Fentanyl Abuse
Overview
Canada’s opioid crisis owes to an increase in the population of black market distributors who provide illicit services for strong painkillers without doctors’ prescriptions. Fentanyl is one such medication associated with pain relief and is reputed as stronger than morphine and heroin. The highly addictive substance is one of the most abused drugs in Canada. Fentanyl overdose is a growing concern in a country that is already dealing with the opioid crisis. The Fentanyl crisis is similar to other concerns over opioid abuse in Canada. The Government of Canada (2022b) reports 5,360 deaths in January 2022 due to the substance. Since 1999, there has been an increase in pharmaceutical opiate fatalities and incidences of non-medical opioid abuse usage in Canada. Figures indicate that non-medical prescriptions opioid abuse surpassed heroin and cocaine usage in terms of frequency in 2008, ranking fourth among all drug use behaviors (Lisa & Jessica, 2018). British Columbia leads in opioid abuse, and fentanyl is no exception.
The demographic composition of British Columbia explains why it should be analyzed. It is one of the most populated places in Canada with 4,943,980 residents, contributing to over 1% annual growth rate (Statista, 2022). One of California’s most interesting facts is that it has the highest population of immigrants in the country. They make up 29% of the British Columbian population, and most occupants of the region come from Mexico through California (Johnson, 2022). Another unease is that British Columbia shares a border with California, which is adjacent to Mexico. Border security is essential since most of the smuggled, the illegal, and counterfeit prescription drug reaches California through the same border. This submission uses the Population Health Promotion Model to analyze the prevalence of Fentanyl cases in British Columbia, Canada. The population is important because it recorded the highest rate of fentanyl use in Canada between 2020 and 2022, making it essential to establish factors that contribute to the problem before applying relevant solutions.
Population Health Promotion Model
In the 90s, Statistics Canada created the Population Health Promotion Model, a simulation framework for health advancement. It simulates the lifetime of the Canadian people while concentrating on health-related factors by combining extensive multivariate evidence from several domains (Manuel et al. 2016). To explain and estimate clinical outcomes such as life expectancy, the model continuously generates the target populations’ health statuses, comorbidities, and health indicators. The model further evaluates the effects of policy and healthcare program interventions on the country’s health without solely focusing on issues affecting the healthcare system. The Public Health Promotion Model further explains how statistics influence health outcomes, especially when governments use policy-driven interventions to solve communal healthcare matters. It means the theory is invaluable in analyzing fentanyl abuse in British Columbia. The three determinants of health relevant to the study population and the theory include behavior, social environment, and literacy.
Behavior
Individual behavior promotes health because it is a product of a personal decision to make positive change. According to Abnousi et al. (2019), individual behavior introduces the argument about nature vs. nurture. The study further mentions that demographics mold individual behavior. For instance, fentanyl use, overindulgence, and deaths are common among two groups, which include young adults and older populations. British Columbia’s youthful population aged between 25 and 44 years are the majority and constitutes about 1.5 million individuals followed by those aged 44 to 64 years old who comprise over 1.4 million individuals in the British Columbian populace (Statista 2022). The young primarily use ‘illicitly manufactured fentanyl’ while their older counterparts manage pain with the opioid. In both cases, addition is possible, but in the younger population, the situation is austere. From an individualized point of view, people within the age bracket should understand that they are at-risk populations. Therefore, they must make deliberate actions to avoid fentanyl. In case they need the drug due to underlying health conditions, such people must use it for the desired goal and in minimal amounts to avoid addiction.
Social Environment
The social environment determines human interactions based on educational level, income, and social status among other demographic factors. Kim (2019) reveals that people with higher social status are associated with better health while their counterparts with lower societal positions record poor health occasioned by life stresses and diminished self-worth. Stability can also create functional families, which allow people to share areas of struggle instead of seeking solace in drugs. Residents of British Columbia make up the social environment, which constitutes diverse populations most of which experience vast socioeconomic challenges (Parkes et al., 2020). Based on the Population Health Promotion Model socioeconomic issues influence life expectations and comorbidities, which are critical health indicators. In a setting such as BC, the social environment exposes young people to ways of managing stress, which means most will access synthetic opioids for recreational purposes. Thus, most consume fake fentanyl, which mostly comes in packages of extremely attractive pill colors (Comer & Cahill, 2019). The ripple effect is the addiction to such drugs, which is common in major cities across the country. Canada in its entirety has a problem with illegally produced fentanyl, which is supplied in liquid and powder forms. Most addicts consume liquid fentanyl through nasal sprays and eye drops making the substance attractive to young people. British Columbian laws further increase access to the substance since illegal possession of the opioid is a misdemeanor that attracts no jail term or fine for an adult aged 18 years and above handling below 2.5 grams of fentanyl (Johnson, 2022). The freedom contributes to the high rates of deliberate fentanyl poisoning, which contributes to 18% of such cases. From a social-environmental point of view, policies should be implemented to fight illegally produced fentanyl. This would translate into harsh sentences for those found in possession of the substance. Its rationale would be to reduce fentanyl dependency due to the social issues affecting BC residents.
Literacy
Most users of counterfeit fentanyl overlook its effects or are unaware of the consequences. Literacy plays a critical role in determining the effects of risky behavior .literacy is intertwined with education and it analyzes one’s level of awareness about their environment. Communities with high socioeconomic statuses can afford better educational quality and opportunities to improve literacy levels. In BC, 45.9% of the population aged between 16 and 65 years reads at a level under two while 38.7% learns at level three, and 15.4% attained level 4 to 5, as British Columbia (2022) states. It means literacy levels are low. The danger with such a population is its inability to understand the consequences of certain actions. A growing concern is that some drugs contain minute amounts of fentanyl that go undetected. For a substance that is 100 times stronger than heroin and 50 times more effective than morphine, the effect of negligible amounts of fentanyl remains significant. Petrifying statistics requires immediate intervention. Unlawfully manufactured Fentanyl is frequently combined with other drugs including methamphetamine, heroin, and fake medications. Subsequently, most consumers are unaware they are taking fentanyl, which might cause unintentional overdose and fatality. The epidemiological and demographic data of British Columba concerning fentanyl consumption is of concern. Several young people and individual citizens consume the substance without consent or knowledge. One must use the fentanyl test strips to establish the presence of the substance in the other drugs or meals. Due to the costliness of the test strips, most substances go untested, which means several Americans face the risk of death in the case of overdose. Low literacy levels affect decision-making even in a country run by sound policies (Parkes et al., 2020). Consequently, such communities will ignore key messages on health management. BC residents should have health-seeking behaviors to understand the origins of illegal fentanyl emanates, and its impacts on society. Using data-driven solutions, they can make informed decisions by sealing the porous borders of Canada and California to intercept fentanyl from Mexico.
Analysis
From a physical health point of view, fentanyl ingestion produces life-threatening effects. In population health, the burden of care is with families and the public health system. As afore established, test strips are costly, which means individuals cannot know whether they consumed a substance with fentanyl. Public health facilities must intervene to verify the presence of the substance in a patient’s bloodstream. In such a context, public health resources are used to manage a situation that involves fentanyl intake. If many people are in such situations, they overwhelm the healthcare system and reduce their quality of life. The Population Health Promotion Model applies in the context because fentanyl abuse disrupts public life and requires communal resources to facilitate treatment and save lives on rare occasions since most victims die.
Fentanyl is a public health issue that demands intervention from the government and legal entities to ensure the substance is distributed to the right people. The government of Canada remains dedicated to intercepting illegally manufactured and distributed fentanyl. Through the Substance Use and Addictions Program, the Canadian government contributed $800 million to create awareness about opioids, which included fentanyl (Government of Canada, 2023). The initiative supports the safe use of pharmaceutical fentanyl and reduces access to illegal drugs. According to the government, illicit substances overburden social services and affect the distribution of resources to priority areas. The Public Health Promotion Model applies in the context because it applies evidence-based practice to promote policy-driven interventions in community health issues (Manuel et al. 2016). As a result, the Canadian government funds interventions based on policies.
Policies primarily depend on data and statistics. Important statistics include the exposure of 34% of Canadians to fentanyl through medication and the deliberate poisoning of 18% of the same population using the substance. Other numbers reveal that 14% of illegal fentanyl in Canada comes from other countries, especially China through Mexico. Another finding is that some laboratories in the country manufacture fentanyl and other products come from fentanyl patches, which are medically diagnosed and supplied (Government of Canada, 2022a). Such findings explain why the government of Canada set up the Pain Canada Program with $4.5 million over half a decade to support patients with pain. The same institution committed $650 million to the Hope for Wellness Initiative to support mental health between 2022 and 2023 (Government of Canada, 2023). The disparity in funding was informed by the statistics, which detailed areas that needed an emergency response. For instance, mental health is a critical area that the government should support because most people use fentanyl for mental health. The same substance causes mental health problems.
The Population Health Promotion model is data-driven and it relies on statistics to justify the need for collective action over a chronic societal problem. Based on the numbers, fentanyl emerges as a highly toxic substance that nobody should take without a prescription. In addition, even those that consume it medically must exercise precaution because fentanyl is highly addictive. The ripple effect of addiction is the possibility of disruption in relationships, the development of criminal behaviors to fund the addition, and loss of employment. In essence, physical and mental health issues re-emerge whenever experts discuss fentanyl. Interventions require the application of a model that applies microsimulation to introduce public health policies with long-term effects. One of the recommendations in Canada is to ensure that illegal fentanyl does not enter its borders. The country should align its public healthcare policies with security measures to seal all loopholes of drug entry into Canada.
Community Nursing Diagnosis
A wellness diagnosis or health promotion involves making a clinical determination regarding the motivation and drive to enhance health. It is a declaration that pinpoints if the client is prepared to partake in behaviors that advance their well-being. It is more relevant in this context compared to a deficit diagnosis. From the findings, it is apparent that the Canadian population should embrace healthier lifestyles since the government funds programs to support their well-being. BC residents should only take recommended doses of pharmaceutical fentanyl. Addicts should pursue recovery in rehabilitation facilities and other members of society must assist the government in barring the entry of illicitly produced fentanyl from smugglers in other countries. Users should also access fully funded health insurance services when they opt for rehabilitation. With the relief of the burden of care, the socioeconomic status would rise. This would culminate in an improvement in literacy levels, as most individuals will change behaviors to enjoy long and fulfilling lives A final essential recommendation is to facilitate community awareness programs that enhance literacy levels and support decision-making concerning the health issue. The population should understand that fentanyl ingestion could culminate into life-threatening intoxication even in moderation. Canada is an area of interest when assessing fentanyl’s spread because, in 2022, 31% of opioid-associated poisoning involved the drug. The population must know that BC will start exposing children to fentanyl one youth and older populations extensively use it.
A health promotion framework fits the situation because most Canadians overlook the consequences of fentanyl, yet they know the drug is dangerous. A wellness diagnosis will utilize policy issues, funded initiatives, and awareness creation programs to support anti-illegal fentanyl campaigns. Instead, programs such as Pain need support with additional resources to ensure those deserving of pharmaceutical fentanyl access the medication. By applying the model, fentanyl use is no longer an individual issue, but a communal concern deserving of public health response.
References
British Columbia. (2022 Oct 22). Audience diversity. https://www2.gov.bc.ca/gov/content/home/accessible-government/toolkit/audience-diversity
Comer, S. D., & Cahill, C. M. (2019). Fentanyl: Receptor pharmacology, abuse potential, and implications for treatment. Neuroscience & Biobehavioral Reviews, 106, 49-57.
Government of Canada. (2022a). Fentanyl. https://www.canada.ca/en/health-canada/services/substance-use/controlled-illegal-drugs/fentanyl.html
Government of Canada. (2022b). Fentanyl. https://www.canada.ca/en/health-canada/services/substance-use/controlled-illegal-drugs/fentanyl.html
Government of Canada. (2023). Federal actions on opioids to date. https://www.canada.ca/en/health-canada/services/opioids/federal-actions/overview.html
Johnson, K. (2022). Opioid-related deaths reach record high in Canada. https://www.medscape.com/viewarticle/976491
Kim, P. J. (2019). Social determinants of health inequities in indigenous Canadians through a life course approach to colonialism and the residential school system. Health Equity, 3(1), 378-381.
Lisa, B., & Jessica, H. (2018). Evidence synthesis-The opioid crisis in Canada: a national perspective. Health promotion and chronic disease prevention in Canada: research, policy, and practice, 38(6), 224.
Manuel, D. G., Garner, R., Finès, P., Bancej, C., Flanagan, W., Tu, K., … & Bernier, J. (2016). Alzheimer’s and other dementias in Canada, 2011 to 2031: a microsimulation Population Health Modeling (POHEM) study of projected prevalence, health burden, health services, and caregiving use. Population health metrics, 14, 1-10.
Parkes, M. W., Poland, B., Allison, S., Cole, D. C., Culbert, I., Gislason, M. K., … & Waheed, F. (2020). Preparing for the future of public health: ecological determinants of health and the call for an eco-social approach to public health education. Canadian Journal of Public Health, 111(1), 60-64.
Statista. (2022). Population estimate of British Columbia, Canada in 2022, by age and sex. https://www.statista.com/statistics/605971/population-of-british-columbia-by-age-and-sex/
