Heroin misuse is one of the major causes of death in the United States of America due to the opioid crisis. Prescription and non-prescription behaviors can contribute to the abuse. Overdose is the leading cause of death associated with the use of this medicine. According to National Overdose Deaths, the annual death toll from heroin overdose in the United States is expected to reach 33,000 in 2015. The number of deaths from this drug overdose is increasing by hundreds each year, making it an epidemic that must be addressed quickly. This healthcare issue affects both men and women, and it affects people of all ages. It is most prevalent among the youths according to studies (Manchikanti, Kaye, & Kaye, 2016).
Heroin is a morphine derivative opioid. Inappropriate use of heroin leads to addiction. It is an illegal substances that find its way to the market through the backdoor. It is introduced into the body through various routes. It can either be smoked like a cigarette or sniffed as powder. Some people inject this drug through the intravenous or intramuscular routes. Injection of this drug into the body can introduce disease causing organisms into the body. The drug can either be taken alone or with other substances. Other substances include milk or cocaine.
Heroin is taken by people as a stimulant. This is but it also has negative healthcare problems. Some people have developed tolerance after using the drug in high doses for a long period. Some of the effects of using this drug are flush skin, the eyes become watery and running nose. Episodes of nausea and or vomiting with itchiness follows. Using heroin continuously leads to both physical and psychological dependence. Individuals will not be able to function actively without using this drug. Stopping the use of heroin in an individual leads to withdrawal symptoms including death (Suryaprasad, et al., 2014)
Today in many societies across America, not only heroin is abused. Some other substances both legal and illegal are abused by many people of all ages and, top and lower income earners. These other substances include cocaine and painkillers. Cocaine is also an illegal drug that has penetrated into the American black markets and largely traded by drug cartels. Painkillers such as morphine are abused across America also. Morphine abuse occurs both at healthcare facilities and beyond the hospitals walls. These substance are abused to achieve the same objectives as heroin. Their health outcomes are more or less similar to those of heroin (Jones, 2013).
Drug overdose has resulted to far reaching consequences. The consequences are physical, psychological, social and cultural. This has had impacts to both the individual and the surrounding the he or she is found. The surrounding maybe an organization, culture or family. Heroin overdose leads to impaired physiological process in the body such kidney diseases and lung problems (Volkow, 2014). Use of equipment to introduce introduces infection to the body of an individual leading to hepatitis and HIV due to sharing of injecting objects. Such illness to a senior member of the family whom the family depends on may lead to an interrupted family function.
Daily and long-term use of heroin result in dependence to the substance. For individuals working for organizations, drug addiction negatively impact their work. Workplaces prohibit individuals from abusing drugs. Drug dependence by individuals make them not able to work optimally without using the drug. If one stops using the drug so as to be allowed to work in any organization, he or she may have withdrawal symptoms such as depression which further and negatively affects his or her input at work. Withdrawal symptoms also includes detaching from social groups both in the community and at work places (Jones, 2013).
How to prevent and control communicable diseases among heroin users
PICO TABLE
Element
Example
Problem
Bacterial hepatitis C
Intervention
No sharing of injecting equipment among
Comparison
Avoid heroin abuse through intravenous or intramuscular route
Outcome
Reduced cases of hepatitis infection among heroin users
Searching for data from the databases and documenting the information involved an organized strategy to retrieve the appropriate sources for studies. The healthcare problem was specific and focused on one item for easy access to information from the websites and other resources present. Several key terms assisted in retrieve the information. They included; heroin abuse, heroin overdose, health problems from opioid crisis and effects of heroin abuse. Each key term retrieved several results. The results from the data base bared relatively similar articles. Some articles were different but the information relatively the same.
The retrieved articles were more than hundred in number. Some were consider while others were not. The considered articles were six in number. Criteria for inclusion of these articles was the components of each articles. The components of these articles were either research-based while others were not evidenced-based. Researched or evidenced-based articles included journals from Centre of Disease Control and the National Overdose Deaths. The number of researched-based articles and journals were four in number. These journals were composed of the abstract, introduction, study designs, results and discussion, and conclusion part. Non-evidenced based articles were two in number. These journals had information concerning the signs and symptoms of heroin overdose, effects of heroin overdose and the treatment of heroin overdose.
The two evidenced-based articles that were considered are by Volkow, N.D and Jones, C. M. These two are quantitative study and correlational studies respectively. These were considered due to their components of research studies. They have the abstract, methods of collecting data, the results of the research study, the discussion and the conclusion of the author about the findings of the research. These two have comprehensive information about opioid abuse. They contain information about the statistics. The two non-evidenced based articles by Manchikanti, et al., and Suryaprasad, et al. They are experimental study designs based on observational process that do not have any tests to prove their effectiveness. These studies focused much on the causative factors, signs and symptoms of hepatitis, treatment and the complications of hepatitis
Author’s
Name
Journal name
Year of publication
Research design
Sample size
Outcome variable measures
Level (I-III)
Quality (A,B,C)
Results/author’s conclusions
Volker, N.D
American’s addiction to heroin.
2014
Quantitative study design
86%
431 samples
the variable were the maximum benefits of the drug as compared to the associated risk.
II
B
There is an increasing number of people dying from overdosing drugs after abusing drugs prescribed to them by the physicians. It is therefore the duty of nurses to educate the patients on how to use painkillers prescribed to them.
Manchikanti, et al.,
Current state of opioid therapy and abuse.
2016
Correlational study design
169 interviews
There is an increase overdose death with increasing prescription of opioid for pain
II
B
the study reveals that there is an increase in death due to opioid overdose prescribed for pain relievers.
Suryaprasad, et al.,
Emerging epidemic of hepatitis C virus infections among nonurban persons injecting drugs in the U.S.
2014
Experimental study design
635 interviews.
85%
It is clear that death from overdose is depended on age and race
III
A
The study reveal that the virus is common among the white race heroin abusers. The victims of the disease are the youths who live in the rural areas in the U.S
Jones, C. M.
Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid pain relievers U.S. 2002-2004 and 2008-2010.
2013
Correlational study design
95%
heroin injection is increasing among non-medical users as compared to those use heroin for medical users.
II
B
It is clear that heroin use among individuals is increased. Interventions to prevent this use and its associated effects are required to be implemented.
Communicable disease such as hepatitis C is common among heroin and other drug abusers. It is more common in individuals directly introduce the drug into the body through injection by use of a syringe. These diseases are mostly viral that are transmitted from one person to another through sharing of objects used to introduce the drug into the body. The disease is a life threatening condition that need an immediate interventions to prevent occurrence of new diseases, treat the present condition and assist the people with disabilities to cope up with life through rehabilitation.
Prevention of cases of morbidity and mortality resulting from hepatitis C that is contracted through injection among drug users is a topic that is broad. It require interdisciplinary collaboration of medical professions to control these cases. Its recommended that three strategies should be employed while managing such situation; reducing the cases of exposure to such virus, reducing the number of people getting the disease after exposure and thirdly is reducing the impact of the disease among the infected people (Shalmani, Ranjbar, & Alizadeh, 2013).
Prevention of exposure to the virus involves both the drug users and the medical professionals to work together to reduce the number of exposure probabilities. Education of the drug users about the determinants of health is important. Actions should be taken to prevent the exposed individuals from getting infected. The medical professionals play an important role in this situation by providing extensive medical services to the exposed individuals. For those already suffering from the disease they should be assisted to reduce the disease from being contracted to other people. Severity of the disease is an important factor that needs to be considered to reduce cases of disability from such diseases. Death can also be prevented by taking care of the already people (Martin, et al., 2013).
As mentioned earlier the there is need of interdisciplinary collaboration for effective control of this situation. Teaching the drug users about health determinants is very important. The education is provided by both clinical officers and community health care workers. Provide information about how disease are transmitted from one person to another. Teach the drug users about safety practices of introduction of drugs into the body. The safe practices includes use of sterile objects to introduce drugs into the body. The sterile objects are found in the clinical areas and community pharmacies. Sharing of equipment for injection should be avoided to prevent transmission of the disease between drug users (Shalmani, Ranjbar, & Alizadeh, 2013).
Alternatively exposure to the virus can be prevented through abstinence of the drug by individuals. Avoiding the drug at all cost will not only prevent one from exposure to the drug, but also will prevent other healthcare problems associated with drug abuse. For who find it difficult to abstain from the drug, can use alternative methods to introduce the drug into the body such as smoking or sniffing the drug. For those already infected with the disease, should be treated and measures taken to stop them from contracting the disease to other individuals.
Severity of the viral disease is a concern to every stakeholders. The disease should be controlled to prevent it from advancing to more severe stages that may result to disability. Hepatitis is a condition that affects the liver, which is a vital organ that purifies blood. Therefore this disease can be easily transmitted to the other vital organs such as the brain. Comprehensive medical management of this condition is required because the involvement of the other organs can be happen at a faster rate. All these actions are initiated to reduce morbidity and mortality cases among drug users (Martin, et al., 2013).
Implementation of these changes to overcome the mortality and morbidity cases from heroin abuse-related hepatitis have also encounter barriers. The barriers are both institutional and individual related. At the institutional level, lack of equipment and enough medical personnel are leading factors that negatively influence the implementation process. Individual factors that influences the implementation of the recommendations are lack of enough information by the nurses. The role of nurses in implementation of evidenced based practice is key in promoting the health of individuals. Lack of equipment such as drugs and appliances in the hospitals prevent the nurses from performing their roles of preventing diseases and promoting the health of individuals (Shalmani, Ranjbar, & Alizadeh, 2013).
These barriers to implementation of the mentioned recommendations can be removed in the healthcare systems through various steps. They include addressing both institutional factors as well as individual factors from the nurses and other medical professions. The institutions should ensure that enough drugs and other supplies are present to enable effective interventions to the victims of such diseases. Nurses and other professions within the clinical settings should have access to enough medical information. Nurses should also educate these patients suffering from heroin abuse-related communicable disease on how to prevent exposure and infection after using the drug (Shalmani, Ranjbar, & Alizadeh, 2013).
After employment of the strategies to remove the barriers, assessment is very important to evaluate the effectiveness of the interventions. The interventions were having adequate medical supplies and having highly competent medical personnel such as nurses. From the assessment, it is clear that there is adequate supplies and competent nurses to take care of individuals at risk and suffering from hepatitis related to opioid abuse.
References
Jones, C. M. (2013). Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid pain relievers–United States, 2002–2004 and 2008–2010. Drug and alcohol dependence, 132(1), 95-100.
Manchikanti, L., Kaye, A. M., & Kaye, A. D. (2016). Current state of opioid therapy and abuse. Current pain and headache reports, 20(5), 34.
Martin, N. K., Vickerman, P., Grebely, J., Hellard, M., Hutchinson, S. J., Lima, V. D., ... & Hickman, M. (2013). Hepatitis C virus treatment for prevention among people who inject drugs: Modeling treatment scale‐up in the age of direct‐acting antivirals. Hepatology, 58(5), 1598-1609.
Shalmani, H. M., Ranjbar, M., & Alizadeh, A. H. M. (2013). Recommendations for prevention and control of hepatitis C virus (HCV) infection and HCV-related chronic disease. J Liver, 3(147), 2167-0889.
Suryaprasad, A. G., White, J. Z., Xu, F., Eichler, B. A., Hamilton, J., Patel, A., ... & Macomber, K. (2014). Emerging epidemic of hepatitis C virus infections among young nonurban persons who inject drugs in the United States, 2006–2012. Clinical infectious diseases, 59(10), 1411-1419.
Volkow, N. D. (2014). America’s addiction to opioids: heroin and prescription drug abuse. Senate Caucus on International Narcotics Control, 14.
