It is vitally important to determine what substance or substances may have been consumed. The patient often may have taken more than one substance type or mixed the substances with alcohol. If street drugs were consumed, they might have been tainted with unknown chemicals that may create a totally unanticipated patient response. (Box 18)
Box 18: Brief Assessment
• Conscious? • A-B-C assessment? • Vital signs? Stable or unstable? • Track marks or skin lesions? • Ensure safety for individual, family, and staff. Note. Waszak, 2018.
LABORATORY TESTS
Secure toxicology and other tests as indicated. Toxicology and other laboratory tests are critical to understand the substance, the amount in the individual’s system, and the impact on other vital body systems. Even though not all substances can be immediately identified, it is helpful to understand how long a substance remains in the individual’s system (Waszak, 2018). Clinical Care ● Safety for patient, family, and staff is the first priority when an individual is identified as having experienced a nonfatal overdose. ● Provide supportive care to the individual and their support system while in the emergency department or point of contact. ● Begin medication-assisted treatment during the emergency department visit. ● Facilitate the transition of care to a detox or inpatient treatment if possible. ● As a healthcare professional or first responder who has engaged with the patient and built trust, provide a warm handoff to mental health services so that they can experience continuity of care. (Minnesota Department of Health, 2020; Painter, 2017) Resources and education Although providing education during an acute care situation may not be appropriate, it is important to know the resources available in the local community to help those who have addiction or abuse problems. Nationally, the Substance Abuse and Mental Health Services Administration (SAMHSA) provides a treatment location service that offers behavioral health help in the individual’s local community. The agency’s national helpline
is 1-800-662-HELP. The agency’s primary website is http://www. samhsa.gov/find-help. From this location, one can enter a local address, city, or ZIP code to find local or state help. During an encounter where drug abuse is identified, and the individual is ready for help, the most important part the health provider can play is to ensure that a multidisciplinary team is involved and that the individual has a concrete plan and a next step for evaluation and care. It is not helpful to simply provide a pamphlet, a phone number, or website. In addition to resources and education available for individuals and agencies as it relates to drug overdose identification and treatment, there are also resources available through the Emergency Nurses Association for healthcare professionals to learn to respond to an opioid overdose while maintaining a priority of protecting themselves. The Be-Safe© educational intervention for emergency department staff provides 14 sections of information found in two chapters. In addition to information, the book also includes a case study for nurses to apply the Be-Safe© content (Clark et al., 2020). Self-Assessment Quiz Question #10 Joe was called out of the emergency department to a patient’s car because of reported patient unresponsiveness, shallow breathing and suspected overdose. The patient was given naloxone, what is the first priority for Joe?
a. Consider their own safety. b. Consider the patient’s safety. c. Consider the onlooker’s safety. d. None of the above.
NATIONAL DRUG CONTROL STRATEGY
● Advancing recovery-ready workplaces and expanding the addiction workforce. ● Expanding access to recovery support services. Priority 1: Expanding access to evidence-based treatment The administration is committed to achieving universal coverage for individuals who struggle with substance use disorders. Addiction services and healthcare have existed as two separate systems, and it is necessary to provide them in a streamlined, easily accessed, and low-cost manner to be successful in reducing the stigma that individuals with substance use disorders face. The administration strategy in coordination with the Office of National Drug Control Policy (ONDCP) includes: 1. Evaluate progress made since 2016 Mental Health and Substance Use Parity Task Force and identify steps that need to be taken to complete any unfinished recommendations. 2. Review policies related to methadone treatment and create recommendations to modernize. 3. Remove unnecessary barriers to prescribing buprenorphine and identify opportunities for expansion of low-barrier treatment services. 4. Identify and address policy barriers and explore reimbursement related to contingency management interventions for simulant use disorder. 5. Expand access to treatment for incarcerated individuals. 6. Explore, identify barriers, and establish policy to help pregnant women with substance use disorder.
The Biden-Harris administration created a clearly outlined plan to address the overdose and addiction epidemic that plagues the United States. The American Rescue Plan, signed into law in March 2021 appropriated nearly $4 billion dollars to enable SAMHSA and the Health Resources and Services Administration (HRSA) to expand critical behavioral health services to the American public (The White House, 2021). Citing that the COVID-19 pandemic has exacerbated the addiction and overdose epidemic, the White House laid out an aggressive, evidence-based response to implement in the first year with a goal to diminish the curve. Following are some highlights of the strategy, which harnesses the collaborative strength of local, state, tribal, and federal agencies; community-based organizations; and other nongovernmental partners (The White House, 2021). The Biden-Harris administration drug policy priorities include: ● Expanding access to evidence-based treatment, particularly medication for opioid use disorder. ● Advancing racial equity in our approach to drug policy. ● Enhancing evidence-based harm reduction efforts. ● Support evidence-based prevention efforts to reduce youth substance use. ● Reducing the supply of illicit substances. This includes work with key global partners to curb illicit drug production ad trafficking, dismantling drug trafficking networks, and strengthening efforts to halt illicit internet drug sales.
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Book Code: RPTTX2024
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