NU708: Hailey Demascio

  Part A: Marginalized Populations 🔷🔷🔷🔷🔷🔷🔷🔷🔷🔷🔷🔷🔷🔷🔷🔷🔷🔷🔷🔷🔷🔷🔷🔷🔷🔷🔷🔷🔷🔷 What are some of the determinants that make marginalized populations more at risk for chronic disease, substance use, and mental illness?  People experiencing homelessness are at an increased risk for developing and suffering with chronic disease. The homeless or those with housing insecurity are more likely to forgo routine check-ups (Martin et al., 2019). There is a direct correlation between level of housing insecurity and decreased access to care. Adults experiencing homelessness typically have to utilize acute care services as opposed to routine care services (Martin et al., 2019). In addition they typically have to postpone needed medical care and medications due to lack of transportation or other compounding factors (Martin et al., 2019). Veterans are at increased risk for developing substance use disorder. Substance use disorders encompass alcohol and drug use disorders, an...

What Does Treatment Involve for Patients with Substance Use Disorder? Treatment options include: 🟦Outpatient counseling services that often include extensive attendance and long periods of commitment to treatment. 🟦Inpatient rehabilitation programs. 🟦Behavioral health evaluation and treatment by a healthcare professional who specializes in mental health concerns that may result in addiction. (Centers for Disease Control and Prevention, 2024) 🟦Medications:     🔹Methadone     🔹Buprenorphine      🔹Naltrexone (Centers for Disease Control and Prevention, 2024) 🟦Reduce stigma surrounding substance use disorder. (Centers for Disease Control and Prevention, 2024) 🟦Carry-out harm reduction techniques, such as:      🔹Free overdose reversal kits.      🔹Free drug testing kits that have test strips for certain drugs that are known to be linked to high rates of overdose deaths.      🔹Free sterile injection sup...

How Does Stigma Impact the Issue of Treatment and Recovery?           Stigma negatively impacts patient care for those who use substances . Stigma fosters beliefs that hinder individuals from seeking the personal resources needed to access treatment. Resources being limited include:  Self-efficacy. Help seeking. Belief that they deserve care. (Weber et al., 2021)         Patients are made to feel ashamed for what they are experiencing, therefor they are less likely to advocate for themselves or seek out resources. These patients begin to believe they are not deserving of help and often chose not to accept or search for available resources. To help reduce stigma, and to encourage patients to seek resources you can: ⭐Use person first language (Weber et al., 2021). ⭐ Explore system-level causes of addiction (Weber et al., 2021). ⭐ Learn more about harm reduction techniques and programs (Weber et al., 2021). References Weber, ...

  My Reflection on Andrew's Story 🔷🔹🔷🔹🔷🔹🔷🔹🔷🔹🔷🔹🔷🔹🔷🔹🔷🔹🔷🔹🔷🔹🔷🔹🔷🔹🔷🔹🔷🔹           Andrew grew up with a, what seems like, ideal childhood. Parents with good careers, did well in school, a bright future ahead. Back pain from labor intensive jobs and degenerative disk disease sent Andew seeking relief from the pain he experienced. For Andrew hydrocodone turned into oxycodone, that turned into doctor shopping for more meds, that lead Andrew to the streets seeking opioids. Andrew's mother passing away sent Andrew into a spiral. A friend told Andrew about suboxone, that he got from the streets due to lack of health insurance. Even with the assist of suboxone Andrew still found this solution to be lacking. Andrew knew he needed more help, a program in Biddeford was able to help Andrew despite his lack of health insurance. Ninety days of intensive outpatient therapy brought Andrew to where he was during the video interview, almost one y...

 How the Opioid Epidemic Has Impacted Families 👪 How Children Are Impacted 👪 Children who grow up in households with misuse of opioids: Are at an increased risk of experiencing mental health issues  (Winstanley & Stover, 2019). Are more likely to use drugs (Winstanley & Stover, 2019). Are more likely to experience accidental opioid poisoning  (Winstanley & Stover, 2 019). Are at an increased risk of developing a substance use disorder  (Winstanley & Stover, 2019). Are likely to experience family dissolution resulting from parental incarceration (Winstanl ey & Stover, 2019). Loss of a parent due to opioid overdose and death  (Winstanley & Stover, 2019). 👪 How the Individual (Parent and Substance User) Is Impacted 👪 Parental drug use may result in the parent becoming unable to safely care for their child  (Winstanley & Stover, 2019). Parental drug use may result in child detachment from parent  (Winstanley & Stove...

H ow Does America Compare to Global Figures on Substance Use? America vs Europe: Opioid Misuse and Opioid Related Death          ⭐  Approximately 11.5 million Americans misuse opioids in the United States, it is estimated that in Europe this number is approximately half (van den Brink et al., 2022). Why is Europe able to keep opioid consumption at a rate that is so much lower than in the United States? Stricter prescription drug regulations that do not have automatic refills (van den Brink et al., 2022). No direct-to-consumer advertisement   (van den Brink et al., 2022). Initial focus on psychological pain management as opposed to use of opioids  (van den Brink et al., 2022). Personal possession of opioids is de-panelized  (van den Brink et al., 2022). Drug policy is focused on public health and harm reduction   (van den Brink et al., 2022). Prescription drug monitoring programs exist to stop "doctor shopping"  (van den Brink...

What Insights Can Be Gleaned by Examining the Historical Legacy of Opioids in America to Understand the Present Opioid Epidemic?           There are distinct and observable trends in opioid use and overdose deaths in the United States that can provide insight into future trends. According to The Centers for Disease Control and Prevention, there are three historical "waves" that correlate with rises in opioid overdose deaths. 1). The first wave began in 1999 and involved prescription opioids such as oxycodone, hydrocodone, morphine, codeine, and methadone (Centers for Disease Control and Prevention, 2024). 2). The second wave began in 2010 and was due to a rise in heroin injection resulting in overdose deaths (Centers for Disease Control and Prevention, 2024). 3). The third wave began in 2013 and involved/involves the use of synthetic opioids such as fentanyl. Fentanyl used illegally is often made illicitly and is mixed with other illegal drugs such as h...