Thesis

Collaborative efforts to control the opioid epidemic in Imperial County

Opioids are well known as a pain remedy along with its addictive nature for centuries leading to several waves of opioid epidemic. Qualitative analysis of archival research is done to summarize the factors which contributed to the current opioid epidemic in the U.S. and Imperial County which started in the 1980s and 1990s with a massive campaign by the pharmaceutical companies promoting long-term opioid use for non-cancer pain. This resulted in many folds increase in opioid prescriptions. Illegal use of heroin and synthetic opioids also contributed to the current opioid epidemic. Since 1990s, opioid overdose has caused thousands of Americans lose their lives. This article also summarizes the history of drug policies in the United States which has been punitive towards substance users. The approach to the substance is changed with the adoption of policies such as Comprehensive Addiction and Recovery Act (CARA), 21st Century Cures Act and H.R. 6 which aim at prevention and treatment rather than criminalization and incarceration of people with substance use disorder. Strict prescribing methods and mandatory use of Controlled Substance Utilization Review and Evaluation System (CURES) system has resulted in decrease number of opioid prescription but overdose deaths continue to rise. Efforts are made to have naloxone and Medication Assisted treatment available at Imperial County Behavioral Health Services (ICBHS), local hospitals, emergency department, primary care and federally qualified clinics and criminal justice system. This paper also summarizes the future policies to increase access and fill the gaps in the treatment by implementing the Mental Health Parity and Addiction Equity Act and Medicaid expansion. Future strategies also include public education and awareness about the addictive nature of opioids, reduce stigma to substance use treatment, education and training of providers to get X-waivers to prescribe buprenorphine for Opioid Use Disorder (OUD) and have alternative pain management methods available to all.

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