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Sample Essay Paper on Opioid Use Disorder in San Bernardino County, California

Summary of the Context and Scope of the SDOH in My Community 

Opioid use disorder (OUD) is associated with increased mortality and morbidity rates across the United States as young people succumb to its health implications. OUD is characterized as a public health problem because millions of Americans from the age of 12 years start to misuse opioids. According to Healthy People 2030, 0.74% of people aged 12 years and above misused opioids in 2017. San Bernardino County in California is among the regions in the United States with an increasing population affected by opioid use disorders as people aged 12 to 24 years are at risk of OUD. The social determinants of health (SDOH) in San Bernardino include poverty, violence, and crime, which compromise the youth’s quality of life, and expose them to the risks of substance abuse. The SDOH enhances opioid dependence within the youth population in San Bernardino and it has led to additional physical and mental health challenges that may hinder an adolescent’s developmental stages if timely access to medical intervention is not enabled. Furthermore, opioid use disorders among the youth in San Bernardino expose them to other health risks such as sexually transmitted infections and unwanted pregnancies as it compromises their ability to make sound judgment.

Summary of How the Proposed Policy will address the SDOH in My Community

Implementing a collaborative public health program that supports medication-assisted treatment and cognitive behavioral therapy (CBT) will assist the public health director of San Bernardino in reducing the mortality rate associated with opioid use among the youth. Medicated-assisted treatment will assist in increasing treatment retention in young adults that struggle with opioid addiction as well as treat health risks related with OUD. On the other hand, CBT will be integrated as part of the San Bernardino County Youth Opioid Response (SBCYOR) program that provide counseling to address mental health issues that encourage adolescents to use opioid as a coping mechanism.

Proposal of Persuasive Course of Action for Policy Makers

The proposed policy changes provides the department of health in San Bernardino with the chance to address the physical and mental health problems that contribute to OUD among the youth. The county should work with the state health department and community leaders to implement the proposed policies, which will help in the prevention, mitigation, and treatment of adolescents and young adults affected by opioid use disorders.

Context and Scope

Social Determinant of Health (SDOH) in My Community

Substance abuse is a common public health problem in San Bernardino, California. According to Neeki et al. (2020), substance abuse in the United States has become a priority for public health officials because there is an increase in opioid use and dependency. The increasing rate of substance abuse in San Bernardino has become rampant as the youth depend on opioid use to overcome the developmental challenges and physical and mental health problems. A report filed by the California Health Care Foundation (2018) revealed that 3% of the youths abuse illicit drugs.  In San Bernardino, drug-related hospital admissions have been on the rise as adolescents succumb to opioid overdose and injection drug use.

Opioid use disorder is most prevalent among the young people in San Bernardino. The California Health Care Foundation (2018) affirms that substance use disorder in San Bernardino is common among young people aged between 18 and 25 years old. Additionally, the opioid use disorder within this population often starts during adolescent years when teenagers begin to experiment with different forms of drugs. San Bernardino County emergency room treats fatal and non-fatal incidents related to opioid use as the young population continues to battle with addiction.

Data to Support the SDOH. Data collected by Healthy People 2030 reveal that 0.7 percent of the population aged 12 years and above had opioid use disorder in the year 2018. The economic and social factors associated with substance use disorder contribute to the increasing population of drug addicts in San Bernardino County. Arthur et al. (2019) assert that San Bernardino County’s population mainly consists of vulnerable individuals. Additionally, the social and environmental contexts in this region make the population susceptible to substance abuse disorders. According to Neeki et al. (2020), San Bernardino has a diverse population of 2.2 million people whose demographic make-up consists of 52.3 percent Latino, 29.8 percent White, and 8.0 percent African Americans. The region’s lower cost of living attracts violence, gang-related, and other illegal activities, which increase the social and environmental stressors that may motivate adolescents to use heroin or prescription pain reliever. Arthur et al. (2019) affirm that violence and crime are the common stressors within this population, an issue occasioned by at least 15 percent of the population living below the poverty line, a quarter of it being below 18 years old. Therefore, children are exposed to criminal activities within their communities from a young age, which may account for the increased rates of substance use disorder among adolescents.

Violence and criminal activities in San Bernardino enable the community factors that promote substance use disorders. For example, gang-related activities in the area make substances more available for youths. Consequently, the community practices and norms make it conducive for young people to access drugs and develop substance abuse disorders. Neeki et al. (2020) argue that youths aged between 12 and 24 years old are susceptible to substance use disorder due to the social and family dynamics to which they are exposed. Residents in San Bernardino exhibit high rates of social disorganization, conflict, and inadequate family management practices, which are attitudes that encourage drug dependence (California Health Care Foundation, 2018). As such, adolescents and young adults develop substance use disorders as a coping mechanism that helps them deal with social, familial, and environmental stressors.

Individual and peer influence are also social determinants that promote early drug use. Adolescents encounter favorable environments for substance use disorders when they engage with friends that abuse opioid. For example, early initiation to substance abuse occurs among school-going adolescents when they fear being alienated by their peers. The California Health Care Foundation (2018) affirms that adolescents in California abuse cough medication. These drugs are easily accessible to the San Bernardino population; thus, increasing the number of people that have developed substance abuse disorders. In California, at least one out of three students in the 11th-grade report having abused drugs at least once in the lives (California Health Care Foundation, 2018). These students use drugs to get high and escape their realities.

The economic conditions in San Bernardino promote drug supply as gang members participate in sourcing and selling the substances. Brighthaupt et al. (2019) aver that urban environments include a range of social factors related to economic depreciation, such as poverty, which increases a population’s susceptibility to substance abuse and substance use disorders. Consequently, the population’s beliefs, attitudes, and norms towards drug abuse have normalized substance use among adolescents. Normalizing drug abuse within the community creates structural and attitudinal barriers related to treatment and permission. For instance, young people are more hesitant to seek medical assistance to overcome the substance use disorders they are experiencing due to beliefs and attitudes related to treatment.

Three Characteristics of Target Population Affected by SDOH

The young population aged between 12-24 years is susceptible to substance use disorders in San Bernardino due to the accessibility to different types of drugs within the community. Neeking et al. (2020) explain that youths have a high risk for developing drug addiction due to the limited prefrontal cortical function that leads to risky behaviors. As a result, the mortality and morbidity rate within this population is high since more young people are likely to succumb to a drug overdose. For instance, in 2017, it is reported that a least 70 000 youths succumbed to drug addiction, making substance use disorders the number one cause of injury-related deaths among teenagers and young adults across the United States. In addition, youths experience other health-related issues, such as mental illness, depression, anxiety, and suicide ideation, which are strongly related to substance abuse.

Opioid use among young people between 12 and 24 years is an epidemic in urban areas. Urban environments are associated with increased accessibility to illicit drugs and prescription drugs for young people due to the social and economic settings. For example, youths in San Bernardino are highly likely to begin using drugs from the age of 12 years old due to peer influence, violence, and criminal activities witnessed in the area. The social and economic settings of San Bernardino create a favorable attitude towards substance use disorders as they influence the community’s perceptions of behavioral health and public education regarding drug abuse (Neeki et al., 2020). Therefore, to understand how individuals aged between 12 and 24 years are affected by substance use disorders, it is imperative to examine how the environmental contexts contribute to adverse outcomes seen among youths.

Youths aged between 12 and 24 years commonly use injection as a way of administering opioids into their bodies, which is risky. According to Brighthaupt et al. (2019), many youths prefer injection for opioid administration. A survey conducted by Johnston et al. (2020) revealed that out of the 0.6 percent of students in 12th grade who reported having opioid addiction, one-third confirmed administering the drug through injection. The fact that many youths easily access and administer opioids through injections underlines the increased rates of opioid use among adolescents. Injecting opioids exposes youths to unique health risks, most of which are linked to sharing of needles used in the process. Moreover, the presence of bacterial pathogens in drugs exposes adolescents and young adults to the risk of developing skin abscesses and infections. Other than the health risks triggered by the injection of opioids, opioid use and abuse are associated with high-risk sexual behaviors that are responsible for sexually transmitted infections and unplanned pregnancies. Understanding the use of injection in administering opioids and other drugs among adolescents is important in preventing the spread of HIV and Hepatitis C virus.

Opioid use disorder among adolescents and young adults in San Bernardino is also related to several social ills, such as abuse in the family, violence, and criminal activities. Johnston et al. (2020) affirm that adolescents with substance use disorders are likely to display signs of social misconduct, such as theft, violence, or abuse. Evaluating and understanding how these social ills contribute to substance use among the community's youths and adults would create a firm foundation in reducing cases of substance use disorders within this population. Additionally, Brighthaupt et al. (2019) argue that monitoring adolescents’ drug use in urban settings is important in recognizing effective strategies to intervene and eliminate social, health, and psychological problems related to opioid use disorders. However, the economic and social disparities in vulnerable populations, such as that in San Bernardino, introduce numerous health challenges that make it difficult for the target population to access medical assistance.

Identification of Appropriate Policy Makers or Legislators

The San Bernardino’s Public Health Director, Corwin Porter, is responsible for implementing laws in the educational, correctional, and healthcare systems that help to govern and control youths aged between 12 and 24 years; thus, curtailing their involvement in substance abuse. The health and legislative policies are designed to act as prospective observational tools within the healthcare system to screen for health, social, and environmental determinants of drug and substance abuse among young people. San Bernardino’s current public health director previously acted as the assistant director and has now assumed the responsibilities of the head of the Department of Public Health. One of his duties is tracking mortality and morbidity cases associated with substance use disorders within the population. Porter is assisted by other health officers who have been active in enforcing laws and policies to reduce incidents substance abuse among the youth.

The public health department and public health director in San Bernardino County play a critical role in addressing the social and health disparities affecting the youths. The department has the Substance Use Disorder and Recovery Services (SUDRS) that provides treatment and care to individuals with alcohol and drug addiction. The public health department provides resources that ensure that residents of San Bernardino County have access to substance-use disorder treatment services irrespective of their age, health status, gender, religion, sexuality, or disability. For instance, treatment is provided to individuals that inject drugs and require treatment to aid in the recovery process.

Why the SDOH Requires the Policy Maker’s Attention

The U.S. is dealing with unprecedented cases of drug abuse among young people. Brighthaupt et al. (2019) confirm a high prevalence rate of non-medicinal drug use and alcohol consumption amongst young people in the U.S.; thus, leading to unnecessary deaths. In San Bernardino, non-medicinal drug use is common among young people aged between 12 and 24 years. Most of the youths in the county depend on opioids to function effectively and ultimately develop opioid use disorder (Neeki et al., 2020). San Bernardino County has witnessed an increase in the number of young people developing opioid use disorder. The number of people succumbing to health complications associated with opioid use disorder is also on the rise.

Increased prevalence of substance abuse mainly affects socio-demographic populations in urban areas that are underprivileged. San Bernardino’s large population is made up of vulnerable members of the society in urban areas. Social stressors existing at the community level motivate young people to consume and opioids. Arthur et al. (2019) explain that substance use disorders are an epidemic that is reinforced by different environmental factors, such as violence, crime, or poverty. The geographic context of San Bernardino shows that the epidemic of substance abuse among the youth is supported by the violence in the home, gang-related activities, or poverty.

Policymakers need to assess the risky behaviors among youths San Bernardino community caused by substance abuse disorders. Youths that begin to use opioids during their adolescent years are at risk of developing serious mental health problems, emotional instability, and psychological disorders (Neeki et al., 2020). The correlation between substance abuse and the subsequent health issues demonstrates the severity of the opioid use epidemic among the youths in San Bernardino. Young people are also at risk of developing sexually transmitted diseases while under the influence of drugs since their ability to make sound decisions is compromised in such a circumstance. Neeki et al. (2020) assert that youths that are dependent on drugs are more likely to engage in high-risk sexual behaviors that may lead to sexually transmitted infections (STIs) or unplanned pregnancies. Therefore, policymakers must evaluate the health implications of opioid use disorders among the youth in San Bernardino to determine the severity and proper response mechanisms.

Current Policy or the Effect of Not Having a Current Policy. A lack of inclusion and a weak healthcare sector are key barriers to the fight against substance use disorders in San Bernardino County. Neeki et al. (2020) affirm that youths are excluded from treatment programs that address substance use disorders within a population. The county must understand opioid use disorders as chronic illnesses that threaten the current and future generations. Policymakers in San Bernardino must also evaluate social, health, and economic challenges faced by youths struggling with drug addiction. As an underprivileged region, most of the youths in San Bernardino battle with challenges related to low socioeconomic status. Neeki et al. (2020) explain that low socioeconomic status introduces complexities within the healthcare system as the majority of the population cannot afford insurance cover or the health insurance coverage does not pay for the treatment of substance use disorders. As a result, adolescents that struggle with drug abuse cannot access treatment for substance dependence. Thus, they often continue with the habit into adulthood. The healthcare system and policymakers in San Bernardino County must ensure that residents have access to drug treatment programs whether they have health insurance or not.

Ethical Implications of Current Policy or Absence of Existing Policy. Opioid use disorders among the youth in San Bernardino expose health inequality within the community. Neeki et al. (2020) affirm that the youth are excluded from the community-based recovery program in the community since the majority of the resources and treatment interventions are designed for adults. This trend contributes to the increasing cases of drug-related deaths among the youth, as they do not gain access to medical-assisted treatment on time. According to a study by Feder et al. (2017), for every 2.4 percent of youths receiving medical-assisted treatment for opioid use disorder, there is 26.3 percent of adults. The mentioned health disparity explains why the majority of the population in San Bernardino with substance use disorder is primarily the youth.

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