Opioid Addiction in West Virginia

West Virginia is the eastern United States of America in the tree-covered Appalachian Mountains, there used to be a town with beautiful nature, bustling coalmines, and developing cities. It’s now infested with drug-addicted zombies. What I called home, other people know as the drug capital of America (Hendershot, 2018)

. In 2013, a song is known as “Boone Country Mating Call” by Mini Thin, a rapper from West Virginia was released. The song describes how to attract a Boone County girl by simply shaking a pill bottle. It makes humor of the disgusting actions that still go on in that backwoods town today. West Virginia has the highest age-adjusted rate of drug overdose deaths involving opioids. In 2007, there were 833 drug overdose deaths involving opioids in West Virginia – a rate of 49.6 deaths per 100,000 persons. This is the double rate in 2010 and threefold higher than the national rate of 14.6 deaths per 100,000 persons. The sharpest increase in opioid-involved overdose deaths was seen in cases involving synthetic opioids other than methadone: a rise from 122 deaths in 2014 to 618 deaths in 2017 (National Institute on Drug Abuse, 2019).

The core value that is being challenged in this issue is the lack of policy action to end the opioid addiction. On one hand, you have the current stock of people addicted to opioids; the people in this population need treatment or they will simply find other, potentially deadlier opioids to use if they lose access to painkillers. On the other hand, you have to stop new generations of people from potentially accessing and missing opioids. Perhaps the solution here is to educate people on the basic realities of addiction and why it needs our attention (Lopez, 2017). PART BI chose Alex Michael Azar II as our leader, was sworn in as the Secretary of Health and Human Services on January 29, 2018. Azar has spent his career working in both the public and private sectors, as an attorney and in senior leadership roles focused on advancing healthcare reform, research, and innovation. HHS and the entire federal government are committed to ending the crisis of opioid addiction and overdose in America, and the Department has formulated a five-point strategy to stop the epidemic-

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1. Better addiction prevention, treatment, and recovery services
2. Better data
3. Better pain management
4. Better targeting of overdose-reversing drugs
5. Better research (Giroir, 2019).

Alex Azar (born June 17, 1967) is an American politician, lawyer, pharmaceutical lobbyist, and former drug company executive who are the current United States Secretary of Health and Human Services. Azar was nominated by President Donald Trump on November 13, 2017, and confirmed by the United States Senate on January 24, 2018. Azar clerked for U.S. Supreme Court Justice Antonin Scalia before practicing law for several years. Azar graduated summa cum laude with a bachelor’s degree in economics and government from Dartmouth College and earned his law degree from Yale University. For the past 10 years, Azar has lived in Indiana with his wife and their two children (The White House, 2018).The compassionate leaders are working to create positive change for the people of Virginia. Azar highlighted the importance of ensuring affordable and available healthcare and seemed to place blame on the ACA (Affordable Care Act) for people’s lack of coverage (Leo, 2017). According to Becker’s Hospital Review (2017), acting Human and Health Services secretary Eric Hargan declared the opioid crisis a “public health emergency” in October, and Mr. Azar said he would continue to try and fight the opioid epidemic. “We need aggressive prevention, education, regulatory, and enforcement efforts to stop overprescribing and overuse of these legal and illegal drugs, and we need compassionate treatment for those suffering from dependence and addiction.” Although the transition to value-based care is a top priority in Azar’s lists. “We must better channel the power of health and leverage what is the best working in our programs and in the private competitive marketplace to ensure the individual patient is at the center of decision making and that his or her needs are being met with greater transparency and accountability” (Leo, 2017).PART challenge the Process Leaders search for opportunities to change the status quo (John Wiley & Sons. Inc, 2000-2018). Azar worked in Human and Health Services as a Secretary with other members of HHS. In one Heritage Foundation (2018), Alex said,” In every other sector of our economy, we do not expect the government to set prices. We rely on the free exchange of information between buyers and sellers, among competing interests, to do it. We can get better outcomes from our healthcare system at a lower cost by putting patients, not the government, in charge.” As the cost of American healthcare has kept rising, without commensurate increases in quality, it simply should not have taken us this long to stop talking about fixing them, and actually get down to doing it. Today, fixing American healthcare requires disrupting government-dictated systems, building new ones that encourage choice and competition, and heeding the principles that are laid out today (U.S. Department of Health & Human Services). Azar was also asked about Trump’s hard stance on Mexico drug traffickers and weather they are even related to the opioid epidemic. Azar claimed people can gain access to illegal opioids from our southern borders. The impacts of opioid addiction “devastating” and reiterated the president’s plan to reduce the number of legal opioid prescriptions in the United States (CNBC, 2018, March 21). Change and innovation involve taking risks and experimenting. One way of dealing with the potential risks is to approach change through incremental steps and small wins (Posner, 2107).Inspire a Shared VisionA shared vision can be defined as an end goal or objective that a leader and their team establish and work towards together. In The Leadership Challenge, Kouzes and Posner tell us that looking into the past is important to help us identify why we care about certain things and understand why making things better in the future is important (Mugavin, 2018).

About the opioid addiction, Azar said,” This is not a moral issue”. Alex M. Azar has spent his career working in both the private and public sectors of health care as an attorney and other various leadership roles. “They are not individuals who are seeking out to be drug addicts or are seeking out a high. They are individuals who are getting trapped in the cycle of addiction “Squash Box” (CNBC, 2018, March 21). As deputy secretary, Mr. Azar functioned essentially as the Chief Operating Officer of the department. President Bush had a management agenda to improve the efficiency of the Federal Government. They had developed a series, almost three dozen different areas, of evaluation that were to be graded on a chart that had green, yellow, and red. Azar set a goal to have HHS become the first department in the Federal Government to have every measure green (Committee on Finance United States Senate, 2018, January 09). To enlist support for a common vision, leaders must have intimate knowledge of people’s dreams, hopes, aspirations, and values (Posner, 2017). Azar did just that. Not only had he made new policies for the opioid epidemic but also will be the administration’s policy driver.Model the WayTitles are granted, but behavior earns respect. Exemplary leaders know that if they want to gain commitment and achieve the highest standards, they must be models of the behavior they expect from others (Posner, 2017). According to Azar (2018), “Our fellow citizens who commit to treatment should not be treated as pariahs; they are role models”. Mr. Azar certainly has his work cut out of him. Health and human services is a massive, sprawling department that oversees trillions of dollars in spending and liabilities and encompasses all areas of our Nation’s health care system. As a result, Mr. Azar’s work will impact the lives of every single American. Now, that is a big job. It requires knowledge, experience, and most important strong leadership. Fortunately, our nominee brings all of this to the table, having nearly two decades of experience in the health care system, including about six years working at the highest level of Human and Health Services. Mr. Azar played key roles in implementing new policies, including Medicare Part D and Medicare Advantage Program. He was also a leader that responses to the anthrax attacks shortly after 9/11, the monkeypox crisis, and Hurricane Katrina and so for. He has made clear his intentions to address the growing opioid epidemic that continues to ravage communities across the country (Committee on Finance United States Senate, 2018, January 09). To model the behavior that a leader expects of others, leaders must first be clear about their guiding principles (Posner, 2017) and Azar did it through its mentoring policies. Enable Others to ActAccording to Posner (2017), grand dreams do not become significant realities through the actions of a single person. Team effort is the key to achieve success. Enabling others to act means that collaboration and trust are ought to be fostered by leaders.

In the hearing before Committee on Finance United States Senate, Hon. Ron Wyden (a United States Senator from Oregon) said that as we know, we have teamed up on this now for a time. And the American people said to me- what happened at the end of the year is, the kids got a patch. And if you were powerful, you ran a multinational corporation, you got permanent relief. We are better than that. Significantly, Mr. Azar told the committee staff that while he chaired the company’s pricing committee he never- not even once- signed off on a decrease in the price of drugs. In this nomination, everybody has a different answer for what exactly “welfare reform” means. The common thread to the Republican talk here is pretty obvious: substantial draconian cuts to the program that are lifelines- Medicare, Medicaid, Social Security, anti-hunger programs, and support for struggling families. The Trump team says it wants to end that and Medicaid is built on a guarantee so essential for long term care for the eligible seniors. They have set into motion plans that would make it harder for a lot of people to get the care they need (Khosla, 2018). Ensuring Patient Access and Effective Drug Enforcement Act requires Human and Health Services to submit a report to Congress regarding obstacles to legitimate patient access to controlled substances and issues with the diversion of controlled substances. HHS and the entire Trump administration will continue to work with our partners in New Hampshire- with the Jims, Jeannes, and Chief Goonan’s- to win the battle against the opioid epidemic, and build a brighter future for our state and our entire country (Khosla, 2018).PART President Donald Trump pledged in Washington to put an “extremely big dent” in the scourge of drug addiction in America as he signed legislation intended to help tackle the opioid crisis, the deadliest epidemic of an overdose in the country’s history. Nearly 48,000 people died last year from overdoses involving opioids. Overall, United States drug overdose deaths have started to level off, but Health and Human Services Secretary Alex Azar says it’s too soon to declare victory. The legislation will add treatment options and get the United States Postal Service to screen overseas packages for a synthetic form of opioids called fentanyl that is being shipped largely from China. The measure mandates advance electronic data on all international packages, including those delivered by the Postal Service, and set deadlines for the screening to be put into place by the Department of Homeland Security, Customs and Border Protection, and the Postal Service. Manchin (2018) said, “With the president’s signature, we can finally deliver on our promises for a robust, comprehensive response to the opioid epidemic that is plaguing West Virginia and so many other states across the country. For West Virginia, this law will more than double the state’s opioid funding because of a provision I secured to prioritize states like ours. This bill also addresses more than addiction; education, and life after recovery”. The legislation covers not only opioids but also any kind of substance abuse. It expands Americans’ access to treatment and changes the law that prohibited Medicaid from reimbursing residential treatment at certain facilities with more than 16 beds. Trump said, “together we are going to end the scourge of drug addiction in America”. The White House says the Justice Department has shuttered a large “Darknet” distributor of drugs, also Trump recognized more than 20 corporations for private sector commitments to fight the opioid crisis (Riechmann, 2018). PART E“The seemingly relentless trend of rising overdose deaths seems to be finally bending in the right direction,” Human and Health Secretary Alex Azar said at the Milken Institute’s health care conference in Washington, D.C. (2018, October 23). The United States is “beginning to turn the tide” on the opioid epidemic, also pointing to new federal data showing a slight dip in overdose deaths last year. Preliminary CDC data shows drug overdose deaths, which spiked in 2017, dropped 2.8 percent toward the end of last year and the beginning of 2018.

Azar credited federal, state and local efforts, one day before President Donald Trump will sign overwhelmingly bipartisan legislation to address the opioid crisis (Ehley, 2018).The legislation Trump will sign expands access to treatment and prevention programs and bolsters law enforcement efforts to curb illicit drug shipment. “We are so far from the end of the epidemic, but we are perhaps at the end of the beginning,” Azar said. Azar called out efforts to expand access to medication-assisted treatment- considered the gold standard for treating opioid addiction- and the overdose-reversal drug naloxone. Azar also unveiled a first-of-its-kind federal pilot program designed to help mothers with opioid addiction and their children. The project will be run through Medicare’s innovation office, which was created under Obamacare to test new ways for providing care (Ehley, 2018), Alex Azar said at the Milken Institute’s health care conference in Washington, D.C.“He will be a star for better healthcare and lower drug prices,” President Donald Trump post on Twitter about Alex Michael Azar. As ahead of the Human and Health Services agency, Azar will be tasked with spurring the Republican effort to scrap Obamacare. Mr. Azar does bring previous experience working in the department he has been tasked to lead. From 2005-2007 he served as deputy secretary of the HHS under former President Bush. For four years beforehand, he served as the agency’s general counsel. Alex M. Azar must first be approved by the Senate before he can take up the post (BBC, 2017, November 13).