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Substance Addictions and Alcohol Abuses Paper

 Substance Addictions and Alcohol Abuses Paper

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Develop a 4–6-page position about a specific health care issue as it relates to a target vulnerable population. Include an analysis of existing evidence and position papers to help support your position. Your analysis should also present and respond to one or more opposing viewpoints.

Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.

Assessment Instructions

SCENARIO

Pretend you are a member of an interprofessional team that is attempting to improve the quality of health care and the outcomes in a vulnerable population. For the first step in your team’s work, you have decided to conduct an analysis of current position papers that address the issue and population you are considering.

In your analysis you will note the team’s initial views on the issue in the population as well as the views across a variety of relevant position papers. You have been tasked with finding the most current standard of care or evidenced-based practice and evaluating both the pros and cons of the issue. For the opposing viewpoints, it is important to discuss how the team could respond to encourage support. This paper will be presented to a committee of relevant stakeholders from your care setting and the community. If it receives enough support, you will be asked to create a new policy that could be enacted to improve the outcomes related to your chosen issue and target population.

The care setting, population, and health care issue that you use for this assessment will be used in the other assessments in this course. Consider your choice carefully. There are two main approaches for you to take in selecting the scenario for this assessment:

  1. You may use one of the issues and populations presented in the Vila Health: Health Challenges in Different Populations and Vila Health: Resources for Topical Research media pieces. For this approach, you may consider the population in the context of the Vila Health care setting, or translate it into the context in which you currently practice or have had recent experience.
  2. You may select a population and issue that is of interest to you and set them in the context of your current or desired future care setting. While you are free to choose any population of interest, the issue you choose should fall within one of the following broad categories:
    • Genetics and genomics.
      • Sickle cell, asthma, multiple sclerosis, myasthenia gravis.
    • Immunity.
      • Type 1 diabetes, systemic lupus erythematosus (SLE), congenital neutropenia syndrome.
    • Chronicity.
      • Arthritis, any type of cancer or lung or heart disease, obesity.
    • Addiction.
      • Abuse of alcohol, prescription drugs, tobacco, illegal substances.
    • Emotion and mental health.
      • Post-traumatic stress disorder (PTSD), depression, eating disorders, psychosis.

Note: If you choose the second option, contact the FlexPath faculty for your section to make sure that your chosen issue and population will fit within the topic areas for this course.

INSTRUCTIONS

For this assessment you will develop a position summary and an analysis of relevant position papers on a health care issue in a chosen population. The bullet points below correspond to the grading criteria in the scoring guide. Be sure that your submission addresses all of them. You may also want to read the Analysis of Position Papers for Vulnerable Populations Scoring Guide and Guiding Questions: Analysis of Position Papers for Vulnerable Populations to better understand how each grading criterion will be assessed.

  • Explain a position with regard to health outcomes for a specific issue in a target population.
  • Explain the role of the interprofessional team in facilitating improvements for a specific issue in a target population.
  • Evaluate the evidence and positions of others that could support a team’s approach to improving the quality and outcomes of care for a specific issue in a target population.
  • Evaluate the evidence and positions of others that are contrary to a team’s approach to improving the quality and outcomes of care for a specific issue in a target population.
  • Communicate an initial viewpoint regarding a specific issue in a target population and a synthesis of existing positions in a logically structured and concise manner, writing content clearly with correct use of grammar, punctuation, and spelling.
  • Integrate relevant sources to support assertions, correctly formatting citations and references using APA style.

Example Assessment: You may use the assessment example, linked in the Assessment Example section of the Resources, to give you an idea of what a Proficient or higher rating on the scoring guide would look like.

ADDITIONAL REQUIREMENTS

  • Length of submission: 4–6 double-spaced, typed pages, not including the title and reference pages. Your plan should be succinct yet substantive. No abstract is required.
  • Number of references: Cite a minimum of 3–5 sources of scholarly or professional evidence that support your initial position on the issue, as well as a minimum of 2–3 sources of scholarly or professional evidence that express contrary views or opinions. Resources should be no more than five years old.
  • APA formatting: Use the APA Style Paper Template linked in the Resources. An APA Style Paper Tutorial is also provided to help you in writing and formatting your analysis.

SUGGESTED RESOURCES

The resources provided here are optional. You may use other resources of your choice to prepare for this assessment; however, you will need to ensure that they are appropriate, credible, and valid. The MSN-FP6026 – Biopsychosocial Concepts for Advanced Nursing Practice II Library Guide can help direct your research, and the Supplemental Resources and Research Resources, both linked from the left navigation menu in your courseroom, provide additional resources to help support you.

Assessment
Genetics and Genomics
Pathophysiology
Population and Public Health
Course Resources and Templates

OPTIONAL RESOURCES

Position Papers

Substance Addictions and Alcohol Abuses Paper

vila_health__health_challenges_in_different_populations.pdf
vila_health__resources.pdf
analysis_of_position_papers_for_vulnerable_populations_scoring_guide.pdf
assessment_1_example.pdf

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3/5/2020 Vila Health: Health Challenges in Different Populations Transcript Vila Health: Health Challenges in Different Populations Introduction Carl Alomar Kevin Millard Delia Jensen Conclusion Credits Introduction Vila Health: Health Challenges in Different Populations Different populations in varying social contexts face a variety of medical challenges. Certain problems are more prevalent in a big city, for instance, while others might be more common in a small town. Similarly, the details of a person’s life may leave them more exposed to a given health problem. In this simulation, you will meet three different people from various social contexts, and learn about the health challenges they face. You may choose one of these contexts to follow throughout this course; so feel free to read as many or as few of these as you feel appropriate. Substance Addictions and Alcohol Abuses Papermedia.capella.edu/CourseMedia/MSN6026/VilaHealthHealthChallengesDifferentPopulations/transcript.html 1/6 3/5/2020 Vila Health: Health Challenges in Different Populations Transcript Carl Alomar Urban Veteran Carl Alomar, 36, was admitted with signs of acute opiate withdrawal. I was admitted to St. Anthony Medical Center when I came into the emergency room a total mess. I was sick to my stomach, had really bad muscle cramps, kept throwing up, had to go to the bathroom all the time. I tried to tell them it was the flu at first… but they saw through that pretty fast and got it out of me that it was withdrawal, and that I was trying to get off of Oxycontin cold turkey. I’m taking another stab at detox. I don’t know. I don’t really expect it to help much, since it hasn’t before. But I don’t know what else to do. I don’t have a choice. I can’t keep doing this or I’m not going to live to be 40. I got my leg shredded by an IED in Iraq in ’07, and the army doctors were really worried about pain management. And that meant Oxycontin. It was supposed to be temporary, but it wasn’t. And it’s just been downhill since then, especially after my medical discharge. I just kind of slid after that. I had trouble getting used to life out of the army, and my leg was messed up, and I was medicated pretty heavily all the time. Oxycontin, usually, but I couldn’t always get it and sometimes I was out on the street trying to buy the next best thing. That always scares me… but not enough to keep me from doing it. People were good about favoring vets for job openings, but I had trouble staying in them— aside from my leg and all the medication, I just wasn’t in a very good place in my head then. Or now. I have a job now, doing security at a warehouse, but I think I’m on pretty thin ice with them. I try not to come into work high, or take anything when I’m there, but you know how it goes. My wife left a couple of months ago. I know I’ve got to stop this or I’m just done. I wish I could get into one of the VA rehab programs, but they’re the VA, they’re useless. The waiting list is months. If I waited months, I’d be out on the street. Or just dead. I don’t have any choice but to just try to white-knuckle my way through stopping on my own. media.capella.edu/CourseMedia/MSN6026/VilaHealthHealthChallengesDifferentPopulations/transcript.html 2/6 3/5/2020 Vila Health: Health Challenges in Different Populations Transcript Now that you’ve read Carl’s story, you may have some thoughts. Do you think Carl’s situation is one you would be interested in investigating further for this course? Think about what other considerations you would have to keep in mind if you were trying to help other veterans living in urban areas. Kevin Millard Rural LGBTQ Teen Kevin Millard, 17, came into the clinic with minor injuries after a fight at school. I got into a fight in the bathroom with Bob Heaney, Justin Collins, and Brad Kelzer.
There were three of them but I held my own. They’re not going to mess with me anymore. They were giving me crap for using the boy’s bathroom. But that’s who I am, and I’m tired of pretending and hiding it. I usually try not to go into the bathroom unless I know nobody’s in there, just to avoid trouble, but I went in today and Heaney and those guys were in there. They just started in on me, calling me freak, asking me to show them how I was going to use the urinal. I told them to knock it off and they didn’t, and then we started pushing. I don’t remember who threw the first punch. This is the first time I’ve had to fight, but stuff’s been really hard and weird all year. I decided this year I was going to stop hiding and start living as the person I really am. But I didn’t know it’d be so hard. I don’t do much now, and my grades are in the toilet. The biggest thing is that I feel so alone. There’s nobody in town who’s going through what I’m going through. I have all these questions and I never know where to take them. My mom and dad try to help, but there’s so much they don’t understand. I came home from school last week just crying my head off because Mr. Rossum, my science teacher, kept using my old name even when media.capella.edu/CourseMedia/MSN6026/VilaHealthHealthChallengesDifferentPopulations/transcript.html 3/6 3/5/2020 Vila
Health: Health Challenges in Different Populations Transcript I kept saying to him “I’m not Kathy anymore, I’m Kevin.” My mom, she mostly doesn’t want to rock the boat, so she asked me if I couldn’t just be understanding that Mr. Rossum’s from another generation and just doesn’t get it. Her saying that just made me feel terrible because she wants to be understanding to this mean old guy but not to me. I don’t know, maybe they’re all right and I’m just a freak. I mean, they can’t all be wrong. Now that you’ve read Kevin’s story, you may have some thoughts. Do you think Kevin’s issue is one you would be interested in investigating further for this course? Think about what other considerations you would have to keep in mind if you were trying to help other GLBTQ youth in rural areas. Delia Jensen Elderly Home Health Care Delia Jensen, 79, an immunocompromised cancer patient. She lives at home alone, and is visited daily by a home health care nurse. I guess I’m as good as I can be today. My pain’s still there, but it’s not as bad as it can be some days, and I’m far enough out from the last round of chemo that the nausea’s gone. So that’s good. But it’s just hard. It’s hard living with this checklist of things I have to do to keep from getting some kind of infection. Wash my hands, sure, I can do that. I should be doing that anyway! But I’m not used to having to do it so much! And I lose a lot sleep worrying about what would happen if I got an infection- on top of all the sleep I’m losing worrying about cancer. Substance Addictions and Alcohol Abuses Papermedia.capella.edu/CourseMedia/MSN6026/VilaHealthHealthChallengesDifferentPopulations/transcript.html 4/6 3/5/2020 Vila Health: Health Challenges in Different Populations Transcript It just gets to be a lot. Cooking for myself and washing all the produce. And I’m at the mercy of Sara, my daughter, helping to get groceries for me since I can’t really go out into crowds like that. I don’t mean to complain! She’s been a blessing. but she’s a busy woman and as much as she helps, she has to fit it in between the rest of the things she does in her life- going to work, taking care of the kids. And then every time she comes over, it’s hard for her to have to deal with all the cleanliness, too. She spends a lot of time here when I’m at my worst, right after chemo, but that means that she has less time to spend other times. It’s also hard for Sara to bring the kids over, because of germs. So feel like I never see my grandkids, right when I really need to see them. We talk on Skype, and that helps a little, but it’s not the same. I used to have a lot of friends at the senior center, but I think I was just making people feel uncomfortable, going there in a surgical mask and washing my hands all the time. I can’t even have a cat for company! Now that you’ve read Delia’s story, you may have some thoughts. Do you think Delia’s issue is one you would be interested in investigating further for this course? Think about what other considerations you would have to keep in mind if you were trying to help other elderly members of the community who are receiving home health care. Conclusion You have completed the Population Health Resources activity. These suggestions should give you an idea of other resources you can locate and include in your annotated bibliography. Substance Addictions and Alcohol Abuses Paper
Credits Subject Matter Expert: Marylee Bressie media.capella.edu/CourseMedia/MSN6026/VilaHealthHealthChallengesDifferentPopulations/transcript.html 5/6 3/5/2020 Vila Health: Health Challenges in Different Populations Transcript Interactive Design: Lori Olson Instructional Design: Brian Hagen Media Instructional Design: Keith Pille, Felicity Pearson Project Management: Nakeela Hall Licensed under a Creative Commons Attribution 3.0 License (https://creativecommons.org/licenses/by-ncnd/3.0/) media.capella.edu/CourseMedia/MSN6026/VilaHealthHealthChallengesDifferentPopulations/transcript.html 6/6 3/5/2020 Vila Health: Resources for Topical Research Transcript Vila Health: Resources for Topical Research Introduction Veterans LGBTQ Elderly Conclusion Credits Introduction Vila Health: Resources for Topical Research Staying on top of the health challenges to diverse populations can be intimidating. Fortunately, there exists a wealth of information relevant to the situations of a wide variety of demographic groups. Consider these collections of resources as starting points from which you might move on to further research and build an annotated bibliography. Veterans Issues https://media.capella.edu/CourseMedia/MSN6026/VilaHealthResourcesTopicalResearch/transcript.html 1/13 3/5/2020 Vila Health: Resources for Topical Research Transcript These resources may help in your research to build an annotated bibliography. This set of diagnostic criteria is relevant to the issue: Prescription drug abuse is on the rise. Substance abuse may vary depending on geographical area, age, rural vs. urban settings. Veterans who live in rural settings may not have access to adequate Veteran health care. What are the symptoms of veteran substance abuse? Decreased interest in personal hygiene and appearance. Abnormal behavioral responses. Abnormal mood swings. Unexplained weight loss. Lethargy and/or excessive sleepiness. Sores on the face or mouth. Watery or red eyes. Giving up cherished activities. Withdrawing from company. Secretive behavior. Spending money without being able to account for the expenses. Substance Addictions and Alcohol Abuses Paper
This data illuminates a problem related to this issue as well. A higher percentage of female Veterans than male Veterans had a service-connected disability rating in 2009. A higher percentage of male Veterans used VA health care at all but a higher percentage of female Veterans used VA health care only. Female Veterans were more likely than male Veterans to be uninsured, have no earnings or income, and live below the poverty threshold. Selected Characteristics of Veterans (in percent) https://media.capella.edu/CourseMedia/MSN6026/VilaHealthResourcesTopicalResearch/transcript.html 2/13 3/5/2020 Vila Health: Resources for Topical Research Transcript Has a service-connected disability Male: 14.7 Female: 17.8 Uses VA health care Male: 26.1 Female: 23.1 Uses VA only Male: 3.8 Female: 4.8 No health insurance coverage Male: 6.3 Female: 8.0 No earnings, no income Male: 2.6 Female: 6.9 Below poverty Male: 6.2 Female: 9.5 US Department of Veterans Affairs. 2011. Profile of Veterans: 2009 Data from the American Community Survey. Retrieved from: https://www.va.gov/vetdata/docs/specialreports/profile_of_veterans_2009_final.pdf (https://www.va.gov/vetdata/docs/specialreports/profile_of_veterans_2009_final.pdf) Scholarly Journal Articles These citations for articles from scholarly journals may be relevant, or may get you started on your own research. Find them – and other articles – by searching the Capella library. https://campus.capella.edu/web/library/home#summon-search-box (https://campus.capella.edu/web/library/home#summon-search-box) Substance Addictions and Alcohol Abuses Paperhttps://media.capella.edu/CourseMedia/MSN6026/VilaHealthResourcesTopicalResearch/transcript.html 3/13 3/5/2020 Vila Health: Resources for Topical Research Transcript Behavior Therapy Acosta, M., Possemato, K., Maisto, S., Marsch, L., Barrie, K., & Lantinga, L. et al. (2017). WebDelivered CBT Reduces Heavy Drinking in OEF-OIF Veterans in Primary Care With Symptomatic Substance Use and PTSD. Behavior Therapy, 48(2), 262-276. http://dx.doi.org/10.1016/j.beth.2016.09.001 (http://dx.doi.org/10.1016/j.beth.2016.09.001) The American Journal On Addictions Lan, C., Fiellin, D., Barry, D., Bryant, K., Gordon, A., & Edelman, E. et al. (2015). The epidemiology of substance use disorders in US Veterans: A systematic review and analysis of assessment methods. The American Journal On Addictions, 25(1), 7-24. http://dx.doi.org/10.1111/ajad.12319 (http://dx.doi.org/10.1111/ajad.12319) This position paper from a related professional organization may open other possible lines of research: AOAAM- Naloxone Public Policy Statement: The Use of Naloxone for the Prevention of Opioid Overdose Deaths http://c.ymcdn.com/sites/www.aoaam.org/resource/resmgr/Docs/AOAAM_NALOXONE_POLICY _2015.pdf (http://c.ymcdn.com/sites/www.aoaam.org/resource/resmgr/Docs/AOAAM_NALOXONE_POLICY _2015.pdf) Vila Health: Mission, Vision, and Values Mission Vila Health is a comprehensive system of health dedicated to preventing and treating illness and improving the health of the people it serves through innovative and compassionate care. Vision Vila Health aspires to transform lives through science, education, and exceptional care, locally and globally. https://media.capella.edu/CourseMedia/MSN6026/VilaHealthResourcesTopicalResearch/transcript.html 4/13 3/5/2020 Vila Health: Resources for Topical Research Transcript Values Vila Health is dedicated to providing quality health care by creating a system of care that promotes compassion, integrity, and accountability in all its dealings with patients, staff, and other partners. LGBTQ Issues These resources may help in your research to build an annotated bibliography. This set of diagnostic criteria is relevant to the issue: Although members of the LGBT community face similar health concerns as the general population, certain disparities are reported at a higher rate among LGBT persons than the heterosexual population (1). These disparities experienced by LGBT persons may be compounded if they are also part of a racial or ethnic minority (1). Of note, LGBT persons are more likely to identify themselves as being in poor health than heterosexual individuals, and different segments of the LGBT population have individual health risks and needs. For example, gay and bisexual men are at increased risk for certain sexually transmitted infections and account for more than half of all persons living with HIV or AIDS in the United States (1); lesbian women are less likely to have mammography or Papanicolaou test screening for cancer (2); lesbian and bisexual women are more likely to be overweight or obese (3); and lesbian, gay, and bisexual persons are more likely to become disabled at a younger age than heterosexual individuals Quote from Daniel & Butkus, 2015 p 137. In 2012, the United States (U.S.) Surgeon General identified lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) youth as at heightened risk for suicide [1]. Risk factors include depression, substance use, inadequate social support, and not feeling safe at school [1–7]. Large
https://media.capella.edu/CourseMedia/MSN6026/VilaHealthResourcesTopicalResearch/transcript.html 5/13 3/5/2020 Vila Health: Resources for Topical Research Transcript population-based studies over the past 15 years have found that lesbian, gay, and bisexual (LGB) youth are at two to four times increased risk for suicidal ideation and attempts when compared to their cisgender, heterosexual peers [1–3, 5, 8–16]. Within LGB populations, suicidality disproportionately affects racial and ethnic minorities, including American Indian and Hispanic people [1, 17, 18]. In numerous surveys and qualitative studies, transgender youth report elevated risk for suicide, depression, and substance use [19–24]. Copied directly from Willging, C.E, Green, A.E., & Ramos, M.M. (2016). Implementing school nursing strategies to reduce LGBTQ adolescent suicide: A randomized cluster trial study protocol. Implementation Science. 11 (145). 1-10 doi: 10.1186/s13012-016-0507-2 This data illuminates a problem related to this issue as well. HIV Diagnoses Among Transgender People in the United States by Race/Ethnicity, 2009-2014 From 2009 to 2014, 2,351 transgender people were diagnosed with HIV in the United States.b Eighty-four percent (1,974) were transgender women, 15% (361) were transgender men, and less than 1% (16) had another gender identity. Black/African American Transgender Men: 58% (211) Transgender Women: 51% (1,002) Hispanic/Latino Transgender Men: 15% (55) Transgender Women: 29% (578) White Transgender Men: 16% (56)_ Transgender Women: 11% (212) Other https://media.capella.edu/CourseMedia/MSN6026/VilaHealthResourcesTopicalResearch/transcript.html 6/13 3/5/2020 Vila Health: Resources for Topical Research Transcript Transgender Men: 11% (39) Transgender Women: 9% (182) Source:
https://www.cdc.gov/hiv/group/gender/transgender/index.html (https://www.cdc.gov/hiv/group/gender/transgender/index.html) Scholarly Journal Articles These citations for articles from scholarly journals may be relevant, or may get you started on your own research. Find them – and other articles – by searching the Capella library. https://campus.capella.edu/web/library/home#summon-search-box (https://campus.capella.edu/web/library/home#summon-search-box) Prevention Science Ybarra, M., Mitchell, K., Kosciw, J., & Korchmaros, J. (2014). Understanding Linkages Between Bullying and Suicidal Ideation in a National Sample of LGB and Heterosexual Youth in the United States. Prevention Science, 16(3), 451-462. http://dx.doi.org/10.1007/s11121-014-0510-2 (http://dx.doi.org/10.1007/s11121-014-0510-2) Journal Of School Health Hillard, P., Love, L., Franks, H., Laris, B., & Coyle, K. (2013). “They Were Only Joking”: Efforts to Decrease LGBTQ Bullying and Harassment in Seattle Public Schools. Journal Of School Health, 84(1), 1-9. http://dx.doi.org/10.1111/josh.12120 (http://dx.doi.org/10.1111/josh.12120) This position paper from a related professional organization may open other possible lines of research: NASP National Association of School Psychologists Position Statement: Lesbian, Gay, Bisexual, Transgender, and Questioning Youth https://www.nasponline.org/x26826.xml (https://www.nasponline.org/x26826.xml) Vila Health: Mission, Vision, and Values
https://media.capella.edu/CourseMedia/MSN6026/VilaHealthResourcesTopicalResearch/transcript.html 7/13 3/5/2020 Vila Health: Resources for Topical Research Transcript Mission Vila Health is a comprehensive system of health dedicated to preventing and treating illness and improving the health of the people it serves through innovative and compassionate care. Vision Vila Health aspires to transform lives through science, education, and exceptional care, locally and globally. Values Vila Health is dedicated to providing quality health care by creating a system of care that promotes compassion, integrity, and accountability in all its dealings with patients, staff, and other partners. Elderly Issues These resources may help in your research to build an annotated bibliography. This set of diagnostic criteria is relevant to the issue: Common variable immune deficiency (CVID) is the most frequent symptomatic primary immune defic …