Opioid Crisis Effects on Older Adults: MSN Capstone Project Proposal

Opioid Crisis effects on older adults

State Your Clinical Question

·      State your clinical question or topic for your capstone project proposal.

·      What issue is the question/topic addressing?

·      What are the reasons you selected this question/topic?

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Address the following questions/bullets in completing this section:

·      Start at the starting point – What, Where, When, Why, and How?

·      What is known about this topic or what is the evidence on this topic (Scoping Search)?

·      What is the outcome of interest?

·      What are the gaps in our understanding or knowing related to this topic?

Other dangers can include unintentional prescription drug abuse and the possible deterioration of current mental health conditions. For instance, a 2019 study of patients above the age of 50 found that, compared to 2% of those who do not use them, more than 25% of those who misuse prescription painkillers or benzodiazepine drugs expressed suicidal ideation, highlighting the necessity for comprehensive screening before administering these prescriptions (Jayasinha et al., 2020). When older persons are also dealing with other health issues, persistent pain may become more challenging. About eighty percent of patients suffering from advanced cancer, seventy-seven percent of those with heart illness, and about forty percent of patients aged sixty-five and above report experiencing discomfort. About  4–9% of persons 65 and older who need pain relief take opioid prescription drugs. Opioids prescribed to senior citizens during routine clinic visits climbed by a factor of nine from 1995 to 2010.

From 2017-2020, the percentage of Americans aged fifty-five and above rose by six percent; however, a greater percentage sought treatment for opioid abuse disorders. Between 2013 and 2015, the percentage of older persons who used heroin more than doubled4, in part because some individuals abusing prescription opioids switched to this less expensive substance.

According to 2018 research, despite the fact that illicit drug use typically declines after early adulthood, around 1 million people aged 65 and up have a substance use disorder. While the total number of substance use disorder treatment and rehabilitation centers’ admissions fluctuated somewhat between 2008 and 2018, the percentage of admissions of older people increased from three to seven percent.

Literature Search Strategies

Provide details of your exhaustive search process. Be certain to list:

·      Databases searched.

·      All the keywords or search phrases used.

·      How many articles in total that were found?

·      List the inclusion/exclusion criteria.

·      Provide the number of articles that were retained and a description on why those articles were retained.

·      Consider using a flowchart to outline the search process.

2.     Opioids, side effects of opioids, pain killers, addiction to opioids, older citizens

3.     10 articles

4.     The articles had to be at not more than five years, and they had to be published by credible publishers; they also had to focus on older citizens in relation to opioids

5.     Six articles. These six articles had to be at no more than five years, and they had to be published by credible publishers; they also had to focus on older citizens in relation to opioids. Further, the articles considered recent issues in the society that would make the topic of study more relevant in today’s family nursing needs.

Busse, J. W., Wang, L., Kamaleldin, M., Craigie, S., Riva, J. J., Montoya, L., Mulla, S. M., Lopes, L. C., Vogel, N., Chen, E., Kirmayr, K., De Oliveira, K., Olivieri, L., Kaushal, A., Chaparro, L. E., Oyberman, I., Agarwal, A., Couban, R., Tsoi, L., & Lam, T. (2018). Opioids for Chronic Noncancer Pain. JAMA, 320(23), 2448. https://doi.org/10.1001/jama.2018.18472

Cicero, T., & Ellis, M. (2017). The prescription opioid epidemic: a review of qualitative studies on the progression from initial use to abuse. Dialogues in Clinical Neuroscience, 19(3), 259–269. https://doi.org/10.31887/dcns.2017.19.3/tcicero

Klimas, J., Gorfinkel, L., Fairbairn, N., Amato, L., Ahamad, K., Nolan, S., Simel, D. L., & Wood, E. (2019). Strategies to Identify Patient Risks of Prescription Opioid Addiction When Initiating Opioids for Pain. JAMA Network Open, 2(5), e193365. https://doi.org/10.1001/jamanetworkopen.2019.3365

McClure, F. L., Niles, J. K., Kaufman, H. W., & Gudin, J. (2017). Concurrent Use of Opioids and Benzodiazepines: Evaluation of Prescription Drug Monitoring by a United States Laboratory. Journal of Addiction Medicine, 11(6), 420–426. https://doi.org/10.1097/ADM.0000000000000354

Nadeau, S. E., Wu, J. K., & Lawhern, R. A. (2021). Opioids and Chronic Pain: An Analytic Review of the Clinical Evidence. Frontiers in Pain Research, 2. https://doi.org/10.3389/fpain.2021.721357

Sordo, L., Barrio, G., Bravo, M. J., Indave, B. I., Degenhardt, L., Wiessing, L., Ferri, M., & Pastor-Barriuso, R. (2017). Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studies. BMJ, 357, j1550. https://doi.org/10.1136/bmj.j1550

Voon, P., Karamouzian, M., & Kerr, T. (2017). Chronic pain and opioid misuse: a review of reviews. Substance Abuse Treatment, Prevention, and Policy, 12(1). https://doi.org/10.1186/s13011-017-0120-7

Literature Review

Conduct a review of the literature. Include at least five (5) research articles and/or evidence-based guidelines. Address the following questions/bullets in completing this section:

·      Conduct a review of the literature.

·      Provide the highlights from the research.

·      Synthesize the literature on the topic.

·      Summarize how the project will contribute to knowledge by filling in gaps, validating, or testing knowledge.

·      Cite references in this section per APA and list the reference in the References section at the end of the form.

This section outlines the side effects of opioids on black market sales. It also analyzes the surveillance systems and reviews key relevant statistics on the consumption of opioids. Jayasinha et al. (2020), also highlight health risks linked with opioid-related harms that account for the rise in the use of heroin and other illegally processed opioids. Nonetheless, it considers the connection to the prescription opioid epidemic. Due to their importance to the United States Food and Drug Administration’s (FDA) operation of its power to regulate prescription opioid products, the committee specifically chose these matters to be discussed. Every section of this chapter discusses factors that should be considered when assessing the implications of these goods’ social effects and public health implications when assessed for new medication approval or post-market certifications and authentication.

Prescriptions for opioids began to rise dramatically in the early 2000s. Shortly after, nonmedical opioid use began to rise sharply, reaching a record high of 2.7 million new addicts in 2020. In 2021, there were about 1.8 million new nonmedical users annually, a gradual decline from earlier years, but the total number of nonmedical users is still enormous. Mason et al. (2022), claim that later, the consumption of oxycodone increased by more than fivefold, while the use of hydrocodone more than doubled, and the death rate from opioid-related overdose nearly tripled. The most apparent impact of increasing opioid use is overdose death, but there are other effects as well. Since 2020, rates of nonmedical opioid use, newborn abstinence syndrome (NAS), and OUD treatment admissions have increased.

Almost all demographic groups have shown a rise in the fatality rate from opioid overdose, but males under the age of 50 had the highest rate. Between 2017 and 2020, males under the age of 50 in Massachusetts accounted for 76% of opioid overdose deaths, while men aged 18 to 34 had roughly three times as many fatalities as women in the same age range (Marshall & Hale, 2019). Additionally, those who had recently been released from prison, those who filled their opioid prescriptions at multiple pharmacies, and those who purchased opioid pills together with other prescribed medications experienced a higher incidence of opioid-related fatalities.

The literature review analyzes the important issues of opioids in relation to old citizens. The project aims at highlighting past studies on the subject, giving more light to understanding current issues. The project reviews the gaps that articles from the past had not filled, trying to identify and address them in the future. Literature reviews are important as they help identify the weaknesses in the field, thus creating a need for additional research. From the previous pieces of literature on the study, it would be possible to make the subject more understandable. The project aims to simplify the study, giving light to the terminologies used and introducing more to bring more light into the subject. Nonetheless, literature reviews link the study to other fields, such as nursing. The literature makes it easier to understand the relationship between nursing and the effects of opioids on society. Lastly, the project also aims to review the past articles’ weaknesses and strengths.

As a family nurse practitioner, the literature review helps me understand the issues most families in the United States experience. My responsibility as a family nurse is to serve the family’s health needs. The family is my first client as a result of the health issues that affect the elderly in the community. The information from the research reports helps me understand the issues around opioid disorders and how it relates to the elderly. More so, I get to understand the leading cause of the opioid pandemic among the elderly. By understanding the root cause of the problem, it will be easy to find a solution and a plan to solve the problem. Further, the literature’s information will let me know what to expect in such cases. Literature reviews are very important in informing people on what they need to know about a given field, thus having know-how on issues of concern. In conclusion, they are significant in my field of study, helping me understand the needs of the field much better than before.

PICOT Question

State your PICOt question here. Use the elements of the PICOt in separate sections below to describe each component.

·      Population – Provide a description of the targeted population.

·      Intervention – Describe your evidence-based intervention.

·      Comparison – What is currently happening?

·      Outcomes – List at least two (2) measurable outcomes.

·      time – What duration of the study for the project? (e.g., usually 6 months or 3 months)

Population(P):

Intervention (I):

Comparison (C):

Outcomes (O):

time (t):

Address the following questions/bullets in completing this section:

·      Who is your target population?

·      Describe your population, i.e., age, ethnicity, gender, condition/diagnosis, etc.?

·      Describe the setting where this project be implemented?

Address the following questions/bullets in completing this section:

·       What are you planning to investigate or implement as a policy/process or program?

·       What are you doing that is different than what is currently happening?

·       List 2-3 potential actions that will be applied in this practice change.

NOTE: Be very specific in your description.

*For purposes of this Proposal Project Form the assumption will be that the C (Comparison Group) is ‘traditional care or current care’

Every project is required to have an evaluation plan. Address the following questions/bullets in completing this section:

·      Which 2-3 outcomes are expected for your project?

·      What outcomes will be measured?

o   How do you plan to do this?

o   What tool will you be using to measure your outcome(s)?

o   What data will be used to validate success of the project?

Be sure your outcomes link to the identified problem.

·      How will you know if your intervention resulted in change?

·      Provide a summary for your MSN Capstone Project.

·      Select and provide the rationale for three (3) competencies or specialty standards that you would expect to use in implementing this project [List of your specialty competencies are listed in the Week 9 Reflection Post]

9. 2 References

·      Add your references in APA formats on the last page.