Chapter Eleven: Current Topics
Overview
Community health nurses play a vital role in the communities they serve as advocates for patients and members of the community as they negotiate the health impact of pressing current issues. This chapter provides a brief overview of four of the issues facing nurses and the communities they serve.
Key Terms
Opioid use Disorder
Substance use disorder (SUD) occurs when the recurrent use of alcohol and/or drugs causes clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school, or home. Opioid use disorder is one type of SUD. The terms opiate and opioid are often used interchangeably, but there are differences between the two. Opiates are a class of drugs naturally found in the opium poppy plant and include the drugs morphine and codeine; these are referred to as “natural opioids.” The term opioid is a broader term and encompasses all substances natural or synthetic (derived in a laboratory) that bind to the receptors in the brain. This includes the naturally derived opiates (morphine) as well as synthetic (fentanyl) and semi-synthetic (natural and laboratory) opioids like oxycodone. Opioids are used to treat pain because they block pain signals between the brain and the body. Opioids were originally prescribed for cancer pain. Heroin, a street drug, is also a natural opiate. In addition to providing pain relief, opioids make some people feel relaxed and high (Butanis, 2022).
Since 1999, more than 932,000 people have died from a drug overdose. In 2020 alone, nearly 92,000 people died from a drug overdose, and over 68,000 or 75% of these deaths involved an opioid overdose (Centers for Disease Control and Prevention [CDC], 2022f). In 2020, an average of four Virginians died every day from an opioid overdose (Virginia Department of Health, 2021).
The Opioid Epidemic
Figure 11.1: The Opioid Epidemic by the Numbers (Adapted from U.S. Department of Health and Human Services Digital Communications Division, 2022)
Long Description for Figure 11.1
70,630 people died from drug overdose in 2019. 1.6 million people had an opioid use disorder in the past year. 745,000 people used heroin in the past year. 1.6 million people misused prescription pain relievers for the first time. 48,006 deaths attributed to overdosing on synthetic opioids other than methadone, in 12-month period ending June 2020. 10.1 million people misused prescription opioids in the past year. 2 million people used methamphetamine in the past year. 50,000 people used heroin for the first time. 14,480 deaths attributed to overdosing on heroin, in 12-months period ending June 2020. Sources: 1, 2019 National Survey on Drugs Use and Health, 2020. 2, N C H S Data Brief Number 394, December 2020. 3, N C H S, National Vital Statistics System, Provisional drug overdose death counts.
In the late 1990s, pharmaceutical companies used aggressive marketing to encourage providers to prescribe opioid