The Ecosystem and the Stakeholders: (Coming in September 2021) 

 

We take a deeper dive into the various stakeholders associated with the epidemic  and highlight the potential for citizen action.

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Our democracy is a fragile, complex political system made of easily corruptible, intricate web of institutions, interest groups, individual leaders and associated elites, and citizens that are connected to each other in countless ways. Every attempt to influence some aspect of this complex system produces a ripple of other reactions – some may be predictable, but many are not. This can make it difficult to anticipate what will happen when we intervene to try to make our democracy work better.  In many ways the opioid epidemic has come to highlight and act as a symptoms for many underlying challenges faced by the body politic of the United States. It is symbolic of the symptoms of the social and political pathology in the US if not a major symptom. The many explanations for the initiation and continued use of opioids for each individual victim of the epidemic, the general forces contributing to the epidemic as well as the barriers to effectively addressing the challenges reflect the personal, social, political dynamics that shape our politics. We believe that the symptoms associated with opioid use and the societal response to the challenge offer an opportunity to focus on a complex issue and as such more broadly  to explore the political system, its limitations and most importantly, examine the potential for citizen involvement in their political ecosystem.

 

The interconnected and complex challenges of pain and its optimal treatment/management, opioid use disorders and its fatal consequences, and the “failed” War on Drugs provides an excellent framework to test a citizen centric approach to address the problems facing our nation. It allows for a more comprehensive approach that includes identifying and addressing the many factors that lead to and sustain the opioid crisis, including the social determinants, public policy, systemic realities. Additionally, it is clear that there are many “citizen” focused interventions that can stem various symptoms of the epidemic. The challenge we face is providing a process that will achieve the best outcome with acceptable unintended consequences. Providing the right citizen engagement tools and framework, citizens, patients, consumers, healthcare professionals, public servants and politicians, working together can achieve great results addressing the challenges facing our nation.  The approach must address the complexity associated with the Opioid Problem by focusing on the entire Opioid ecosystem and target and hold accountable the various stakeholders. Federal, state and local governmental efforts underway to treat the epidemic are a positive step however limited. Unintended consequences impact on the government and stakeholders.
 

The Pain Opioid Ecosystem requires a complexity lens to address the devastating consequences of Pain Opioid Epidemic. Our approach recognizes that any meaningful solution must address the entire arc of the Opioid Ecosystem, including pain management, opioid use disorders, opioid overdoses, public policy, law enforcement, criminal justice and related challenges. We build on an understanding of complexity, the potential of information and communication technology (ICT) as well as insights from behavioral economics to address the challenge.The challenge of pain and related opioid use and abuse requires a well formulated, coordinated effort that addresses the complexity of the pain-opioid ecosystem* as well as to leverage our understanding of the institutional challenges that must be identified and overcome.

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Mapping the Pain-Opioid Ecosystem

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Stakeholders and the  Process of The Pain-Opioid Ecosystem 

 

The Role of Government 

• The US Federal Government

• Opioid Epidemic and the Federal Budget

• The Legislative Branch Ecosystem: 

  • Legislative Branch: 

  • Senate Health, Education, Labor and Pensions (HELP)

• The Executive Branch

  • US Presidents the War on Drugs and the Opioid Epidemic

  • Me and The Drug Enforcement Agency (DEA) DEA citizen brief, FDA 

  • Citizen Brief: The Drug Enforcement Administration 

• The Judicial Branch  

• Criminal Justice system

• Reimagine the War on Drugs

• Police and Opioid Addiction

• The state and local government: 

  • The Governors and the Opioid Epidemic

• • State Government

    • ​PA State: The PA experience

  • Heroin in Philly

• Media and the Opioid Epidemic 

  • Media and the changing nature of American society  

• The public voice in government decision making

• Non Profits:  The medical profession 

  • The Medical Profession as Drug Dealers 

  • The AMA’s Response to the Opioid Epidemic

  • Hospitals and Health Systems

  • Emergency Department 

  • Clinicians 

  • Pharmacists

  • Insurance

  • DC Guidelines for Pain Management

• The commercial: 

  • Pharma

• Citizen Groups

 

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Media and the Opioid Epidemic

Media outlets coverage of the opioid epidemic illustrate the challenges and opportunities for the media in reporting and covering  complex social issues. As the shapers of public opinion, the media plays a crucial role within the pain opioid ecosystem. When complete this section will include the latest articles, social media, lectures and related information relevant to the Pain Opioid Epidemic Case.

 

The goal of the media stakeholder section is to explore  the challenges of and provides a journalistic framework that can enhance the performance of the media. The approach, addresses the many challenges facing the media in the digital era. The “ symptom” of the  opioid epidemic is explored as a vehicle to address the challenges Madison foresaw in the body politic and to provide a case study to help understand the complexity of challenges facing our ”body politic” and potential for the Media (The Atlantic ) to contribute to the role for “Public opinion” in political discourse.

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The Legislative Branch: Congress: Senate Health, Education, Labor and Pensions (HELP)

“We passed legislation, increased funding , we recognize that you have to focus on education and prevention, law enforcement  treatment and recovery, and yet we seem not to be making any progress that we need to make”.

 

Susan M. Collins ,U.S. Senator [R] Maine, OCTOBER 5, 2017 Opioid Crisis  1:00

The Senate Health, Education, Labor and Pensions Committee convened a hearing on federal response to the nation’s opioid epidemic.

 

Senate Health, Education, Labor and Pensions (HELP): The SUPPORT Patient and Communities Act of 2018-Part Two

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The Executive Branch, US Presidents the War on Drugs and the Opioid Epidemic

 

In the 45 years since President Nixon called on congress to engage in a fight against drug addiction, the opioid epidemic continues to have a devastating impact on many individuals and communities throughout the United States. According to the Centers for Disease Control and Prevention, Opioids, which include prescription painkillers and heroin, were involved in 28,648 deaths in the United States in 2014. It is clear that the federal response to the problem of drug use has failed. In his 2016 SOTU address, president Obama singled out the prescription and heroin abuse problems as an area for bipartisan congressional legislation. This week The Obama administration indicated that it would ask Congress to spend an additional $1.1 billion next year to combat a growing epidemic of prescription Opioid Pain Relievers (OPR) and heroin abuse. Pumping more money into the current ecosystem of federal, state and local government efforts are being mobilized and coordinated with multiple medical, and other community stakeholders is not likely to significantly change the problem. There is a need to reassess the approach being promoted to address the challenges of opioid use.

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Philadelphia Seeking Solutions to the Opioid Crisis

Oxycontin: Its Use and Abuse , Hearing before the Committee on Energy and Commerce Subcommittee on Oversight and Investigations (Took place in Bensalem PA)

Congressman James C. Greenwood

Firstly, what kinds of information do we now collect to monitor this problem, and do we need to have different structures and different mechanisms for developing this information so that we know what the scope of the problem is.

 

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Opioid Use Disorder: Hospital & Healthcare System Setting

The Opioid Use Disorder: Hospital & Health care System Setting is closely related to the The Case of the Opioid Epidemic and is driven by the Vision of Optimal Care for Addiction (Medium- Crowdsourcing) and Vision of Optimal Care for Pain Disorders. The project is informed by the challenges associated with complexity of the opioid epidemic. It provides a framework to view the challenges of the individual within the pain-opioid ecosystem and employs a complexity lens to suggest a path to improving health and wellness outcomes. The position of the hospital system within the ecosystem will be explored. Given that best practice are well recognized measures to facilitate implementation are discussed and incentives, barriers to optimal performance will be highlighted. In addition to information and data, the goal is to provide citizen tools, including “citizen briefs”, checklists, information technology and communication tools to engage with the ecosystem to achieve meaningful solutions and treatments.

 

 

Google Doc: Healthcare System* and Hospital Setting

Google Sheets: Hospital Network Resources

Wix: Healthcare system and the hospital setting

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