See attachments. 

OpioidCrisis in Winston-Salem, NC

Professor Feedback:

Mara: There is no clear identification of option 2 in the title. Your outline gives a good idea of what you will need to cover in the final project and is detailed enough (more than the assigned 2 pages). It shows the logic of your analysis of opioid abuse in Winston-Salem. You cited several appropriate sources. It is clearly organized in Symptoms, Diagnosis, Cure, and Prevention sections, and is written correctly as an outline. APA is ok.

I. Introduction

A. Opioid crisis entails extensive opioid overuse from medical and non-medical prescriptions

B. This issue started in the late 1990s, following the increased prescription of opioids for the management of pain. It led to an increase in the usage of opioids, both prescription and non-prescription, throughout the U.S in subsequent years (Guy Jr, Zhang, Bohm, Losby, Lewis, Young & Dowell, 2017).

C. Winston-Salem, North Carolina, is not excluded from this opioid crisis.

a. Winston-Salem is a city in Forsyth County. According to Briker (2008), the town emerged following the merger of Winston and Salem towns in 1913.

D. Thesis: Opioid crisis is a significant public health issue in Winston-Salem, calling for action.

II. Body paragraphs

A. Symptoms

a. The issue affects mostly non-Hispanic whites aged 18 and above.

i. People aged 26 years and older are the most frequent users of prescription opioids, while the age group with the highest non-medical opioids use is young adults between the ages of 18 and 25 (Green, 2017).

b. The signs of symptoms of this crisis among individuals include dependence on opioids, prioritization of acquisition and use of opioids over other activities such as school and work, and weight loss. Other symptoms include lack of hygiene, drowsiness, isolation from family and friends, engaging in risky behaviors, being nervous, losing interest in activities previously enjoyed, and experiencing financial hardships (Green, 2017).

c. In the community, the symptoms indicate that opioid use has become a crisis include increased health care and criminal justice costs (Birnbaum, White, Schiller, Waldman, Cleveland & Roland, 2011).

B. Diagnosis

a. One of the primary roots of the opioid crisis is the initiation of opioids for pain management (Green, 2017).

i. Increased number of people affected by chronic pain pushed the use of painkilling opioids.

b. Continued use of opioids beyond doctor prescriptions to minimize pain or induce eutrophic feelings (Green, 2017).

c. Opioids are inexpensive to acquire.

i. When compared to alternative intervention for pain management such as physical therapy, opioids are relatively inexpensive (Green, 2017).

d. Other communities affected by this opioid crisis include Lockbourne in Pickaway County, Ohio, and Kermit in Mingo County in West Virginia.

e. Measures to address this issue by these communities:

i. Providing education and distributing naloxone (Palombi, Olivarez, Bennett & Hawthorne, 2019)

ii. Educating members of the community on safe usage, storing, and discarding of prescription medication

iii. Providing support for community members in the recovery process (Palombi et al., 2019)

C. Cure

a. Pharmacological treatment

i. Medications too address the issue includes opioid agonists such as methadone, acetate, and levomethadyl, opioid antagonists such as naloxone and naltrexone, and non-opioid medication including clonidine and lofexidine (Veilleux, Colvin, Anderson, York & Heinz, 2010).

b. Psychosocial treatment

i. Biofeedback, cognitive behavioral therapy, and psychodynamic therapies improve relapses and treatment retention (Veilleux et al., 2010).

c. Precision Addiction Management has been suggested as an approach to the effectively compact opioid crisis (Blum, Gondré-Lewis, Baron, Thanos, Braverman, Neary, … & Badgaiyan, 2018).

d. Increasing access to treatment and recovery sustenance would enable people with this problem to seek treatment.

D. Prevention

a. Prescription monitoring programs (Hahn, 2011)

b. Ending supply of unfitting prescriptions and illegal opioids

c. Enhancing maternal and prenatal care for females struggling with substance misuse (Hahn, 2011)

d. Supporting the youths through targeted initiatives to lessen youth misuses of opioids

e. Enhance awareness on the risks of opioids use and the costs of opioid misuse on individuals and the community (Hahn, 2011).

III. Conclusion

A. The opioid crisis is a huge public health issue, and thus, addressing this problem is a priority for communities.

References

Birnbaum, H. G., White, A. G., Schiller, M., Waldman, T., Cleveland, J. M., & Roland, C. L. (2011). Societal costs of prescription opioid abuse, dependence, and misuse in the United States. Pain medicine, 12(4), 657-667.

https://www.asam.org/docs/advocacy/societal-costs-of-prescription-opioid-abuse-dependence-and-misuse-in-the-united-states

Blum, K., Gondré-Lewis, M. C., Baron, D., Thanos, P. K., Braverman, E. R., Neary, J., … & Badgaiyan, R. D. (2018). Introducing precision addiction management of reward deficiency syndrome, the construct that underpins all addictive behaviors. Frontiers in psychiatry, 9, 548.

https://www.frontiersin.org/articles/10.3389/fpsyt.2018.00548/full

Bricker, M. L. (2008). Winston-Salem: A twin city history. The History Press.

Green, J. (2017). Epidemiology of opioid abuse and addiction. Journal of Emergency Nursing, 43(2), 106-113.

Guy Jr, G. P., Zhang, K., Bohm, M. K., Losby, J., Lewis, B., Young, R., … & Dowell, D. (2017). Vital signs: changes in opioid prescribing in the United States, 2006–2015. MMWR. Morbidity and mortality weekly report, 66(26), 697-704

https://www.cdc.gov/mmwr/volumes/66/wr/mm6626a4.htm

Hahn, K. L. (2011). Strategies to prevent opioid misuse, abuse, and diversion that may also reduce the associated costs. American health & drug benefits, 4(2), 107-114

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106581/pdf/ahdb-04-107

Palombi, L., Olivarez, M., Bennett, L., & Hawthorne, A. N. (2019). Community Forums to Address the Opioid Crisis: An Effective Grassroots Approach to Rural Community Engagement. Substance abuse: research and treatment, 13, 1178221819827595.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378421/pdf/10.1177_1178221819827595

Veilleux, J. C., Colvin, P. J., Anderson, J., York, C., & Heinz, A. J. (2010). A review of opioid dependence treatment: pharmacological and psychosocial interventions to treat opioid addiction. Clinical psychology review, 30(2), 155-166.

Assignment Due Sunday:

Preliminary Written Report and Peer Review Feedback

This week, you will submit a preliminary (rough) draft of the written portion of your Portfolio Project. Remember to include the following sections: introduction, symptoms, diagnosis, cure, prevention, and a brief closing summary. 4-5pages

Actual Portfolio Project: Not due yet, but use as a reference 

The Community Action Plan: Written Report and Handout
Your Portfolio Project for this class is a Community Action Plan designed to alleviate or correct a public health issue in your community. Your community can be your business, school, neighborhood, town or city of residence or birth, or county. 
For option 2, your Community Action Plan will be a professional portfolio that includes a written report and a handout. 
Below is a useful site where you can find an example of the elements of an action plan.
http://www.cityofchicago.org/dam/city/depts/cdph/tobacco_alchohol_and_drug_abuse/LGBTCommunityActionPlanHC  

Paper Instructions:
· Your case study should have four sections: Symptoms, Diagnosis, Cure, and Prevention. Each section should be about a page in length. Your entire paper must be 4-5 pages in length, not counting the title or reference pages, which must be included.
· In the Symptoms section, describe the public health issue that you have observed in your community. What “symptoms” does it exhibit? Think about whom it affects, where it affects them, and how.
· In the Diagnosis section, discuss the causes of the issue and give examples of other communities that have suffered the same problem. How did those communities solve or attempt to address the issue?
· In the Cure section, discuss possible options for a cure for this public health issue. How can you eradicate it or reduce its occurrence in your community?
· In the Prevention section, discuss possible options for prevention of the public health issue that you have selected. How can you reduce the chance of people being impacted by your issue in the future?
· You must back up your sections using at least two scholarly articles. You may use readings other than the textbook to meet this requirement. The paper should be based on references to scholarly materials (rather than on introductory textbooks, popular website writings, or musings, for example) and should support your claims with evidence.
· Incorporate into this final plan any classmates’ critiques that you found useful, as well as your instructor’s feedback. Identify the key community members or partners that you plan on contacting, with an explanation why these individuals or organizations make sense as potential partners. This could include partners from your list of potential partners created in Week 4 Critical Thinking Assignment Option #1 or your interview of one key partner completed in Week 4 Critical Thinking Option #2. Incorporate them into a discussion of your plan; do not just list them.
· Your case study should include a special emphasis on either the demographics of the affected population or the economic implications, depending on what Critical Thinking assignment you completed for Week 5.
· You should also include a realistic timeline for your plan. Discuss the time needed for campaigning, education, funding, building, and implementation. Use ideas developed through Week 6 Critical Thinking Assignments, from the feedback on your detailed outline. I’ve attached the outline for reference