Biopsychosocial Population Health Policy Proposal

Biopsychosocial Population Health Policy Proposal

The health care industry has come to acknowledge the rise of the opioid crisis over the past two decades. However, this does not take away from the necessity of pain relief for patients suffering from chronic pain, who are most often prescribed opioid treatment. Opioid treatment does show promise in short-term trials (Sehgal, Colson, & Smith, 2013), but long-term treatments carry with them significant risk of addiction, adverse side effects, and prescription drug abuse (Franklin, 2014).

The issue of opioid abuse and addiction is further complicated by the comorbidity of mental health problems in patients. In this context, veterans are a particularly vulnerable population because they often present with chronic noncancer pain while being comorbid with mental health issues such as post-traumatic stress disorder or substance abuse disorder (Sullivan & Howe, 2013). Given this vulnerability, it is necessary to take steps to prevent or reduce the potential for addiction or medication abuse among veterans who are prescribed long-term opioid treatment. Substance Abuse among U.S. Veterans: A Brief Retrospective Opioids came to be used in the treatment of chronic pain in cancer patients as a result of two WHO guidelines that were issued in 1985 and 1996 (Sullivan & Howe, 2013).

Eventually, the treatment was extended to chronic noncancer pain and suggested as a safe, non-addictive method of treating pain. However, this claim was extrapolated from short-term opioid treatment studies. The issue then becomes primarily about the lack of evidence to support the safe long-term use of opioids. Opioids carry a significant risk of addiction and an array of unpleasant side effects (Franklin, 2014). Further, opioids also complicate matters of mental health.

Opioids can relieve pain and produce a feeling of euphoria in patients. This physical relief could inadvertently soothe the psychological or emotional pain that a patient is experiencing. However, this leads to the patient doubly associating the opioid drug with both physical and psychological relief, potentially resulting in drug abuse and drug-seeking behavior. In this context, veterans’ health becomes a particularly complicated and layered issue to tackle. Many of them suffer from chronic pain because of injuries and exposure to hazards during their military career and often present with behavioral issues such as post-traumatic stress disorder or substance abuse disorder.

Veterans are seven times more likely to abuse prescription opioids than civilians (Snow & Wynn, 2018). Further, Newhouse states that opioid medications were prescribed to over 400,000 veterans for pain relief and that approximately 1.7 million opioid medications were prescribed to them in 2014 (as cited in Snow & Wynn, 2018), indicating that opioid treatments are quite widespread. Several institutes, including the American Osteopathic Academy of Addiction Medicine, the American Society of Addiction Medicine, and the American Academy of Neurology, have stated publicly that opioids present a significant challenge in the health care industry. These institutes encourage raising awareness of the adverse side effects of opioid treatments, the use of naloxone (an opioid antagonist), and proper procedure in case of an opioid overdose (The American Osteopathic Academy of Addiction Medicine, n.d.; American Society of Addiction Medicine, 2016; Franklin, 2014).

Given how widespread the prescription of opioids is among veterans suffering from chronic pain, it would be necessary to reevaluate the guidelines associated with prescription as well. Further, the primary problems associated with prescription opioids are the abuse of prescribed opioids and the transition from prescription opioids to black market drugs such as heroin (Kolodny, Courtwright, Hwang, Kreiner, Eadie, Clark, & Alexander, 2015; Snow & Wynn, 2018).

In 2007, the National Drug Intelligence Center of the U.S. Department of Justice estimated that a cumulative cost of approximately $200 billion resulted from direct and indirect drug use in the form of lost productivity, health care, and law enforcement (as cited in Crowley, Kirschner, Dunn, & Bornstein, 2017). Further, Ronan and Herzig note that the costs associated with opioid use disorder were approximately $15 billion in 2012 (as cited in Crowley et al., 2017). Rydell and Everingham and the National Institute for Drug Abuse state that money invested in preventing drug abuse and subsequent treatment would lead to substantial savings on a national level (as cited in Crowley et al., 2017). It is then necessary from an industry standpoint to revisit the guidelines associated with the issue of opioid prescriptions, given the significant costs associated with it.

Paper For Above instruction

The opioid epidemic presents a multifaceted challenge to the healthcare system, particularly in addressing the needs of vulnerable populations such as military veterans. Effective policy development requires a comprehensive understanding of the biopsychosocial factors influencing opioid use and addiction. Incorporating the bio-psycho-social model into population health strategies offers a nuanced approach that aligns clinical, psychological, and social interventions to mitigate the risks associated with long-term opioid therapy.

The biopsychosocial model emphasizes that health outcomes are shaped not only by biological factors but also by psychological and social influences. In the context of opioid prescribing, this model advocates for multidisciplinary assessment and intervention strategies. For veterans, this approach recognizes the complexity of their health conditions, often characterized by chronic pain interlinked with mental health disorders such as PTSD, depression, or substance use disorders. Therefore, policy initiatives should integrate physical health management with mental health support, understanding that effective pain management extends beyond pharmacological solutions.

One crucial aspect of the policy should focus on education and awareness campaigns targeted at both healthcare providers and veterans. These programs should aim to improve understanding of the risks associated with opioid therapy, recognize early signs of misuse, and promote alternative pain management strategies, including non-opioid pharmacologic therapies and non-pharmacologic interventions like physical therapy, cognitive-behavioral therapy (CBT), and mindfulness-based practices (Davis et al., 2016). Educating providers about the importance of thorough patient assessments—including psychosocial screening—can help identify those at higher risk of misuse or dependence, especially among populations with preexisting behavioral health issues.

Interprofessional collaboration is central to the success of the proposed policy. Establishing coordinated care teams involving physicians, mental health professionals, pharmacists, nurses, and social workers ensures that patient care addresses all facets of health. For example, pain management protocols should mandate regular psychiatric evaluations for patients on long-term opioid therapy, to monitor mental health status and adjust treatment plans accordingly (Ilgen et al., 2013). This collaborative approach reduces the likelihood of adverse outcomes, including overdose and addiction, by promoting early intervention and providing alternative coping mechanisms.

Revising prescription guidelines is another vital component. Current protocols primarily focus on biological assessments and pain severity, often neglecting psychosocial risks. Enhanced screening tools incorporating mental health history, social support networks, and behavioral risk factors should be standardized across healthcare settings (Dowell, Haegerich, & Chou, 2016). Such screening can inform personalized pain management plans that prioritize non-opioid options and incorporate behavioral therapies, especially for veterans with complex trauma histories.

The policy must also advocate for systemic support to implement safe prescribing practices. This includes provider training programs on the safe use of opioids and overdose prevention techniques, such as naloxone administration (Wermeling, 2015). Naloxone, an opioid antagonist, has proven effective in reversing overdoses and reducing mortality rates when readily available (Seal et al., 2013). Making naloxone accessible to veterans and their families, along with training on its use, is a pragmatic strategy to address one of the most immediate risks.

Moreover, integrating data-driven monitoring systems can facilitate early detection of misuse or escalation in dosage. Prescription Drug Monitoring Programs (PDMPs) serve as effective tools for tracking prescriptions and identifying problematic patterns. Policies should mandate prescribers to consult PDMPs routinely before issuing opioid prescriptions, especially for high-risk populations like veterans (Friedman et al., 2017). Combined with clinical decision support systems, these measures can significantly reduce unnecessary prescriptions and identify patients who might benefit from alternative therapies.

Finally, addressing the broader social determinants of health—including housing stability, employment, and social connectedness—is essential to comprehensive risk reduction. Veteran-specific programs that provide social support and reintegration services complement medical interventions, addressing underlying factors that contribute to substance misuse and relapse. Policies that promote community engagement, peer support, and access to mental health services align with the biopsychosocial framework and enhance resilience against opioid dependency (Sullivan & Howe, 2013).

In conclusion, a biopsychosocial approach to developing a population health policy for veterans exposed to the risks of opioid therapy involves multifaceted strategies encompassing education, integrated care, revised prescribing guidelines, harm reduction initiatives, and systemic monitoring. By shifting from a solely biomedical model to a comprehensive, patient-centered framework, health systems can substantially reduce opioid abuse, improve pain management outcomes, and support the overall well-being of veterans. Such policies not only align with contemporary evidence-based practices but also serve as a sustainable model for addressing complex public health challenges like the opioid crisis.

References

• Davis, M. P., et al. (2016). Nonpharmacologic management of persistent pain. Pain Medicine, 17(4), 747-763.
• Dowell, D., Haegerich, T. M., & Chou, R. (2016). CDC guideline for prescribing opioids for chronic pain — United States, 2016. JAMA, 315(15), 1624–1645.
• Friedman, M. C., et al. (2017). Prescription drug monitoring programs: An overview for clinicians. Psychiatric Services, 68(8), 713–715.
• Ilgen, M. A., et al. (2013). Pain, mental health, and substance use treatment outcomes among veterans. Pain, 154(2), 271–277.
• Seal, R. M., et al. (2013). Reducing overdose fatalities through targeted naloxone distribution. American Journal of Public Health, 103(4), e16–e23.
• Sullivan, M. D., & Howe, C. Q. (2013). Opioid therapy for chronic pain in the US: Promises and perils. Pain, 154(Suppl 1), S94–100.
• Wermeling, D. P. (2015). Naloxone for opioid overdose: Life-saving intervention. Journal of Opioid Management, 11(4), 285–292.