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Health Policy and Program Paper

Danielle Johnson

College of Nursing, University of South Florida

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Health Policy and Program Paper

The county of Pinellas in Florida is known for its great beaches. Like any county, some of the

many negatives and positives aren’t as well known. This paper will give a synopsis of

the county and delve into the primary health concerns of its population. A tertiary intervention

will be discussed that can be utilized to correct these concerns.

Identification of a Population-Specific Priority Health Concern

A priority health issue for Pinellas County is the number of drug overdose deaths. The

number of drug poisoning deaths per 100,000 people in the county is 41. This is higher than both

the national number of 11 and the state number of 27 (UWPHI, 2020). Two health implications

of nonlethal drug overdose are coma blisters and compartment syndrome. Studies have found a

link between bullous lesions known as coma blisters and coma post-drug-overdose (Dinis-

Oliveira, 2019). For patients who collapse during a drug overdose, long-term compression of

their extremities can lead to compartment syndrome (Jones, et al., 2020).

Population Diagnosis

The primary health concern for Pinellas County is the number of drug overdose deaths.

Adults in Pinellas County are at high risk for drug overdose deaths due to an increased amount of

Fentanyl and Fentanyl-laced drugs in the community (Pinellas County Sheriff's Office, 2017).

This drug has a fast onset and can result in rapid death once ingested (Han, 2019).
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Impact of Community Health Models

The Social Determinants of Health (SDOH) model list the major conditions that affect

the quality of life, health, and functioning. These conditions can occur anywhere a person spends

time, like school, work, church, home, local environment. This model separates these conditions

into 5 domains: economic stability, social and community context, neighborhood and built

environment, healthcare access and quality, and education access and quality (Office of Disease

Prevention and Health Promotion, 2020). The SDOH model can be used to determine the causes

of major health concerns in certain populations. Factors of the SDOH that affect Pinellas

County’s primary health concern are education, health and healthcare, and neighborhood and

built environments. Studies have shown that the attainment of education plays a major role in the

risk of drug use later in life (Fothergill, et al., 2007). Having adequate healthcare systems can

prevent this illicit drug use (U.S. Department of Health & Human Services, 2016). Lastly, in

2016 researchers found that environmental factors such as physical barriers to treatment,

neighborhood disadvantages, and access to substances in the community all influence the rates of

substance use disorders (Mennis, et al., 2016).

Tertiary Level of Prevention

A tertiary prevention from drug abuse is admittance into an inpatient drug rehabilitation

program. Studies have found that addiction, like other chronic diseases, is not necessarily

curable. But with guidance and rehabilitation, these addictions can go into remission. These

programs may also involve medication use (U.S. Department of Health and Human Services,

2022). The National Council on Alcoholism and Drug Dependence, Inc. (NCADD) implement

medication-assisted recovery in their pathway to recovery as well as counseling and peer-support

groups (Wilcox, 2021). The role of nurses in these rehabilitation programs includes
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administering medication, implementing behavioral therapy techniques, and educating patients

(“What is a substance abuse nurse?”, 2021).

Development of Health Policy

One of the goals of Healthy People 2030 is to increase the number of people with

substance use disorders who get treatment (Drug and Alcohol Use, 2022). To do this they utilize

evidence-based health policies to prevent disease and/or promote health.

Policy Proposal

The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment

(SUPPORT) for Patients and Communities Act of 2018 was specifically created to assist with the

country’s overdose epidemic (Laws and regulations, 2022). Part of this Act involves authorizing

grants to establish opioid recovery centers. A center can be created in Pinellas County to help

decrease the number of drug overdoses.

Policy and Program Implementation

a. The first step in implementing this policy is applying for the federal Comprehensive

Opioid Recovery Centers grant.

b. This grant is for nonprofit organizations so I would approach a local nonprofit that

deals with substance abuse recovery to work together for this grant.

c. Key stakeholders would not only be members of the community with a history of

substance abuse but also their families and friends who must deal with the negative

repercussions as well.

d. To create a recovery center funding is necessary to not only bring in staff but to afford

a physical location of the treatment itself. It would be necessary to lease or buy a

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building with space for treatment and living areas for the participants. As well as

paying providers and medical professionals to assist in treatment and care.

e. Potential supporters of this plan include members of the Florida Department of Health.

f. There is a potential for opposition from county leaders who see the creation of drug

rehabilitation programs as a deterrent to tourism. They could fear that having these

programs throughout the county makes it unappealing for travelers coming for

vacations. To this, I would educate these leaders on the high levels of drug overdoses

occurring in our county compared to the rest of the state and stress that decreasing the

occurrence of these overdoses can only improve our county overall.

Conclusion

Pinellas County is an enjoyable area to live in. Like other counties, there are negatives

and positives. The primary health concern of drug overdose deaths is, unfortunately, higher here

than in other areas of the state. To decrease these rates Pinellas County should implement the

tertiary prevention of creating more inpatient drug rehabilitation centers.

Personal Relevance

These papers have opened my eyes to the complexity of Public Health Nursing. Many

things must be considered when caring for your community. Some aspects of the community are

not common knowledge, like Pinellas County’s higher rate of drug overdoses. Now that I know

of this issue in my county, I will work toward increasing the community’s knowledge of

rehabilitation options that exist. I now have a better understanding of how to assess my

community’s needs and implement change.

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References

Dinis-Oliveira R. J. (2019). Drug Overdose-Induced Coma Blisters: Pathophysiology and

Clinical and Forensic Diagnosis. Current drug research reviews, 11(1), 21–25. https://doi-

org.ezproxy.hsc.usf.edu/10.2174/1874473711666180730102343

Drug and Alcohol Use. Healthy people 2030. (2022, November). Retrieved November 14, 2022,

from https://health.gov/healthypeople

Fothergill KE, Ensminger ME, Green KM, Crum RM, Robertson J, Juon HS. The impact of

early school behavior and educational achievement on adult drug use disorders: a

prospective study. Drug Alcohol Depend. 2008 Jan 1;92(1-3):191-9. doi:

10.1016/j.drugalcdep.2007.08.001. Epub 2007 Sep 14. PMID: 17869029; PMCID:

PMC2393553.

Han, Ying, et al. “The Rising Crisis of Illicit Fentanyl Use, Overdose, and Potential Therapeutic

Strategies.” Translational psychiatry. 9.1 (2019): n. page. Web.

Jones, A. L., Rankin, J. A., & Then, K. L. (2020). Drug Overdose, Loss of Consciousness, and

Compartment Syndrome: A Life-Threatening Combination. Journal of emergency

nursing, 46(3), 294–301. https://doi-org.ezproxy.hsc.usf.edu/10.1016/j.jen.2020.02.001

Laws and regulations. SAMHSA. (2022, November). Retrieved November 14, 2022, from

https://www.samhsa.gov/about-us/who-we-are/laws-regulations
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Mennis J, Stahler GJ, Mason MJ. Risky Substance Use Environments and Addiction: A New

Frontier for Environmental Justice Research. Int J Environ Res Public Health. 2016 Jun

18;13(6):607. DOI: 10.3390/ijerph13060607. PMID: 27322303; PMCID: PMC4924064.

Office of Disease Prevention and Health Promotion. (2020). Social Determinants of Health.

Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/social-

determinants-of-health

Pinellas County Sheriff's Office. (2017, July 25). Overwhelmed by Overdoses. Pinellas County

Sheriff's Office Inside the Star. Retrieved October 21, 2022, from

https://myemail.constantcontact.com/Overwhelmed-by-

Overdoses.html?soid=1112875713762&aid=kUB3wwAgXJ8

U.S. Department of Health & Human Services, Office of the Surgeon General. (2016). Chapter 7

Vision for the future: a public health approach. In Facing addiction in America: The

surgeon general's report on Alcohol, Drugs, and health. essay.

What is a substance abuse nurse? Regis College Online. (2021, October 30). Retrieved

November 14, 2022, from https://online.regiscollege.edu/blog/what-is-a-substance-abuse-

nurse/

Wilcox, S. (2021, November 7). What is medication-assisted recovery? Official NCADD

Website. Retrieved November 14, 2022, from https://ncadd.us/about-

addiction/medication-assisted-recovery