Analysis of Position Papers for Vulnerable Populations
The old aged individual in any given setting often faces a myriad of predicaments that range from self-care deficiencies to trauma and conditions related to experiences. In the United States, the problem is even magnified due to challenges facing this population that include risk of post-traumatic stress disorder, narcotic addiction, and homelessness. The old community is at risk of narcotic addiction due to extensive war engagements that predisposed them to injuries needing constant pain management. The participation also puts the risk of developing post-traumatic stress disorder, which leads to depression a stimulant for accidental narcotic overdose as compared to non-military personnel (Collett, 2016). These predicaments make it imperative to discuss inter-professional team role in improvements on the issue, evaluation of evidence as well as positions that support and contradict the team approach.
Health Outcomes for Veterans with Chronic Pain and Opioid Abuse
Health advancements concerning technology and treatment have enabled war veterans to lead productive and sustainable lives. The situation has not been without consequences on the physical, cognitive, and emotional realms of these individuals resulting in deviations. For instance, opioid use among veterans has been on a steady incline due to the chronic pain they experience. The situation is majorly prevalent because opioid prescriptions are common in soldier populations as a means of alleviating the consequences of extensive injuries. In a study conducted in 2015 by Army report, more than half of the soldiers in active duty were diagnosed with war-related injuries (Teyhen et al. 2018).
In a case study related to war injuries, Carl Alomar developed an injury in the Iraq war of 2007, which shattered his leg from an explosive device. Consequent to the injury, a prescription of OxyContin occurred as denoted by the military physician. During the treatment process, Mr. Alomar developed an addiction making him unstable and devoid of capabilities of sustaining a job as well as a strained relationship with family and friends. This situation is similar to many experiences that veterans face in the course to recovery from injuries related to war. Therefore, from the case study, it is clear that war experiences among veterans likely lead to addictions that destabilize personal and public relationships.
The Role of Inter-professional Team in Treating Opioid Abuse among Veterans
From the discussion outlined above, chronic pain, opioid abuse, and post-traumatic stress disorder happen to be the most prevalent factors that derange many war veterans. Chronic pain being the initial predisposing factor, would need an inter-professional team consisting of pharmacists, physical therapists, psychologists, and physicians. The decision to allow pharmacists is critical in that they serve a huge role in the interdisciplinary approach against opioid abuse. According to Gellad, Good, & Shulkin, (2017), Pharmacists play an essential role in decreasing opioid abuse among veterans facing chronic pain.
Clinical psychologists, on the other hand, are essential in alleviating the scourge among the veteran populations. The psychologists prescribe medications offering opioid substitution therapy that include buprenorphine and methadone. The classified drugs truncate cravings as well as impede withdrawal symptoms. Moreover, psychotherapies, including cognitive-behavioral therapy (CBT), family, and career counseling, are proven methods of reducing opioid abuse among war veterans (Yaugher et al. 2020). The role the clinical psychologists play is immense in decreasing the effects of trauma passed through the years.
Due to extensive injuries such as the one denoted in the above case study, physical therapists are indispensable in the fight against opioid abuse among war veterans. According to Mintken et al. (2018), the first-line treatment of musculoskeletal pain is mainly preferred through physical therapists due to the minimal effects and high recovery rates. Therefore, physicians and psychologists must work hand in hand to ensure that opioid use is minimal. Physicians should also strive to adopt prescription of non-opioid in relieving pain attributed to war injuries. Altogether, trust-building and reduction of the stigma of opioid use should occur in the inter-professional team.
Team Approach as a Way to Improve Outcomes
From the case study outlined earlier, the team approach is necessary for alleviating symptoms related to the effects of war. The research is relevant to many other scenarios present in the veteran populations affected by PTSD and chronic pain. The initial team strategy on every veteran affected by PTSD should be to practice CBT (Cognitive Behavioral Therapy). The form of therapy employs associations between behaviors, emotions, and thoughts to enable affected individuals to cope with addictions. Overall, the treatment impedes insecurities relating to drug abuse through the provision of methods that elevate moods, thereby aiding communication (Moore et al. 2016).
Additionally, the other technique as a team approach is contingency management therapy, which includes rewarding patients exhibiting positive behavior. The method involves encouraging patients to develop abstinence from drug-related actions. Therefore, in this context, urine samples extracted from veterans would be used to identify any opioid use, which may be utilized to reward the veterans. According to Sofuoglu, DeVito, & Carroll (2019), CMT (contingency-management therapy) is an effective method of alleviating opioid abuse in veterans through its active role in promoting abstinence.
Positions of Others Contrary to a Team Approach to Improve Outcomes
From the excerpt, the team approach that utilizes CMT and CBT together with family counseling is touted as the effective method of reducing opioid use, chronic pain, and PTSD among veterans. However, some researchers outline that the required professionals may not be available in the rural setting where the majority of the veterans reside. According to an article done by Nelson et al. (2017), the office of mental health and suicide prevention did a study on detoxification services after substance use disorder. In the study, the investigators coached the veterans for a period of 3 to 6 months over the telephone that realized better health outcomes showed that the traditional techniques were more costly.
Another treatment fronted is the use of Medically Assisted Therapy to treat opioid use in the VA system. In this form, the drugs used in the reduction of symptoms are combined with counseling to alleviate the “highs.” Another Veteran Association system method is the Specialty Care Access Network-Extension for Community Healthcare Outcomes (SCAN-ECHO). The method includes addressing barriers attributed to access to specialized care. The model holds similarities to the MAT due to its combination with telemonitoring that enables access to skilled care remotely.
Conclusion
Pain in the chronic form is prevalent in the older population, especially war era participants. In a bid to curtail effects of the injuries manifesting as increased pain, many veterans are exposed to opioid use that often results in addiction. The impact of opioid addiction is massive and necessitates rapid measures such as Cognitive behavior therapy and contingency management therapy. However, there is a dissenting opinion on the better forms of treatment that elude specialist availability crises, including telemonitoring and medically assisted therapy. Altogether, there is a need to ensure physical setups with clients as envisioned in the team approach as mental assessments majorly rely on physical qualities.
References
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Gellad, W. F., Good, C. B., & Shulkin, D. J. (2017). Addressing the opioid epidemic in the United States: lessons from the Department of Veterans Affairs. JAMA internal medicine, 177(5), 611-612.
Mintken, P. E., Moore, J. R., & Flynn, T. W. (2018). Physical Therapists’ Role in Solving the Opioid Epidemic. The Journal of orthopaedic and sports physical therapy, 48(5), 349.
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Sofuoglu, M., DeVito, E. E., & Carroll, K. M. (2019). Pharmacological and behavioral treatment of opioid use disorder. Psychiatric Research and Clinical Practice, 1(1), 4-15.
Teyhen, D. S., Goffar, S. L., Shaffer, S. W., Kiesel, K., Butler, R. J., Tedaldi, A. M., … & Plisky, P. J. (2018). Incidence of musculoskeletal injury in US Army unit types: a prospective cohort study. journal of orthopaedic & sports physical therapy, 48(10), 749-757.
Yaugher, A. C., Bench, S. W., Meyers, K. J., & Voss, M. W. (2020). How psychologists can impact the opioid epidemic. Professional Psychology: Research and Practice, 51(1), 85.