Pro-Con position paper on Opioid Crisis

· Length: 4-5 pages (not including title page or references page)

· 1-inch margins

· Double spaced

· 12-point Times New Roman font

· Title page

· References page (minimum of 5 scholarly resources)

Running head: PUT YOUR TITLE IN ALL CAPS HERE 1

PUT YOUR TITLE HERE IN ALL CAPS 2

Title in Upper and Lower Case

Your Name

Chamberlain Univesrity

Course Number: Course Name

Term Month and Year

Title of your Paper in Upper and Lower Case (Centered, not Bold)

This page begins your Pro-Con position Paper. Begin your introduction here. Be sure to incorporate an attention grabber. You may also provide any necessary contextual or background info here if needed. Do not attempt to prove the thesis statement in these sentences; don’t have obvious ideas. Prove the thesis below it, not above it. If appropriate, provide a bridge from the introductory sentences to the thesis. Remember to employ an objective tone by applying only 3rd person point of view (no 1st: I, me, my, we, our, us, mine) or 2nd: you, your person point of view), unless in direct quote. Then put your thesis statement here; the thesis must be one complete sentence combining your opposition’s argument and your rebuttal.

1st Counter-Argument (your oppositions’ point)

Begin with a topic sentence written in your own words that presents your grounds. Next, apply the evidence/warrant. Signal phrases are highly recommended to introduce new sources (ex: According to Dr. John Smith, head physician at the Mayo Clinic…). Cite your sources in APA format via parenthetical citations. Follow through with a few sentences examining the evidence and connecting it back to your main point. If needed, apply any conciliatory language to connect to the audience and avoid putting them on the defensive. Strive 5-10 developed sentences in a college level paragraph.

****Note: based on which outline approach you chose in Week 5 (divided or alternating) your draft will either continue with 2 other counter-arguments similar to the one above, followed by 3 rebuttal paragraphs – or it will jump straight to the 1st rebuttal as demonstrated below.

1st Rebuttal (your point)

Begin with a topic sentence written in your own words that presents your grounds. Then identify the first point of contention. Discuss this point and why you disagree with it. Point out faults in the argument; explain why the point has little merit. Then argue why your ideas are superior. Then, apply the evidence/warrant. Signal phrases are highly recommended to introduce new sources (ex: According to Dr. John Smith, head physician at the Mayo Clinic…). Cite your sources in APA format via parenthetical citations. Follow through with a few sentences examining the evidence and connecting it back to your main point. No conciliatory verbiage is needed in the rebuttal parag

Prevention and Treatment of Opioid Misuse and Addiction
A Review
Nora D. Volkow, MD; Emily B. Jones, PhD; Emily B. Einstein, PhD; Eric M. Wargo, PhD

M ore than 2 million Americans have an opioid use disor-der (OUD), and in 2016, more than 42 000 Americansdied of opioid overdoses.1,2 Although in the first years
of the opioid crisis, most overdose-associated deaths were caused
by misuse of prescription analgesics, heroin and synthetic opioids
(fentanyl and its analogues) currently account for most of the fa-
talities, a scenario that reflects the changing nature of the opioid cri-
sis (Figure 1). We reviewed the pharmacology of opioids because it
is relevant to their rewarding and analgesic effects that lead to their
misuse, the epidemiology of the crisis and its transformations in the
past 2 decades, and the interventions to treat and prevent OUD that
must be implemented to overcome the current crisis and prevent it
from happening again.

Opioid Pharmacology

Opioid drugs—prescription analgesics and illicit drugs—exert their
pharmacologic effects by engaging the endogenous opioid sys-
tem, where they act as agonists at the μ-opioid receptor (MOR).
The agonist action at the MOR is responsible for the rewarding
effects of opioids and analgesia. In the brain, these receptors are
highly concentrated in regions that are part of the pain and
reward networks. They are also located in regions that regulate
emotions, which is why long-term opioid exposure is frequently
associated with depression and anxiety.4 In addition, MORs are
located in brainstem regions that regulate breathing; there,

IMPORTANCE More than 42 000 Americans died of opioid overdoses in 2016, and the
fatalities continue to increase. This review analyzes the factors that triggered the opioid crisis
and its further evolution, along with the interventions to manage and prevent opioid use
disorder (OUD), which are fundamental for curtailing the opioid crisis.

OBSERVATIONS Opioid drugs are among the most powerful analgesics but also among the
most addictive. The current opioid crisis, initially triggered by overprescription of opioid
analgesics, which facilitated their diversion and misuse, has now expanded to heroin and illicit
synthetic opioids (fentanyl and its analogues), the potency of which further increases their
addictiveness and lethality. Although there are effective medications to treat OUD
(methadone hydrochloride, buprenorphine, and naltrexone hydrochloride), these
medications are underused, and the risk of relapse is still high. Strategies to expand
medication use and treatment retention include greater involvement of health care
professionals (including psychiatrists) and approaches to address comorbidities. In particular,
the high prevalence of depression and suicidality among patients with OUD, if untreated,
contributes to relapse and increases the risk of overdose fatalities. Prevention interven

SPECIAL ARTICLE

For editorial
comment, see
page 269

From the Department
Psychiatry & Psychology
(T.A.R.) and Departmen
Internal Medicine (M.C.
Mayo Clinic, Rochester
and Department of Inte
Medicine, Mayo Clinic,
sonville, FL (N.L.D.).

344

How Good Intentions Contributed to Bad
Outcomes: The Opioid Crisis

of

t of
B.),
, MN;
rnal
Jack-

Teresa A. Rummans, MD; M. Caroline Burton, MD; and Nancy L. Dawson, MD

Abstract

The opioid crisis that exists today developed over the past 30 years. The reasons for this are many. Good
intentions to improve pain and suffering led to increased prescribing of opioids, which contributed to
misuse of opioids and even death. Following the publication of a short letter to the editor in a major
medical journal declaring that those with chronic pain who received opioids rarely became addicted,
prescriber attitude toward opioid use changed. Opioids were no longer reserved for treatment of acute
pain or terminal pain conditions but now were used to treat any pain condition. Governing agencies began
to evaluate doctors and hospitals on their control of patients’ pain. Ultimately, reimbursement became tied
to patients’ perception of pain control. As a result, increasing amounts of opioids were prescribed, which
led to dependence. When this occurred, patients sought more in the form of opioid prescriptions from
providers or from illegal sources. Illegal, unregulated sources of opioids are now a factor in the increasing
death rate from opioid overdoses. Stopping the opioid crisis will require the engagement of all, including
health care providers, hospitals, the pharmaceutical industry, and federal and state government agencies.

ª 2017 Mayo Foundation for Medical Education and Research n Mayo Clin Proc. 2018;93(3):344-350

T
here is no debate that the United
States is in the midst of an opioid
crisis. Between 1999 and 2014, drug

overdose deaths nearly tripled.1 In 2016,
more than 60,000 people died from drug
overdoses, and opioids were responsible for
most of these deaths.2 For the first time since
1999, life expectancy decreased for US citizens
compared with citizens of other developed
countries, and opioid overdoses were a factor.3

This crisis includes both prescription and
nonprescription (illegal) use of opioid drugs.
Prescription opioids include natural and semi-
synthetic opioids such as codeine and
morphine, and synthetic opioids such as
methadone, fentanyl, and tramadol. Many of
the synthetic agents such as fentanyl are man-
ufactured and distributed illegally. With the
increased availability of both prescribed and
illegally obtained opioids over the past 30
years, there has been an increase in misuse
and deaths (Figure).4

Various opioids have been available for
more than a century, and opioid misuse has
occurred during that time. Following the Civil
War, veterans who suff