Discussion 1
Elizabeth Layne Lang
One of the U.S. fastest rising epidemic concerns is that of the opioid crisis. Data collected by the
National Center for Health Statistics at the Centers for Disease Control and Prevention has shown an
alarming increase of opioid related deaths spanning from 1999-2021. Although there has been a steady
increase of opioid related deaths over the last 21 years the greatest increase was between 2010-2017,
but remained steady until 2020 (NIH) According to the National Institute on Drug Abuse, over 106,000
people died from a drug-involved overdose (National Institute on Drug Abuse, 2022). Of those deaths
reported, deaths involving synthetic opioids other than methadone reached the staggering number of
70,601, with the primary cause being fentanyl (National Institute on Drug Abuse, 2022) . What is the
cause for all of these alarming death rates and what can be done to prevent the numbers from
climbing?
The U.S. Customs and Border Protection agents have increased efforts since 2016 to fight the ongoing
and growing crisis by partnering with scientists to help identify unknown substances brought into U.S.
ports. Any item that appears to be suspicious to CBP agents can be immediately taken to their lab for
testing John F. Kennedy International Airport in New York processes 60% of the states international mail
and one of the first known encounters of fentanyl as an illicit drug (Crisis Control | U.S. Customs and
Border Protection, n.d.). Even though there appears to be a tight grasp on the airport system, there are
still plenty of other entry points for drugs into the states (Crisis Control | U.S. Customs and Border
Protection, n.d.). In September of 2020, the Memphis FedEx 1.5 kilograms of “sand” was found being
exported from China, which after testing was identified as Xylazine, a farm animal tranquilizer (Crisis
Control | U.S. Customs and Border Protection, n.d.). While Customs appears to deal with large volume
opioid busts, much of the crisis can be traced to those using drugs on the street and those who are
impoverished.
Social determinants of health can cause a great shift on the scales for those who are trying to over
come drug addiction or improve health. According to the World Health Organization, SDoH are defined
as “the conditions in which people are born, grow, live, work, and age. These circumstances are shaped
by the distribution of money, power, and resources at global, national, and local levels” (Grinspoon
2021). Even though many of the cases involve synthetic drugs being mixed with illicit drugs, there are
many cases that involve overdoses on proscribed medication. Unintentional drug overdoses, overtook
motor vehicle accidents to become the leading cause of accidental death among adults in the United
States (CDUHR). These medical errors or miss use could be caused by economic status and lower
educational outcomes or generalized stressors such as poverty or unemployment (Grinspoon 2021).
Education is the key to preventing misuse of prescribed medications.
While the war on drugs will be a political hot topic for years to come there have been several efforts to
slow down the growing crisis by many political leaders. In March of 2017 President Donald Trump,
established the President’s Commission on Combating Drug Addiction and Opioid Crisis, and while in
office, more that $1 billion in funds was allocated directly addressing the drug addiction and opioid
crisis. There was also an emphasis on tighter border protection in attempts to prevent known drug
cartels from infiltrating onto U.S, soil. One of Trump’s predecessors, George W. Bush, proposed $3.8
billion for drug treatment and research, and further requested $731 million to target the supply of illegal
drugs from other nations such as, Ecuador, Panama, Peru and Venezuela (President Bush Announces
Drug Control Strategy, 2002). In terms of which president had a better grasp on attacking the issue at its
core, I feel that President Trump had a stronger approach by protecting the boarders of the United
States and having a tighter control on what comes in at boarder stations. Though there are many
political strategies and oppositions all candidates have, there may not only be one answer to solve this
fast growing and ever evolving issue.
One was as a practicing professional I plan to do all I can to help raise awareness and help educate my
patients on the importance of proper medication administration and help educate family members on
warning signs of misuse and addiction. One particular change I would attempt to make is to use
alternative therapies for pain relief instead of opioid use. This is a particular goal of working in advance
practice and limiting the use of opioids in near and dear to me because I lost an aunt to an opioid
addiction and her death was a great loss to my family. It is my personal feeling that if patients are not
given access to these drugs, it lessens the chance of medical misuse and subsequently lessen the death
toll.
National Institute on Drug Abuse. (2022, January 20). Overdose Death Rates. National Institute on Drug
Abuse. https://nida.nih.gov/research-topics/trends-statistics/overdose-death-ratesLinks to an external
site.
Crisis Control | U.S. Customs and Border Protection. (n.d.).
Www.cbp.gov. https://www.cbp.gov/frontline/crisis-controlLinks to an external site.
President Bush Announces Drug Control Strategy. (2002, February 12). State.gov. https://20012009.state.gov/p/inl/rls/rm/8451.htmLinks to an external site.
The White House. (n.d.). The cabinetLinks to an external site.. Retrieved September 20, 2018,
from https://www.whitehouse.gov/the-trump-administration/the-cabinet/Links to an external site.
Grinspoon, P. (2021, September 28). Poverty, homelessness, and social stigma make addiction more
deadly. Harvard Health. https://www.health.harvard.edu/blog/poverty-homelessness-and-socialstigma-make-addiction-more-deadly-202109282602
Discussion reply 2
Amaka Iheaka
Main Question Post: Presidential Agendas
Which social determinant most affects this health issue
This discussion post aims to discuss obesity in African American communities in the United States.
Obesity is a growing public health crisis in the United States. It is associated with a substantial disease
burden due to an increased risk for multiple complications, including cardiovascular and metabolic
diseases (Lofton et al., 2023))festyle choices like physical activities and food choices mainly cause
obesity. African Americans are known to be at higher risk for these diseases due to different reasons.
Obesity disproportionately affects African Americans, particularly women, regardless of socioeconomic
status. Structural racism contributes significantly to health disparities between African Americans and
the general population. It limits access to healthy foods, safe spaces to exercise, adequate health
insurance, and medication, all impacting obesity prevalence and outcomes (Lofton et al., 2023). Health
disparities are a severe barrier in the healthcare system because they affect the type of care available to
patients. Patients also are unaware of the resources available to them, which is why some patients do
not get help because they fear the bill they might receive.
To eradicate health disparities and promote quality care, the Affordable Care Act, also known as Obama
care, was created in March 2010 to make care accessible to everyone, especially low-income families.
With Obamacare, people could get help without worrying about bills also made more people seek help.
The Affordable Care Act includes several provisions that promote preventive care, including obesityrelated services and coverage. Obesity screening and counseling for children, adolescents, and adults is
a USPSTF-recommended service and to design public awareness campaigns to educate Medicaid
enrollees on the availability and coverage of preventive services, including obesity-related services.
How did two recent presidents handle the problem, and What would you do differently
The current president, Joe Biden administration (2023), released, “We have made record-breaking
progress in expanding coverage and lowering health care costs for American families, saving them
money and giving more Americans the peace of mind that comes with affordable health insurance.” this
administration is promoting healthy living by building more parks to increase physical activity for kids,
promoting healthy eating, creating awareness at schools and communities. Organizations like healthy
people 2020 promote healthy living. On the other hand, the Trump administration was trying to
eliminate the act that has proven to help people access healthcare. During this administration, racism
was indirectly encouraged, which brought back health disparities. I will focus on primary
interventions/prevention, which is cheaper%aching patients how to control their health and make
healthy choices while enjoying it. For instance, instead of completely stopping pasta, one can exchange
it with wheat or vegetable pasta. The goal is to make it a lifestyle.
Conclusion
In conclusion, obesity causes many cardiovascular and other diseases making it a serious topic. The fact
that it can be avoidable makes it worth considering. With promotions of primary prevention, the
government can save money. Promoting health equality is also essential, as no life is more important
than the other.
Reference
Lofton, H., Ard, J. D., Hunt, R. R., & Knight, M. G. (2023, January 25). Obesity among African American
people in the United States: A review … The Obesity Society. Retrieved February 28, 2023, from
https://onlinelibrary.wiley.com/doi/full/10.1002/oby.23640
Reducing obesity. Medicaid. (n.d.). Retrieved February 27, 2023, from
https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement-initiatives/reducingobesity/index.html
The United States Government. (2023, January 25). Statement from President Joe Biden on record ACA
enrollment numbers. The White House. Retrieved February 27, 2023, from
https://www.whitehouse.gov/briefing-room/statements-releases/2023/01/25/statement-frompresident-joe-biden-on-record-aca-enrollment-numbers/

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