A Review of Substance Use Disorders Policy


The Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment for Patients and Communities Act or the SUPPORT for Patients and Communities Act is a Medicaid provision aimed at addressing the Opioid Crisis in the American Society (“H.R.6,” 2018).


In recent years, the United States has continued to experience a problem with the use of pain medications. Some laws and legislations aimed at restricting opioid prescriptions and use have been approved to address this ravaging problem of substance addictions (Short, 2017). In this regard, nurses, being the primary care providers, face the challenges as immediately as they come. According to Smart et al. (2020), about fifty thousand people in the United States lost their lives as a result of opioid overuse. Smart et al. (2020) further note that the opioid problem costs the United States government close to about USD 79 million, with the inclusion of costs of care access, management of the addictions, and decreased productivity.

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Increasing the management policies and protocols in substance use addictions is a timely initiative, for reversing the negative trend. According to Liu et al. (2020), the United States Department of Health and Human Services (HHS) is focused on increasing recovery management services. These policies are aimed to enhance the use of overdose-limiting drugs, conduct more public health sensitization through research on opioids, and increase access to recovery facilities.

Under title II of the SUPPORT on Medicare provisions to address the opioid use problems, section 2003, prescribing controlled substances that are considered drugs under the Medicare program, must be transmitted through electronic prescription programs (“H.R.6,” 2018). Therefore, the electronic medical prescription of some opioids will limit the use and misuse of the drugs, as they have to be approved by a qualified health professional before the drug is dispensed.

Evidence Base to Support the Proposed Policy

There is a paucity of knowledge in support of electronic prescription of opioid medications. In my opinion, the electronic prescription of opioids is beneficial as a means of reducing substance use addiction in the United States. According to Jones and McCance-Katz, (2019), currently, the substance use problem, especially opioid use disorder (OUD) has affected over two million individuals, all of whom have been affected by the prescription process.

According to Liu et al. (2020), prescription opioids serve a critical role in the escalation of the opioid problem, thus warranting the use of electronic prescribing of controlled substances (EPCS), as a means to reduce the effects of the opioid crisis. In a study to determine the strengths and weaknesses of data in favor of opioid addiction, it was discovered that electronic prescription is one important way of addressing the problem (Smart et al., 2020). However, Smart et al. (2020), noted that there is a need for more data on the use of electronic prescriptions to support informed and clear decision-making in the process.

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In conclusion, the current opioid crisis is a priority problem that should be mitigated to avoid future problems. Electronic prescription platforms are the best areas of investment to avert the problem, especially if the proposed legislation comes into effect. This is because it will limit prescriptions of opioids only to qualified healthcare professionals and limit the use by offering appropriate medication dosages. However, more research needs to be done into the practice to allow for more information in favor of denial of the need for better opioid prescription mechanisms. It however remains known that the opioid crisis is a crisis of an epidemic nature and which needs a prompt and urgent response in tackling its effects.

Role of RN and APRN in Policy

The backbone of medical practice is stable on research-informed policies, used as guiding principles for decision-making, and regulatory processes in healthcare practice. Professional Nurses have been at the forefront in implementing many policies, and sometimes developing, and enforcing policies at the primary care level. However, several studies have highlighted the off-handed nature of nurses when it comes to policy formulation, especially those involving the government. Nurses are well familiar with the primary care environment’s daily politics but the thought of handling the public on a larger scale as politicians capable of formulating and implementing policies is not one known to many of them.

According to Tummers and Bekkers (2014), there are several policies of concern to nurses, ranging from the environment to educational policies. As an example, the Affordable Health choices Act-title I: Quality, Affordable Health Care for All Americans advocates for numerous policy amendments aimed at increasing Quality care all across America (CDC). The Nurse’s voice in helping inform such policies by bringing in first-hand patient needs could help change the tides for the patients.

Opportunities for RN/APRNs in Policy Development

Nurses have a chance to earn themselves an opportunity to join policymakers if and when the individual nurse reaches out to the opportunities available. According to Schirle et al. (2020), an APRN or an RN nurse has the necessary education, better information relay with coworkers and the patient, as well as the decision-making skills that come with competent leadership. Moreover, as Sacristán and Dilla (2015) note, these employees have appropriate research skills to analyze the current trends and statistical correlations. These attributes are among the most looked after skills a legislator would need. Most of the nursing care practice has been informed by theories and nursing care models that were developed by former practicing nurses, as proof that being legislators is not huge a task for the APRNs and the RNS.

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Nurses also work in close consultation with the patients and their families, their fellow care providers, hospital administrators, and other stakeholders, all of which are attributes that are important for aspiring policymakers (Schaeffer & Haebler, 2019). According to Tummers and Bekkers (2014), RN and APRN nurses are the largest groups of all primary care professionals and with the ability to master the numbers to influence policies, besides most of them residing with the populations with whom they work.

Nurses have a chance at being political activists, voicing their concerns over pertinent issues and bills to them.

Challenges of the Opportunities

These opportunities are however limited to some very fundamental aspects including the nurses’ skillset from practice experience, knowledge, and the education needed for change management, political negotiations, and managing the wider populations. These skills are necessary for policy-makers who intend to make and influence decisions. Klein and Sorra (1996) remark that stakeholders are not always consistent, which compromises the effectiveness of interventions. Nurses should be informed on the current and predicted trends in the healthcare system as a basis that guides their thinking and helps them take the necessary steps.

Strategies Advocating for APRN and RNs Opportunities

The first strategy would be for APRNs and RNs to be professional lobbyists, driving changes in organizations through new policies. Nurses could also take the lead by serving as chairpersons in legislative committees or gathering the courage to present their issues before a group of legislators. APRN and RN Nurses in the modern-day practice of nursing are taking to the policy arena, better equipped with irrefutable knowledge and experience, ready to tackle and handle their duties effectively. For the healthcare system to bear the brand of quality care providers, healthcare policies must foster the efforts of clinical care activities, for increased quality.

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Centers for Disease Control and Prevention (CDC). (n.d.). Step by step: Evaluating violence and injury prevention policies: Brief 4: Evaluating policy implementation. Web.

H.R.6 – SUPPORT for Patients and Communities Act. (2018). Congress. Web.

Jones, C. M., & McCance-Katz, E. F. (2019). Co-occurring substance use and mental disorders among adults with opioid use disorder. Drug and Alcohol Dependence, 197, 78-82. Web.

Klein, K. J., & Sorra, J. S. (1996). The challenge of innovation implementation. Academy of Management Review, 21(4), 1055-1080. Web.

Liu, J., Storfer-Isser, A., Mark, T. L., Oberlander, T., Horgan, C., Garnick, D. W., & Scholle, S. H. (2020). Access to and engagement in substance use disorder treatment over time. Psychiatric Services, 71(7), 722-725. Web.

Sacristán, J., & Dilla, T. D. (2015). No big data without small data: Learning health care systems begin and end with the individual patient. Journal of Evaluation in Clinical Practice, 21(6), 1014-1017. Web.

Schaeffer, R., & Haebler, J. (2019). Nurse leaders: Extending your policy influence. Nurse Leader, 17(4), 340-343. Web.

Schirle, L., Norful, A. A., Rudner, N., & Poghosyan, L. (2020). Organizational facilitators and barriers to optimal APRN practice: An integrative review. Health Care Management Review, 45(4), 311-320. Web.

Short, N. M. (Ed.). (2017). Health policy and politics. Jones & Bartlett Learning.

Smart, R., Kase, C. A., Taylor, E. A., Lumsden, S., Smith, S. R., & Stein, B. D. (2020). Strengths and weaknesses of existing data sources to support research to address the opioids crisis. Preventive Medicine Reports, 17, 1-14. Web.

Tummers, L., & Bekkers, V. (2014). Policy implementation, street level bureaucracy, and the importance of discretion. Public Management Review, 16(4), 527-547. Web.

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