Introduction
Overdose deaths from drugs have been the leading cause of death among Americans during the past two decades, surpassing deaths from any other reason. Because it is such a crisis for public health, federal, state and local officials have come up with plans to cut fatality rates and eliminate the factors that contribute to the outbreak. Both the Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Congress recently enacted Acts to cut down on overdose deaths and provide addicts with access to treatment. The 2018 Interdict Act was signed into law by the Trump administration to provide law enforcement with the tools necessary to combat the trafficking and sale of illicit and synthetic opioids, both of which contribute to rising rates of opioid overdose across numerous states. These rules have not been very effective in lowering death rates or deterring the use of illegal substances. Therefore, it is necessary to conduct a comprehensive review of the effects that the SUPPORT for Patients and Communities Act has had on the prevention of opioid addiction, the treatment of opioid dependence, and clinical practice in order to identify the Act’s strengths and limitations and propose changes to the policy.
Analysis and Evaluation of the SUPPORT Act
The purpose of the SUPPORT for Patients and Communities Act is to streamline the process by which agencies work together to combat the opioid crisis in the United States and to lessen the number of barriers that patients with substance use disorders face while seeking treatment. In addition, President Trump signed this policy because it addresses some factors that predispose youth, ex-convicts, juveniles as well as the homeless to opioid consumption and usage (Davis, 2019). According to Felix, Sharfstein, and Olsen (2020), this policy prioritizes compensating SUD patients in the Children’s Health Insurance Program (CHIP) at the same rate as beneficiaries with other physical conditions and providing temporary health insurance coverage for ineligible adults receiving treatment for institutional mental diseases. As a result, the SUPPORT Act seeks to better opioid addiction treatment for persons at risk, who constitute the majority of addicts.
The critical evaluation of the SUPPORT Act’s goals revealed that the policy would likely lead to a rise in the number of healthcare facilities that offer MAT for opioid addiction, reducing access gaps. In addition, the vision of the policy expanded the pool of available MAT professionals and the number of people they could help. The SUPPORT Act also provides credit incentives to hospitals as well as treatment institutions in high-risk parts of the country, and it mandates the federal government to expand funding for MAT training programs for specialist nursing practitioners to reduce the availability gap in MAT for SUD patients. The study of the SUPPORT Act’s goals indicated that it was also created to enhance the regulatory environment by introducing a technologically based medicine ordering system. For instance, during the SUPPORT period in pain treatment, strict regulations on the timely delivery of prescriptions and other drug orders were waived for specific groups of patients. This public health strategy was enacted for similar reasons, specifically, to increase collaboration and coordination between government agencies in order to cut down on the distribution of illegal opioids in both urban and rural regions with a disproportionate number of overdose deaths.
Despite the SUPPORT Act’s goal of improving access to MAT therapy while simultaneously meeting patients’ social and emotional needs and protecting vulnerable populations from the hazards of this SUD, research has revealed that its impacts have been negligible. Furthermore, the difficulty of state and federal authorities to authorize funding for loan payback schemes for SUD treatment is another shortcoming of SUD implementation in the last two years, as evidenced by the findings of several studies on the achievement of policy objectives (Shapiro, Villarroel, and George 2019). In addition, despite the Act authorizing Medicaid financing for MATs and other psychiatric treatments for opioid use disorders, the lack of a clearly defined framework limits the potential ramifications of this policy. Due to the limits revealed during the critical analysis of this public health initiative, the projected advantages are unlikely to materialize.
Application into Clinical Practice
Meanwhile, the implementation of the SUPPORT Act in clinical practice is an important area to research to discover how it links to the public health goals of state and federal governments in relation to the opioid use disorder issue and its consequences. Clinical professionals who have not obtained MAT training, such as nurses, PAs as well as grad-level doctors, are needed to participate in the waiver training in order to earn a license to deliver treatments and drugs for opioid use disorders. This policy guarantees that those seeking treatment for opioid use disorders in Medicare-certified institutions can access the full spectrum of treatments available via these programs. The policy not only limits the capacity of disadvantaged populations to access drugs by setting treatment processes, but it also supervises physicians’ and pharmacists’ prescription practices. As a result of the passage of this legislation, clinical practitioners could provide services to disadvantaged populations, establish Medicare reimbursement mechanisms, and provide patients with access to high-quality therapy.
The policy’s greater use of evidence-based practice approaches in treating individuals with opioid use disorder was also revealed in a critical study of its consequences for healthcare professionals. Clinics seeking payment from the Centers for Medicare & Medicaid Services (CMS) for providing bundled Medicare care to these patients must use the services of mental and behavioral health professionals to implement the proven treatment plans (Shapiro et al., 2019). Another consequence of the SUPPORT Act for healthcare providers is the legalization of the policy provisions for the funding of telehealth as well as telemedicine for rural patients with opioid use disorder. In order to provide the appropriate level of care to patients and earn payments from Medicare and other treatment programs, healthcare institutions must engage in the use of evidence-based practice approaches, as mandated by several aspects of this public health policy.
Recommendations to Improve Policy Impacts
Patients suffering from opioid use disorder and members of groups at risk for opioid misuse and abuse will have fewer obstacles to obtaining effective treatment, according to the SUPPORT Act, a piece of public health legislation that aims to improve access to medication-assisted treatment. However, the rising toll from the opioid overdose and addiction crisis indicates that the overarching strategy needs some tweaking to be more effective and efficient. The federal government should seriously consider revising the SUPPORT Act by including a framework to track the results of the many initiatives launched due to the policy and to set up an interdepartmental group to deal with these problems. Reviewing this policy also includes gathering information on how well current evidence-based care procedures for medication-assisted treatment (MAT) are doing at reducing the tragically high mortality rates associated with opioid use disorder. One part of the strategy seeks to promote the development of novel psychosocial and pharmacological approaches to managing advanced illness and pain (Thakur, Frey, & Chewning, 2019). Thus, it is suggested that the SUPPORT Act be revised to add measures that increase its implementation effects on the negative repercussions of the disease on patients.
It is also recommended that medical schools reevaluate and harmonize their curricula to prepare the next generation of healthcare professionals better to help address the opioid problem in the United States. Particularly, strengthening the medical and nursing training programs would boost doctors’ and nurses’ faith in MATs’ ability to alleviate patients’ suffering. In addition, Davis (2019) argues that a uniform curriculum for administering MAT would save time in the classroom and increase the number of doctors available to treat patients with opioid use disorder. Lastly, the critical analysis of the SUPPORT Act suggests that more clinical professionals, such as nurses, should be involved in the decision-making processes that lead to laws like this one, which would allow the FDA to make naloxone available over-the-counter to treat opioid and painkiller addiction.
Conclusion
Opioid use disorder has become a severe public health problem for federal as well as state governments all over the United States because it hurts people, communities, and families in terrible ways. Legislative efforts to deal with the opioid crisis have not successfully reduced addiction and use among high-risk groups. This is mainly due to the shame that comes with getting help. With the SUPPORT Act, which was passed in 2018, stakeholders were able to make it easier for patients to get treatment and keep vulnerable groups from developing opioid use disorders. According to the results of a critical review and assessment, putting this public health strategy into action should improve access to care that is based on evidence, increase the number of healthcare providers, reduce healthcare inequities, and, in the end, lower the death rates that are linked to opioid use disorders. Because of this, the research’s ideas made the strategy’s positive effects on the US opioid crisis even better.
References
Davis, C. S. (2019). The SUPPORT for Patients and Communities Act—What will it mean for the opioid-overdose crisis? New England Journal of Medicine, 380(1), 3–5.
Felix, C., Sharfstein, J. M., & Olsen, Y. (2020). Help Is on the Way: Medicare Coverage of Opioid Treatment Programs. Journal of the American Geriatrics Society, 68(3), 637-640.
Hedberg, K., Bui, L. T., Livingston, C., Shields, L. M., & Van Otterloo, J. (2019). Integrating public health and health care strategies to address the opioid epidemic: the Oregon Health Authority’s opioid initiative. Journal of Public Health Management and Practice, 25(3), 214-220.
Sandoe, E., Fry, C. E., & Frank, R. G. (2018). Policy levers that states can use to improve opioid addiction treatment and address the opioid epidemic. Health Affairs Blog. Retrieved from https://www.healthaffairs.org/do/10.1377/hblog20180927.51221/full/
Shapiro, A., Villarroel, L. R., & George, P. (2019). A call to maximize the impact of the SUPPORT for Patients and Communities Act through standard inclusion of opioid use disorder treatment curricula in medical schools. Advances in Medical Education and Practice, 10, 581.
Thakur, T., Frey, M., & Chewning, B. (2019). Pharmacist services in the opioid crisis: current practices and scope in the United States. Pharmacy, 7(2), 60.
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