Write a letter in which you take a firm stance “against” a particular public health effort

Many topics in public health are placed at an intersection of public good vs. individual right and can become quite controversial and contentious. Prime examples include childhood immunizations, helmet use, obesity, tobacco use, seat belt use, etc. For this week’s discussion board, you will hash out some of these controversies.
In your original post:
1. Begin by selecting a public health topic and an actual physical location.
2. Write a letter in which you take a firm stance “against” a particular public health effort and argue your position from the perspective of someone who has a vested interest (it does not need to represent your real option)
3. Your letter should be addressed to a person who has some control over that issue in real life. Use peer-reviewed literature to back up your arguments.
1. (This assignment is usually more fun if you choose something that’s in the news i.e. CHOOSE ONLY ONE
a. soda tax
b. late school starts
c. medically assisted treatment for substance abuse disorders
d. supervised injection sites
e. helmets in advertising
f. teen vaping
g. limits on fracking
h. condom-less porn
Example Response Post
Dear Senator Angela Williams,
As the representative in Colorado Senate District 33, I encourage Response Post. you to further support equitable strategies to prevent, treat, and reduce harm for substance dependence in our state. The opioid epidemic has been a worsening issue in our country and Colorado has not been immune. Nationally, drug overdoses have been worsening and reached an all-time high in 2017. Per the CDC, estimates have assigned drug overdoses as cause of death for around 72,000 Americans in 2017 which is more deaths than those from HIV, motor vehicle accidents, or guns1. Per the National Institute on Drug Abuse, Colorado death rates are less than the national but the number of deaths have been rising between 2012-2016. Heroin-related deaths increased from 91 to 234 while deaths from synthetic opioids increased from 52 to 722. Currently, 116 people die daily from opioid-related overdoses3. While it is clinically necessary to prescribe to certain patients with acute pain, the healthcare system has contributed greatly to the opioid problem. Per the U.S. Department of Health and Human Services, heroin users report prior misuse of prescriiptions at an alarming rate of almost 80%4. This is a national and local issue that requires buy-in from many stakeholders including our legislators.
The Society of Behavioral Medicine and the Society for Health Psychology have partnered to recommend that Medication-Assisted-Treatment (MAT) for opioid use is a crucial solution, and policymakers need to change legislation to provide insurance coverage and Medicaid funding for treatment5. MAT is a holistic patient treatment that includes medication to reduce withdrawal or cravings, counseling services, and other recovery support services. It is an evidence-based intervention and clinical studies have shown that both methadone and buprenorphine improve treatment retention and decrease illicit opioid use6,7. Patients using these treatment programs have better outcomes than those participating in programs without medication, or programs that only provide medication.
Although regulation on prescriiptions and policy changes need to happen, treatment and recovery services are extremely lacking in Colorado. A 2017 analysis by the Colorado Health Institute determined that 48% of counties in our state do not offer MAT8. There is also an association between overdose deaths and lack of medical resources. In 2014, 10 of the Colorado counties without MAT available had high overdose death rates that were greater than the state rate8. MAT is underutilized in Colorado due to many barriers including insurance coverage and access. Although Senate Bills such as 17-074, 17-207, and 17-193 have been passed to tackle the opioid crisis, our legislators can do more to provide effective evidence-based treatment to those who seek it.
As a parent of a recovering addict, I am lucky to live in a county where my child can access these resources and treatment programs. I urge you to pursue and support solutions that allow all addicts who are interested to have the opportunity to access care regardless of their zip code, insurance status, or income.
A Concerned Parent
This letter asks the senator to engage in Policy Development (core function) through developing policies (essential service) that provide care (essential service) to individuals with substance use disorders (assurance, core function).
• National Center for Health Statistics. (2018, September 12). Provisional drug overdose death counts. CDC. Retrieved from: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm
• National Institute on Drug Abuse. (2018, February). Colorado Opioid Summary. NIH. Retrieved from: https://www.drugabuse.gov/drugs-abuse/opioids/opioid-summaries-by-state/colorado-opioid-summary (Links to an external site.)
• S. Department of Health and Human Services. (2018). The opioid epidemic: By the numbers. CDC. Retrieved from: https://www.hhs.gov/opioids/
• National Institute on Drug Abuse. (2017, March). Improving Opioid Prescribing. Retrieved from: https://www.drugabuse.gov/publications/improving-opioid-prescribing/improving-opioid-prescribing
• Spas, J.J., Buscemi, J., Prasad, R., Janke, A., Nigg, C.R. (2018, June). Help Address the Opioid Crisis by Increasing Funding for Medication-Assisted-Treatment. Society of Behavioral Medicine. Retrieved from: https://www.sbm.org/UserFiles/file/SBM_OpioidCrisisStatement.pdf
• Fullerton, C.A., et al. (2014). Medication Assisted Treatment with Methadone: Assessing the Evidence. Psychiatric Services. 65(2): 146-157. Retrieved from: https://www.thenationalcouncil.org/wp-content/uploads/2018/01/Methadone-final.pdf
• Thomas, C.P., et al. (2014). Medication-Assisted Treatment with Buprenorphine: Assessing the Evidence. Psychiatric Services. 65(2): 158-170. Retrieved from: https://www.thenationalcouncil.org/wp-content/uploads/2018/01/Buprenorphine-final.pdf
• Colorado Health Institute. (2017, May). Miles Away From Help: The Opioid Epidemic and Medication-Assisted Treatment in Colorado. Retrieved from: https://www.coloradohealthinstitute.org/sites/default/files/file_attachments/2017%20MAT%20report.pdf

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