Florida State Health Improvement Plan

Florida State Health Improvement Plan

Thank you for your post. The Nonopioid Alternatives is a critical piece of legislation in support of opioid overdose prevention efforts. The piece of legislation provides guidelines on prescription opioids and alternatives with the aim of reducing the high number of prescription and opioid drug overdoses. Based on the Centers for Disease Control and Prevention (CDC), the U.S recorded close to 92,000 deaths related to drug overdose in 2020, of which opioid overdose made up 68,630 of the total deaths 2020, and 75,673 out of 100,306 drug overdose deaths in 2021 (CDC, 2021). This means that a majority of drug overdose deaths in the U.S are related to opioid overdose. Besides the risk of death, the overdose and abuse of prescription opioids and resulting addiction contribute to graduation to other drugs such as cocaine.

The provision of the Nonopioid Alternatives policy provides both a framework and a technical framework to explore various methods that can reduce and prevent the overdose of prescription drugs. The legislation makes use of evidence-based strategies in opioid prescription to reduce the use of opioids in the management of pain and the risk of addiction and overdose. For instance, the legislation requires health providers to inform patient of nonopioid alternatives and present them with information on the benefits and drawbacks of such alternatives. The reduced use of opioids and use of nonopioid alternatives are advantageous to the patient and treatment outcomes. Research results noted that patients with lower opioid use had increased satisfaction with the use of nonopioid alternatives reducing the number of tablets taken and willingness to dispose of leftover pills according to FDA guidelines (Porter et al., 2021). Therefore, nonopioid alternatives can be used as options for opioids in the treatment of pain with reduced risk of overdose and improved patient experiences.

References

CDC. (2021, November 17). Drug Overdose Deaths in the U.S. Top 100,000 Annually. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/20211117.htm

Porter, E. D., Bessen, S. Y., Molloy, I. B., Kelly, J. L., Ramkumar, N., Phillips, J. D., Loehrer, A. P., Wilson, M. Z., Hasson, R. M., Ivatury, S. J., Henkin, J. R., & Barth, R. J. (2021). Guidelines for Patient-Centered Opioid Prescribing and Optimal FDA-Compliant Disposal of Excess Pills after Inpatient Operation: Prospective Clinical Trial. Journal of the American College of Surgeons, 232(6), 823-835.e2. https://doi.org/10.1016/J.JAMCOLLSURG.2020.12.057

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Nonopioid Alternatives

Effective Date: July 1, 2019

House Bill 451Links to an external site.

To preserve, promote, and enhance the health of all Floridians through the management of the state, county, and community activities, the Florida Department of Health (FDOH), created the Overdose Data to Action (AD2A) in a cooperation agreement with the Center for Disease Control and Prevention (CDC) in September 2019. OD2A aims to strengthen overdose surveillance in support of the Nonopioid Alternatives enacted by the Legislature of the State of Florida: Section 1. Subsection (7) was added to section 456.44, 16 Florida Statutes, on July 1, 2019.

Florida State Health Improvement Plan

The legislature determines that every competent adult has the fundamental right of self-determination concerning health-related decisions, including the freedom to refuse a Schedule II opioid prescription. This law enacts that the Florida Department of Health should prepare and post on its website an educational brochure on the use of nonopioid options for pain management. The booklet must, at a minimum, include information about available alternatives to opioids for pain management, such as nonopioid medications and nonpharmacological therapy.

Before prescribing an opioid medicine categorized as a Schedule II drug, the prescriber must comply with the following requirements: for the treatment of pain, a healthcare practitioner, excluding those licensed under Chapter 465 (n.d.), must inform the patient of available nonopioid alternatives for the treatment of pain, which may include nonopioid drugs and the usage of nonopioid alternatives. In addition, the healthcare provider must provide pros and cons to the patient and allow the patient to have personal preferences.

Opioids are among the most frequently prescribed drugs in the United States. Since the early 2000s, the United States has faced an opioid misuse issue. However, for Florida practitioners, this bill was of the utmost importance. The Sunshine State is home to various opioid use and misuse populations, including seniors and college students. In 2018, according to the National Institute on Drug Abuse (NIH), around 68% of the 4,698 documented drug overdose deaths in Florida involved opioids, for a total of 3,189 deaths due to opioids.

Opioids can be an invaluable ally while treating terminally ill patients and controlling moderate to severe pain for those with chronic pain. Still, unfortunately, these drugs are so addictive that even the most unyielding user can become dependent. To provide the best possible care, the NP should assess patients’ access to health care and social determinants of health such as socioeconomic, education, employment, demographics, and support system. As a future ARNP practising in Florida, I plan on performing a detailed patient evaluation before prescribing opioids, educating patients about the alternative options to opioid use to manage pain whenever possible, and following up by conducting a periodic review of the opioid treatment and efficacy.

Patients should be provided with alternative treatment options such as Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and topical Agents such as Lidocaine and Capsaicin for swelling and muscular pain. Education about RICE Method for treating soft tissue injuries, as well as creating an interdisciplinary treatment plan along with physical therapy to help train and strengthen the body, should be given. Healthcare providers should educate patients about the substantial evidence showing that Massage, Mindful Meditation, Yoga, and Exercise can significantly positively influence chronic pain, even though many may be inclined to disregard them at first. Other treatment options, such as injections of corticosteroids to the affected joint, PRP and Stem Cells injections, nerve blocks, and Acupuncture, should also be discussed.

References

A guide to Florida opioid law and dispensing guidelines. DRUGSCAN®. (n.d.). Retrieved October 17, 2022, from https://drugscan.com/learn/florida-opioid-law

Gonzalez, K., Shaughnessy, M. J., Kabigting, E. R., Tomasulo West, D., Callari Robinson, J. F., Chen, Q., Stewart Fahs, P. (2018). The healthcare of vulnerable populations within rural societies: A systematic review. Online Journal of Rural Nursing & Health Care, 18(1), 112-147. https://doi.org/10.14574/ojrnhc.v18i1.507Links to an external site.

Newest legislation. 2019 Legislation | Florida Department of Health. (n.d.). Retrieved October 17, 2022, from https://www.floridahealth.gov/licensing-and-regulation/newest-legislation/2019-legislation.html

(n.d.). Https://M.flsenate.gov/Statutes/465.0275.