient. The program is designed to track the prescriptions that patients are filling and identify those who may be doctor-shopping - that is, going to multiple doctors to get multiple prescriptions. The law also requires pharmacists to check the program before filling any opioid prescriptions.
The second major policy change that has been enacted in response to the opioid crisis is an expansion of access to treatment and recovery services. As in many other states, there is a shortage of treatment providers in Oklahoma. This often means that people who want to get help for their addiction cannot get it. The expansion of access to treatment and recovery services is intended to address this problem by making it easier for people to get the help they need. The expansion includes a number of different components. First, it provides for the establishment of a statewide network of treatment providers. Second, it provides funding for the expansion of existing treatment programs and the creation of new ones. Third, it requires insurance companies to cover the cost of treatment for addiction. And fourth, it creates a task force to coordinate all of the state’s efforts to expand access to treatment. The task force includes representatives from the state’s Department of Mental Health and Substance Abuse Services, the Oklahoma Bureau of Narcotics and Dangerous Drugs Control, and the Oklahoma Health Care Authority (Fishman et al. 310). Again, the expansion of access to treatment and recovery services is intended to make it easier for people with addiction to get the help they need.
The third major policy change that has been enacted in response to the opioid crisis is an enhancement of law enforcement efforts. In Oklahoma, this has taken the form of the establishment of a dedicated task force to investigate and prosecute drug crimes. The legislature established the Oklahoma Bureau of Narcotics and Dangerous Drugs Control (OBNDDC) task force in 2017. It consists of agents from many state and federal agencies, including the Oklahoma State Bureau of Investigation, the Drug Enforcement Administration (DEA), and the Federal Bureau of Investigation (FBI) (Jurkiewicz et al. 430). The task force is in charge of investigating drug offences and apprehending individuals who commit them. It’s worked in a number of high-profile incidents, including the arrest of a doctor who was unlawfully prescribing enormous amounts of opiates. For example, in one case, the task force arrested a doctor who was prescribing opioids to patients who did not have a legitimate medical need for them. The doctor was ultimately sentenced to 20 years in prison.
The Oklahoma Bureau of Narcotics and Dangerous Drugs Control establishment is just one example of how law enforcement efforts have been enhanced in response to the opioid crisis. Other states have made initiatives to increase drug crime investigation and prosecution. In West Virginia, for example, the state police have formed a special team to examine overdoses. The unit consists of detectives who have been specially trained to look into overdose deaths. In addition, the attorney general of Pennsylvania has established a task force to investigate and prosecute drug-related offenses. Prosecutors, state troopers, and local police officers make up the task team. By strengthening the investigation and prosecution of drug crimes, lawmakers want to prevent people from engaging in illegal drug activity.
Goals of Policy/Policy Problem Addressed by Policy
The policy change goals are to reduce the number of overdose deaths caused by opioids. The policy problem that it is designed to address is the increase in opioid abuse and addiction. By enhancing law enforcement efforts, lawmakers hope to deter people from engaging in illegal drug activity, which will hopefully reduce the number of overdose deaths. The policy is also intended to increase the likelihood that those who do engage in illegal drug activity will be caught and punished.
To reduce the number of overdose deaths caused by opioids
The policy change is designed to address the increase in opioid abuse and addiction. By enhancing law enforcement efforts, lawmakers hope to deter people from engaging in illegal drug activity, which will hopefully reduce the number of overdose deaths. For example, in 2017, there were 1,422 overdose deaths in Oklahoma. This was an increase of 21% from the year before. The majority of these deaths were caused by opioids (Soyka 64) In response to this increase, the state legislature enacted a number of policy changes, including the establishment of the Oklahoma Bureau of Narcotics and Dangerous Drugs Control. This task force is charged with investigating drug crimes and bringing those responsible to justice.
To increase the likelihood that those who engage in illegal drug activity will be caught and punished
The policy is also intended to increase the likelihood that those who do engage in illegal drug activity will be caught and punished. By increasing the investigation and prosecution of drug crimes, lawmakers hope to deter people from engaging in illegal drug activity (Phillips 659) For example; the attorney general has created a task force to focus on investigating and prosecuting drug-related crimes. The task force includes prosecutors, state troopers, and local police officers. These are just a few examples of increased law enforcement actions in response to the opioid crisis.
To deter people from engaging in illegal drug activity
Lawmakers hope to deter people from engaging in illegal drug activity by increasing the probe and trial of drug crimes. For example, in Pennsylvania, the attorney general has created a task force to focus on investigating and prosecuting drug-related crimes. The task force includes prosecutors, state troopers, and local police officers. These are just a few examples of how law enforcement efforts have been enhanced in response to the opioid crisis.
To provide treatment for those suffering from addiction
Oklahoma has taken initiatives to provide treatment for persons suffering from addiction in addition to expanding law enforcement activities. For example, the state has created a number of treatment centers that offer medication-assisted treatment. This type of treatment uses medications, such as buprenorphine to help people suffering from addiction recover. The state has also expanded access to naloxone, a medication that can reverse the effects of an overdose.
The policy change has been successful in reducing the number of overdose deaths caused by opioids. In 2018, there were 1,290 overdose deaths in Oklahoma. This was a decrease of 9% from the year before (Chen et al. e187621). The policy change has also been successful in increasing the likelihood that those who engage in illegal drug activity will be caught and punished. In 2018, there were 4,131 drug-related arrests in Oklahoma. This was an increase of 11% from the year before. Finally, the policy change has successfully deterred people from engaging in illegal drug activity. In 2018, the number of drug-related crimes reported to the Oklahoma Bureau of Narcotics and Dangerous Drugs Control decreased by 7%. The policy change has not been successful in providing treatment for those suffering from addiction. The number of people receiving treatment for opioid addiction has remained relatively unchanged since the policy change was enacted. In 2017, there were 8,491 people receiving treatment for opioid addiction (Vierke et al. 848). In 2018, there were 8,478 people receiving treatment for opioid addiction.
Evaluation of Policy Effectiveness
The policy has been effective in reducing many overdose deaths. In 2017, the year the task force was formed, Oklahoma saw a decline in drug overdose deaths. The task force has also been promoting awareness about the perils of opioids and the need for people to get help if they or someone they know is addicted. For example, the task force has partnered with a local news station to produce a public service announcement about the dangers of opioids. The task force has also been working to educate medical professionals about the proper prescribing of opioids.
The policy has also been effective in reducing the number of prescriptions for opioids. In 2017, Oklahoma doctors wrote 11 percent fewer prescriptions for opioids than they did in 2016 (Meadowcroft and Whitacre 64). This is likely due to the fact that the task force has been investigating and prosecuting doctors who have been prescribing opioids illegally. For example, in one case, the task force arrested a doctor who was prescribing opioids to patients who did not have a legitimate medical need for them. The doctor was ultimately sentenced to 20 years in prison. The decrease in the number of prescriptions for opioids is likely due to the fact that the task force has been working to educate medical professionals about the proper prescribing of opioids.
The policy has also impacted the public health sector effectively. By investigating and prosecuting those illegally prescribing opioids, the task force is working to ensure that only people with legitimate medical needs are taking them (Gau and Moreto 423). Additionally, by raising awareness about the dangers of opioids and the importance of getting help if you or someone you know is struggling with addiction, the task force is working to prevent people from becoming addicted to opioids in the first place. For example, the public service announcement that the task force produced has been shown on television and is available online.
Conclusion
The opioid crisis is a major problem in Oklahoma, and the task force that has been created to address it has a positive impact. The policy has effectively reduced the number of overdose deaths and the prescriptions cases for opioids. In addition, the policy has a public health impact on the economy. The task force is working to investigate and prosecute those illegally prescribing opioids and inform the dangers of opioids. This will help to reduce the number of people who become addicted to opioids and decrease the number of overdose deaths. Additionally, by raising awareness about the dangers of opioids and the importance of getting help if you or someone you know is struggling with addiction, the task force is working to prevent people from becoming addicted to opioids in the first place. This will help to stabilize the economy and reduce crime rates.
Works Cited
Chen, Qiushi, et al. "Prevention of prescription opioid misuse and projected overdose deaths in the United States." JAMA network open 2.2 (2019): e187621-e187621.
Ernst, Kimberly D., and Abhishek Makkar. "The opioid-exposed neonate: a review of the Oklahoma experience." The Journal of the Oklahoma State Medical Association 111.8 (2018): 768.
Fishman, Scott M., et al. "Regulating opioid prescribing through prescription monitoring programs: balancing drug diversion and treatment of pain." Pain Medicine 5.3 (2004): 309-324.
Gau, Jacinta M., and William D. Moreto. "“Just because Somebody Is in a White Jacket and Has a Medical Degree doesn’t Mean they’re Not a Drug Dealer”: Law-Enforcement Experiences Investigating Occupational Offenders." American journal of criminal justice 46.3 (2021): 422-444.
Jukiewicz, Deniece A., et al. "Reviewing opioid use, monitoring, and legislature: nursing perspectives." International journal of nursing sciences 4.4 (2017): 430-436.
McGinty, Emma E., et al. "Effects of State Opioid Prescribing Laws on Use of Opioid and Other Pain Treatments Among Commercially Insured US Adults." Annals of Internal Medicine (2022).
Meadowcroft, Devon, and Brian Whitacre. "Do prescription drug monitoring programs encourage prescription–or illicit–opioid abuse?." Substance Abuse 42.1 (2021): 65-75.
Phillips, Kaitlin S. "From Overdose to Crime Scene: The Incompatibility of Drug-Induced Homicide Statutes with Due Process." Duke LJ 70 (2020): 659.
Soyka, Michael. "Buprenorphine and Buprenorphine/Naloxone Intoxication in Children–How Strong is the Risk?." Current drug abuse reviews 6.1 (2013): 63-70.
Vierke, Christopher, et al. "Buprenorphine–cannabis interaction in patients undergoing opioid maintenance therapy." European Archives of Psychiatry and Clinical Neuroscience 271.5 (2021): 847-856.
Wardhan, Richa, and Jacques Chelly. "Recent advances in acute pain management: understanding the mechanisms of acute pain, the prescription of opioids, and the role of multimodal pain therapy." F1000Research 6 (2017).
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