Advocacy Campaign: Prescription Drug Abuse in Ohio

Description of Health Issue and Population Affected by the Issue

There are staggering statistics that reflect misuse and abuse of prescription drugs in Ohio, the United States of America. The prescription drug abuse issue is a leading cause of injury death not only in Ohio but also in other states adding up to sixteen in total. Nearly 700,000 residents in Ohio aged at least twelve years are associated with the abuse of prescription drugs (Molfenter et al., 2015). It has led to the CDC ranking the state among the top five states with the highest rates of prescription drug abuse. Consequently, Ohio State has reportedly been spending at least two cents out of every dollar in programs associated with the creation of awareness towards dealing with the menacing prescription drug problem.

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Recent studies demonstrate a massive spike in the abuse of prescription drugs in Ohio. Specifically, opioids fall under this category most often, some of them including such medications as hydrocodone, methadone, and morphine (Penn et al., 2017). Various healthcare stakeholders in Ohio explain that different factors fuel the addiction to the above-mentioned prescription drugs. For instance, opioids are considered the most commonly recommended drugs in the management of pain associated with various health problems and procedures. Secondly, the class of medication is known to cause an exponential increase in tolerance of the consumers leading to an urge to consume the same drug more often. Moreover, many Ohio residents suffer because of addiction in silence making it extremely difficult to attain correct statistics on how widespread prescription drug abuse has become.

The prescription drug abuse challenge in Ohio is exacerbated because of almost futile efforts in averting the problem. Various task forces have been put in place to address the challenge but have not successfully eliminated the problem. One such effort is educating and training healthcare professionals on matters concerning prescription drugs. Using newsletters, conferences, and meetings, appropriate medical care associations have addressed the above-mentioned group of stakeholders requesting their unwavering commitment to addressing prescription drug abuse. Secondly, there was a partially effective implementation of policy and legislative changes regarding the issue in Ohio. These changes include the imposition of licensing standards on healthcare facilities including pain management clinics across the state. Additionally, the state deliberated on reviewing the operational legislation in other states to adopt the dictates where necessary. However, the state continues to be ranked among the top five states in the USA that are associated with the highest level of prescription drug abuse.

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Summary of the Researched Advocacy Campaigns

The first advocacy campaign by Penn put forward the role that pharmacists ought to play when implementing and promoting policies and strategies that govern opioid safety. The campaign was spearheaded by the Ohio Board of Pharmacy emphasizing the role of corresponding responsibility in fighting prescription drug abuse. Another instrument that the campaign highlighted was the utilization of the telephone number provided under the law that would enable families and patients to reach treatment programs that dealt with opioid use disorders. Using such a tool, the campaign underpinned the efficiency of pharmacists’ engagement in conversations which otherwise would be difficult when managing patients (Penn et al., 2017). Additionally, the campaign team reiterated the role pharmacists had in evaluating patients and identifying potential opioid use disorders. Other roles that the campaign associates with pharmacists include the establishment of policies regarding opioid prescription and contracting authentic parties that would address opioid use disorders.

Another research campaign was performed by the Ohio Prescription Drug Abuse Task Force in 2015. The campaign was spearheaded by the state’s governor and aimed at increasing public awareness of prescription drug abuse among the citizens in Ohio. Additionally, the campaign aimed at identifying existing task forces, like the Ohio Department of Health (ODH), that were making efforts towards eradication of prescription drug abuse. Besides, the campaign deliberated on educating and training prescribers and healthcare professionals as well as implementing policy and legislative changes that would govern pain management in clinics across the state.

One of the attributes that made the above-mentioned campaigns effective was the recognition of the role that the state government had to play in the implementation of recommendations. Penn et al. (2017) assert that the promotion of public awareness campaigns and implementation of prevention programs required strong political support which would have been impossible without the Ohio state government. Secondly, in both campaigns, the team recognized the crucial role of pharmacists. Overall, pharmacists form an integral component of the state strategy towards containment of prescription drug abuse promoting responsible adoption of prevention practices and opioid prescription.

Proposal of Health Advocacy Campaign Towards Containment of Prescription Drug Abuse in Ohio

  • Background: Prescription drug abuse continues to dominate in most parts of Ohio State. This problem still exists despite the efforts made by community health practitioners in conjunction with the government towards dealing with the challenge. By the year 2017, prescription drug abuse was the leading cause of mortalities as a result of injuries (Penn et al., 2017). The state was ranked fifth in deaths associated with unintentional drug abuse. Furthermore, the challenge is related to the high utilization of naloxone which is an opioid antagonist utilized in healthcare facilities to reverse opioid overdose.
  • Proposed Health Solution: The key recommendation provided by the campaign “Stop Prescription Drug Abuse, Together We Can Help a Friend and a Relative” is to encourage individuals at high risk of prescription drug abuse, their friends, and family members to learn how to prevent and manage prescription drug abuse. Together with other measures, like the promotion of responsible prescribing, the steps made by the campaign will significantly prevent the chances of a prescription drug overdose. The proposed health solution will be geared towards the creation of new policies that should supplement the ones already existing. The following objectives will guide the above-mentioned policy.

Long-Term Goal

  1. Within the next five years, prescription drug abuse-related fatalities in the state of Ohio will be reduced by 10%.
  2. To ensure that parents of children and young adults in Ohio understand the importance of keeping drugs out of reach for the safety of their children.
  3. Ensure that residents understand the significance of not sharing one’s medication with anybody else.
  4. To ascertain that various institutions adopt prevention practices that ensure screening and counseling of teens and other population groups on challenges associated with prescription drug abuse.

The described advocacy campaign can be considered effective because there is less emphasis on the role of parents, friends, relatives, and institutions in addressing prescription drug abuse. Clinicians are viewed as pivotal agents in addressing prescription drug abuse. For instance, studies demonstrate that not less than 84 percent of all Americans contacted a healthcare professional in 2017 (National Academies of Sciences, Engineering, and Medicine, 2017). Similarly, most policy regulations involving control and management of drug prescription revolve around the dispensation and prescription of drugs by authorized individuals. Thus, physicians are placed at a central position in the identification of unsolicited utilization of prescription drugs. Furthermore, patients are also considered fundamental players in controlling the rate of prescription drug abuse in Ohio. For example, policy dictates observing that patients have a role to play in abiding by the directions given by their healthcare providers and being wary of potential interactions that may be precipitated when a drug interacts with other prescribed medications. Most importantly, patients are advised to never change the regime without prior consultation with their caregivers.

Considering that the rate of drug overdose deaths remains worryingly high in Ohio, there is a need to elaborate on other feasible measures. One of the effective additional steps is the realization of the above-mentioned campaign that targets family, friends, and institutions of learning.

Passing a New Policy

According to the objectives of the discussed campaign, a bill should be proposed that pushes for passing a policy underpinning those objectives. Instead of just acting toward teens and young adults caught abusing opioids, a policy needs to be passed requiring learning institutions to teach their students on dangers associated with prescription drug abuse. Civic education provided to this group of citizens can be more effective than limiting their access to prescription drugs. It means that majority of people engaging in prescription drug abuse experience a lack of information on the implications associated with the habit. Studies also underpin that majority of school children in Ohio tend to share prescription drugs thinking that it can substitute a visit to a physician. Additionally, corresponding policies emphasize the role family and friends ought to play in minimizing abuse of such prescription drugs as hydrocodone, oxymorphone, and codeine.

Effects of Existing Laws on the Proposed Legislation

An examination of the existing laws regarding prescription drugs points out that the advocacy of new policy will be positively affected. According to the Ohio Laws and Rules, chapter 2925, the law criminalizes any deliberate act of selling a controlled substance unlawfully, or of preparing shipment, delivery, or distribution of a controlled substance or its analogs (2018). However, the law does not apply to licensed health professionals and manufacturers, which is a phenomenon that explains why most of the existing policies relate to personnel involved in the prescription and dispensation of prescription drugs.

The law also asserts that the trafficking of drugs categorized as schedule III, IV, or IV is not only criminal but is also classified as a felony of the fourth degree (Ohio Laws and Rules, 2018). As such, it is correct to deduce that the existing policy and laws in Ohio only facilitate the passing and implementation of the policy proposed herein. Leaders in different institutions will be in a position to inform the youth and the general public not only about the adverse health effects associated with the abuse of prescription drugs but also about the legislative penalties applied to the traffickers. By understanding the existing policies, families, and friends of persons at risk of abusing prescription drugs will be more invigorated toward educating, warning, and advising their loved ones against indulgence in the trafficking of prescription drugs.

Methods to Influence Legislators and Associated Policy Makers

Legislators and other policymakers that will be instrumental in passing the policy bill will be influenced by the three legs of lobbying. They include direct lobbying, political action committee, and grassroots. During the agenda-setting phase of the policy process, the campaign team (comprised of healthcare professionals and community rights advocates) will make direct contact with the Ohio state legislator. In this case, it can be a senator of the state government. The legislator, through direct lobbying, will be presented with the prescription drug abuse challenge that the Ohio residents deal with despite different legislative measures and efforts made by task forces. The legislator will be presented with the current statistics that provide a grotesque picture of opioid and other prescription drug abuse. Most importantly, the campaign team, through their representative, must emphasize that despite the implementation of policies and legislative changes as well as education of providers and healthcare professionals, there continues to be a gap in the containment of opioid and prescription drug abuse in Ohio state. Thus, it is necessary to formulate clear and efficient policies like the one proposed in this work. There is a need to pass a policy that makes it mandatory to promote awareness of prescription drug abuse among various population groups, especially teens and young adults. The policy, therefore, targets institutions, family members, and friends who tend to spend a considerable amount of time with the targeted groups of the population.

The second leg of lobbying that will be utilized is the political action committee. In this case, the campaign team will assemble enough funds both from political stakeholders and the Ohio community. Other contributions will be from corporate treasuries to provide financial support towards the success of the campaign. The campaign contributions will be amassed and donated to finance the processes involved in the policy implementation process.

The other lobbying strategy that is instrumental in the campaign will be the grassroots. The grassroots leg of lobbying provides that the business community should play a vital role in any legislative process. As an indirect lobbying strategy, grassroots lobbying should be aimed at stimulating the politics in Ohio on matters concerning prescription drug abuse. Two types of tactics are critical in this case. First, there will be media lobbying aimed at expanding the outreach of advocacy against prescription drug abuse. Television, magazines, and the internet will be vital in mobilizing support, educating, and reaching out to unidentified task forces, like the Ohio Department of Health. In return, the ODH will mount social marketing campaigns in areas under high risk. Additionally, grassroots lobbying will be crucial in identifying potential funding sources which may provide positive feedback for the Political Action Committee (PAC), the second leg of the lobbying process.

Obstacles and Their Solution During the Legislative Process

One of the obstacles likely to occur during the legislative process is the lack of transparency among critical stakeholders. Political players, who could double up as legislators representing the state in Congress, may capitalize on the disclosure of records of the meetings held. Consequently, such parties either fail to fully advocate for the need to have the bill passed or are easily influenced by the opposition through bribes. However, the campaign team should minimize the lack of transparency among legislators by keeping a record of all meetings held and passing a requirement that no legislator will be offered any benefits or incidental gifts from any lobbyists.

Another challenge likely to occur is opposition during the policy process as some of the Congress members may be directly linked with the diversion of prescription drugs from the supply chain. Notably, this diversion enables access to prescription drugs to people with inadequate know-how on the right prescription dosages who may sell drugs for other unintended purposes. To minimize unnecessary opposition from other legislators, the campaign team in conjunction with the ODH should ensure that the opponents are reliable and that any opinion against passing the bill is not dictated by any malicious intention.

Ethical Considerations

In spearheading the above-mentioned campaign, the campaign team will face several ethical dilemmas. Guided by the ANA Code of Ethics, the campaign could be said to contravene some laws on human rights existing in the United States. For instance, by advocating for abidance by pharmacist’s prescription instructions, a patient may claim that it would be against his or her rights to own things. This provision observes that the party has the right to share things with anybody one wants which means that one has legal freedom to share his or her medication with other people. This statement is reiterated by provision 8 of the ANA Code of Ethics which asserts that healthcare professionals must always collaborate in protecting human rights (ANA Code of Ethics, 2018). However, it must be observed that the same provision contains that healthcare officers must team up in the promotion of health diplomacy and reduction of disparities in health which are the aspects that the campaign strongly promotes.

Another ethical dilemma will be isolating persons considered to be abusing prescription drugs. First, it is worth noting that such prescription drugs as opioids are primarily fashioned towards treating and managing medical conditions. Some medical conditions require such opioids as codeine since the pain associated with certain conditions is usually unresponsive to other pain medications. In this regard, when such a person decides to abuse a prescription drug either through an authorized prescriber or otherwise, a decision to advise them against the habit will face legislative and ethical criticism. Such a person would be having a right to universal healthcare services, which means that he or she can continue using the same drug in managing a health condition, for instance, cancer treatment, as deduced from provisions eight and nine of the ANA Code of Ethics.

Ethics and Lobbying Laws

The campaign will be guided by strict ethics and lobbying laws. For instance, the campaign and lobbying process will require that all lobbyists register with the clerk of the United States House of Representatives. Any contravention of the above-mentioned rules will lead to a civil monetary fine which is not less than $ 500,000, according to the Lobbying Disclosure Act of 1995. Ethical laws observed by the campaign will be by the ANA Code of Ethics. Where applicable, all the provisions will be taken into consideration when healthcare professionals deal with patients and addicts. Furthermore, family members, institutional leaders, and stakeholders will be briefed on the nine provisions contained in the ANA Code of Ethics. They include compassion and respect for dignity, unique attributes, and the worth of every person (ANA Code of Ethics, 2018). Other ethical laws will be promotion and advocacy for the protection of the population (patient’s rights) through confidentiality, protection of people caught trafficking prescription drugs, and preservation of wholeness and character of young people living with addiction to prescription drugs.

Summary

Prescription drug abuse continues to dominate in most parts of Ohio State. This problem persists despite the efforts made by community health practitioners in collaboration with the government towards dealing with the problem. With the continued existence of prescription drug abuse as the leading cause of injury-related mortalities, there is a need to re-examine various policies and efforts already made by the federal and state government to come up with the best alternative approach.

The campaign "Stop Prescription Drug Abuse, Together We Can Help a Friend and a Relative" is, therefore, one of the alternative ways through which the prescription drug challenge can be alleviated. The objectives of the campaign encourage persons at high risk of prescription drug abuse, friends, and family members to learn how to prevent and manage prescription drug abuse. The long-term goal of the campaign is that by the next five years, the fatalities related to prescription drug abuse in the state of Ohio will be reduced by 10%. Moreover, the campaign endeavors to involve various institutions in adopting efficient prevention practices that would ensure the screening and counseling of adolescents and other groups of the population on prescription drug abuse.

In line with the above-mentioned, the campaign will aim at pushing for a new policy implying stronger involvement of learning, healthcare, rehabilitative, and other related institutions in the prevention of prescription drug abuse among teens and young adults. Luckily, most existing laws will only act towards augmenting the resolution of the above-recommended policy. Through the three legs of lobbying, the campaign team is determined to ensure that the policy process will be smooth despite challenges that may occur. The process will also be guided by the ANA Code of Ethics together with the lobbying laws in Ohia and the United States. The campaign should remain dedicated to its core objectives so that through the realization of the policy, mortalities associated with prescription drug abuse can reduce.

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