Sustainable.edited

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1 Nursing for Sustainable Global Health. Binika Joshi The Wehrheim School of Nursing, Millersville University NURS 506: Sustainable Health Dr. Bryan Weinberg –Wondsidler April 6, 2022

2 Project Description  Title: Strengthen the prevention and treatment of substance abuse.  Type of Sustainable Project: A community intervention project addresses a local health- related concern.  Proponents: Millersville University Positive Energy Grants, health professionals, academic institutions, policymakers, health managers, and citizens  Opponents: Neighborhoods, due to the strong influence of drug peddlers.  Beneficiaries: Children, adolescents, adults, schoolchildren, and alcohol and drug addicts. Population health of non-substance abusers in terms of life expectancy, maternal, all-cause mortality, infant and neonatal mortality, and improvement of mental health outcomes.  Local to Global: This is a local health-related concern related to the UN Sustainable Development Goal of Good Health, whose objective is to ensure that people live healthily  lives to cut child mortality and raise life expectancy.  Implementation: Implementing addiction prevention programs in Lancaster County with the help of Lancaster County Drug and Alcohol Commission, Celebrate Recovery, and Discovery Recovery, mainly in the neighborhoods of Lancaster City. to achieve a positive impact on the target populations by 2025. Sustainability necessitates the Formation of 15 groupings of pupils in 15 schools across the Lancaster County region. Types Background/Situation Analysis Every year, people in this country are directly affected by drug abuse and substance use problems, which result in car accidents, crimes, damages, a worse standard of living, poor health, and yet so many fatalities (Belcher & Shinitzky, 2017). Throughout this project proposal, I have

3 reviewed the data from United Nations Office on Drugs and Crime (UNODC) and National Institute on Drug Abuse (NIDA) to show that the difficulties produced by substance abuse are not confined to disorders associated with substance abuse and how people battling drug abuse can be salvaged. This proposal encompasses a wide range of potential health and safety issues that might arise from substance abuse problems. Various biological and social factors influence substance abuse, and substance abuse problems are medical illnesses characterized by the disruption of important brain circuits (McHugh et al., 2018). Prevention programs and evidence-based concepts significantly reduce substance abuse and related effects (HEALing Communities Study Consortium, 2020). Drug abuse has long been an issue in cities and inner cities (Pear et al., 2019). However, since the frequency of substance use disorders, including substance-related death in rural regions, has increased over the last decade, there is a rising worldwide understanding that the problem of the drug and other substance use has expanded to rural settings across the world (Köck, P., 2020). This applies to both emerging and developed countries (Pear et al., 2019). Opioids (particularly heroin and nonmedical utilization prescription drugs), methamphetamine, cocaine, cannabis, and other narcotics are becoming increasingly popular, particularly in the United States' local region (Lee et al., 2019). When it comes to alcohol, narcotics, smoking, and numerous stimulating substances, including capsules, betel, betel nuts, Students in Pennsylvania, and most importantly, Lancaster's adolescents and schoolchildren become addicted (Tawil et al., 2019). Even adults indulge in these addictive practices (Köck, P., 2020). Despite Lancaster's exorbitant increase of 40% tax on a pack of cigarettes, the percentage of smokers has significantly increased (Rosa,

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4 2017). Alcohol consumption is significantly higher at 42% in Nebraska compared to the national 17% (Lubischer et al., 2019). This is reflected in the local regions of Nebraska. In Lancaster, Pennsylvania, however, female alcohol drinking is uncommon. However, compared to the majority of the country, higher-income earning women consume more alcohol (Chiappini, 2020). The proportion of women of higher economic status who use alcohol was determined in a survey of 368 women over 18 who lived in 15 sub-divisions of five higher economic region (Chiappini, 2020). It was shown that 31.25 percent of women in this industry consume alcohol. This demonstrates that even the agricultural community in Lancaster consumes alcoholic beverages. Arrack, cannabis intoxication pills, toddy, heroin, betel, and betel nuts are being used by a huge number of teenagers and adults inside the district, according to the Pennsylvania narcotics unit. The Lancaster County Drug and Alcohol Commission has also discovered that the aforementioned addictive practice has extended to the island's main schools. Several factors have been attributed to extensive drug abuse. These factors include lack of understanding, ignorance, inherited features, and the community's cultural and social milieu (McHugh et al., 2018). The results of substance abuse are devastating. Addiction to drugs such as alcohol and drugs has caused the collapse of family life, the economy, and children's education. In addition, substance abuse increases the possibility of sexually transmitted illness spreading (Rosa et al., 2017). Children and teenagers between the ages of seven to eighteen should be sufficiently informed about the negative consequences of taking drugs and alcohol. Counseling should be offered to them; counseling and addiction therapy helps to uncover the underlying causes of substance abuse and provide a long-term recommendation to avoid relapse. Young addicts can

5 also be sent to treatment centers (where drug addicts below 21 are being treated). As a result, counseling has become necessary to begin a long-term procedure collaborating with the authorities and the National Dangerous Drugs Control Board to resolve this problem. The work of the UNODC on drugs and health is intrinsically related to SDG 3 targets for Good Health. On various fronts, the Office's mission, for instance, is entirely consistent with Target 3.5. By aiming to reduce prejudice against drug users, the UNODC promotes a balanced health promotion response to the drug problem (Rosa, 2017). Furthermore, through improving access to appropriate, evidence-based, and gender-based programs for drug treatment and prevention of addictive disorders, especially as an alternative to conviction and punishment. Several organizations have been striving to improve the prevention and treatment of drug abuse. The National Institute on Drug Abuse (NIDA) is a prominent stakeholder within Lancaster. NIDA is actively involved in the fight against drug misuse. NIDA helps with research awareness, career development, public education, public-private collaborations, and research distribution (Sindelar & Fiellin, 2021). Part of the preventive strategies for drug abuse includes detecting and responding to growing drug usage patterns and comprehending how drugs function in the brain and nervous system. Therefore, NIDA conducts studies to: Identify the physiological, environmental, cognitive, and social motivations and effects of abuse and addiction through its Intramural Research Program (Sindelar & Fiellin, 2021). It is necessary to continuously come up with innovative and quality treatments to aid individuals diagnosed with drug abuse disorders to achieve and maintain significant and long-term recovery. The need to re-innovate how we deal with substance abuse and substance dependence as a society is long overdue. The national opioid overdose pandemic has gotten the attention of the public, federal, state, and municipal administrations. (Musyoka et al., 2020). Criminal-justice

6 systems have opened new avenues for expanding preventative and treatment programs. Healthcare reforms and parity legislation create new capabilities and motivations to manage drug abuse and associated illnesses in various contexts. Project Goals, Objectives, and Outcome General Objectives  Developing the perspectives and capacities of children, teens, and adults in Pennsylvania Lancaster communities and districts to reduce their alcohol and drug use. Inside this three- year project term, the proposed project aims to accomplish the following precise goal:  Implementing addiction prevention programs in the rural regions and at the school level within the districts and areas of Lancaster to positively impact target populations by 2023.  Formation of 15 groupings of pupils in Lancaster's local communities to be enlightened and be in charge of the anti-drug abuse campaign. By the year 2023, we will have achieved our goal. Target Groups  Children, adolescents, adults, schoolchildren, and alcohol and drug addicts.  Victims of drugs or alcohol abuse (persons in the rural and plantation areas and school children).  Drug addicts (Persons in the local Lancaster communities and students). Expected Outcomes Aspects of the program will include: The PSC's Preventive and Rehabilitative Series is an eight-session drug misuse prevention educational campaign. The education system should conduct a series of 8 to 12-minute individual or group meetings. Individual as well as Group

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7 Counseling. Parent Programs—Through parent educational programs. Project Success engages families as collaborative participants in prevention. Inside the target fields of rural, agricultural, and urban communities, thirty youth groups will have been created and actively involved in the fight against substance abuse. We will be able to make progress sustainable by partnering with the National Institute on Drug Abuse (NIDA). We also intend to strengthen our relationships with hospitals and counseling centers.  In the fifteen schools' divisions, fifteen groups of pupils have been developed.  The National Institute on Drug Abuse (NIDA) and our organization have a complementary relationship.  Our team gathers data on drug and alcohol-related occurrences to compile a report on the program's effectiveness. Implementation and Sustainability Current health reform initiatives and modern technological advancements are significant in moving forward with an improved political health-based paradigm for dealing with substance abuse and its associated setbacks. However, without the involvement of the extended community, the healthcare system may not manage to address all the main health factors related to drug abuse. This report encourages a wide range of stakeholders to have a role in changing the culture, beliefs, and behaviors around drug use and keeping the dialogue continuing until the objective is achieved. Many of the challenges that affect the drug abuse therapy professionals result from prejudice and discrimination. These characteristics can significantly impact one’s urge to speak with a health care provider about their drug use complications, access or seek treatment services,

8 and be honest about the treatment and rehabilitation requirements with friends, family, and coworkers. Active Methodology Information Dissemination: This method provides knowledge and awareness about the type and degree of alcohol tobacco, as well as other drug use, misuse, and addiction, and also facts to improve risk perceptions. It also provides information on preventative initiatives, policies and services and creates awareness about the dangers of substance abuse. It aids in establishing and reinforcing standards (for example, underage drinking and drug peddlers will not be condoned in this hood through parent education). Prevention Education: This includes essential social and human skills such as refusal skills and thoughtful evaluation in the learning curriculum to enable teenagers to manage peer pressure. Alternatives: This method encourages targeted people to participate in activities free of alcohol, cigarettes, and other drugs. Constructive and healthful activities can help reduce the desire to satisfy the needs generally met by alcohol, cigarettes, and other drugs. Problem Identification and Referral: Such technique advocates identifying, educating, and counseling adolescents who have misused tobacco products or alcohol or used illegal substances. Screening drug addiction tendencies, including referral to treatment, would be part of this plan. Community-Based Process: This method aims to enhance the ability of the community to Effectively deliver preventive and therapeutic services for tobacco, alcohol and other drug use problems. Planning/organizing and improving the effectiveness and efficacy of service delivery, coalition building, interagency collaboration, including networking are possible actions that can

9 be undertaken. Health and wellness options are encouraged when communities are groomed to maintain a healthy lifestyle. Environmental Approach: This approach influences the incidence rates of tobacco, alcohol drinking and other drug use issues across the population by establishing or altering established and unestablished community codes, believes and attitudes. Laws restricting availability and access, price hikes, and social initiatives are included. Following-Up Actions The project staff (clinicians, researchers, and physicians) will oversee following up on this project. The pupils in the groups will be followed through their institutional groups, and this will be followed by young groups as well. Weekly review conferences, monthly, bi-annual, and yearly meetings will be used to track progress. Aspects that shall be used in monitoring progress include reduction in demand for abused substances, reduction in supply, and reports from the external corporation. Budget No. Budget ($) 1 Conducting Workshops on Personality Development. 2000 2 Organizing public awareness campaigns. 5000 3 Workshops on TOT. 1500 4 Thirty youth groups have been formed. 3000

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10 5 School surveillance. 500 6 Seminar at the school. 1000 7 Handbills/Posters/Stickers. 2000 8 Monitoring and evaluation. 500 9 Staffing Fees 3000 10 Admin. 2000 Total Expense 20500

11 References Belcher, H. M. E., & Shinitzky, H. E. (2017). Substance Abuse in Children. Archives of Pediatrics & Adolescent Medicine , 152 (10) https://doi.org/10.1001/archpedi.152.10.952 Chiappini, S. (2020). Misuse of prescription and over-the-counter drugs to obtain illicit highs: how pharmacists can prevent abuse. The Pharmaceutical Journal . https://doi.or g /10.1211/pj.2020.20208538 Healing Communities Study Consortium. (2020). The HEALing (Helping to End Addiction Long-term SM) Communities Study: Protocol for a cluster-randomized trial at the community level to reduce opioid overdose deaths through the implementation of an integrated set of evidence-based practices. Drug and alcohol dependence , 217 , 108335. Köck, P., Meyer, M., Elsner, J., Dürsteler, K. M., Vogel, M., & Walter, M. (2022). Co-occurring Mental Disorders in Transitional Aged Youth With Substance Use Disorders–A Narrative Review. Frontiers in Psychiatry , 13 . Lee, J., Kresina, T. F., Campopiano, M., Lubran, R., & Clark, H. W. (2019). Use of Pharmacotherapies in the Treatment of Alcohol Use Disorders and Opioid Dependence in Primary Care. BioMed Research International , 2015 (3). https://doi.org/10.1155/2015/137020

12 Lubischer, Rachel; Gabel, Jodi; Castrianno, Lynn; Faimon, Kristina; Frain, Dawne; Harder, Jeanette; Schafer, Josie; and Armstrong, Gaylene, "Drug Use Behaviors: A Needs Assessment of Treatment Providers" (2019). Reports . 13. https://digitalcommons.unomaha.edu/step_reports/13 Pear, V., Ponicki, W., Gaidus, A., Keyes, K., Martins, S., & Fink, D. et al. (2019). Urban-rural variation in the socioeconomic determinants of opioid overdose. Drug And Alcohol Dependence, 195 , 66-73. https://doi.org/10.1016/j.drugalcdep.2018.11.024 McHugh, R., Votaw, V., Sugarman, D., & Greenfield, S. (2018). Sex and gender differences in substance use disorders. Clinical Psychology Review , 66 , 12-23. https://doi.org/10.1016/j.cpr.2017.10.012 Musyoka, C. M., Mbwayo, A., Donovan, D., & Mathai, M. (2020). Alcohol and substance use among first-year students at the University of Nairobi, Kenya: Prevalence and patterns. PLOS ONE , 15 (8), e0238170. https://doi.org/10.1371/journal.pone.0238170 Rosa, W. (2017). A New Era in Global Health: Nursing and the United Nations 2030 Agenda for Sustainable Development . Springer Publishing Company. Sindelar, J. L., & Fiellin, D. A. (2021). Innovations in Treatment for Drug Abuse: Solutions to a Public Health Problem. Annual Review of Public Health , 22 (1), 249–272. https://doi.org/10.1146/annurev.publhealth .22.1.249 Tawil, T. M. (2019). Reducing Opioid Overdose Deaths in Lancaster County. The Journal , 14 (3), 68.

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