Kent State College of Nursing Opioid Debate – spring 2018
Kent State College of Nursing Opioid Debate – spring 2018

I want to take a minute to thank all of you for coming out. This is our second interdisciplinary student issue debate and we’re really happy to have all of you here. Student government and the speech and debate team have worked very hard on sponsoring this event with us. And so I hope that through the course of the evening you’ll get to know them a little bit and get to know what it took for them to be here. I would like to take a moment to recognize a couple of people who worked very hard to organize this event and to arranged for the support from student government. They have a policy for or passion for policy education and communication and respectful exchange of opinion and fact. Tommy Watral is standing out to my left and is from the College of Nursing and he is the director of governmental affairs And I think he also now has a new title Tommy, what’s your new title? (Tommy) President. Now he’s the President of Student Government, so if you didn’t know that, you have someone to help you to resolve any issues you may have. The second person that I would like to acknowledge who is truly amazing is Emelia Sherin. Emelia is a public relations student here at KSU and she’s also the creator of the Independent. It’s amazing to me than alias started this process because the first time we got together to talk about this, it was just like a flash idea of how could we do something interesting that could engage students that kind of show debating and policy, what it was like. She took it to a whole nother level. She’s done a tremendous job with it, and I think forever Kent State is going to remember her for her efforts in this area. So thank you very, very much. I’d also like to thank Sarah Kearney. Sarah’s a Ph.D. student in exercise physiology and I have been very blessed to have her as my graduate assistant this year. She’s been instrumental in helping with research and getting any issues resolved and Sarah is sitting in the back. Thank you very, very, much. I think that it’s really important that you know what I’m doing here. I’m the faculty person who is going to be your mentor for the evening and your hostess. I’m the coordinator for undergraduate and graduate health policy for the College of Nursing. And I have a little bit of an odd duck background while I am prepared as an adult nurse practitioner, I’m also a practicing nurse attorney. So my passion is twofold. It’s to support and build the education of nurses regarding population justice advocacy and policy development and also to educate the community on the unique disciplinary contributions of nursing and population-based advocacy and policy development, and I think that this evening goes along in advancing that passion, so thank you for all of you who are here and all of you who have prepared. One of the things I need to tell you about audience participation, prior to tonight, the folks that you see here have worked very, very, hard in developing their argument. The discussion for this evening doesn’t necessarily reflect their opinions on the issues, but it reflects the outcomes of their research and analysis on the issues on either side of this particular discussion and they were chosen to be on this debate team so it was a competitive endeavor to be here this evening. During the engagement of our teams I’m going to ask that everyone please refrain from clapping or verbally acknowledging comments made because this reduces the amount of time that each side has. I’ll tell you one of the things that shocks most people when they come to an event like this is that there’s so much structure to it. But it is so that we can really democratically discuss the issues in a respectful manner and allow both sides to have opinions. So please hold your acknowledgements until the end. We will go ahead and educate you as to what each side has to do in how many minutes they have as we go through the issues for this evening. So to give you a little bit about the opioid crisis in Ohio, the crisis has touched our community, our state, and our nation. The effects are expected to provide devastating financial, social, and healthcare impacts across the United States and particularly in the state of Ohio. We learned as a team that there is no one person who can fix this and there’s no one person to blame for this dilemma. There is no known cure, but there are a number of dedicated individuals who will not stop working hard until the issue is controlled and resolved. We hear and we’ve read about what’s going on nationally. I’d like to point out just a few facts and comments that are noteworthy and that help frame this issue for you as an audience. Secretary of HHS, Tom Price, stated this is about the opioid crisis in April of 2017 when he was announcing the 21st century care grants. He said “I want you to ensure or know and be ensured that resources and policies are properly going to be aligned with and remain responsive to this evolving problem.” To date we know that in 2015, 33,000 people have died as a result of opioid overdose. In 2016, 42,000 people have died as a result of the opioid overdose. The current administration has come up with five different areas that they want to focus on as goals: Improving access to treatment and recovery services; promoting use of overdose reversing drugs; strengthening our understanding of the epidemic through better public health surveillance; providing support for cutting edge research; and advancing better practices for pain medication. There are strong discussions on all sides of this. With that said, let me introduce the folks who will be making sure that you understand this issue in its entirety. Kody Elsayed is a CCI Global Opioid Epidemic member. He also works on this campaign. And he works with a team that hopes to lessen the stigma of NARCAN® in Trumbull County. Inola Howe works with the Dr. Delahanty stress and health lab in Kent State’s Psychologist Department. One study in particular looked at trauma and substance abuse pulling from a sample at a detox center in Akron. She also works as a victim crime advocate for Townhall II in downtown Kent. We also have with us Brianna Sharp, who has held both internship and research positions with Oriana House. She’s an executive board member of the American Medical Student Association. And we also have Nick Denman with us, who is an active community volunteer, who is also the president of the KSU Speech and Debate team. So I think you’ve got a lot of wonderful people with a lot of wonderful insight to bring to you evening. I hope we find this very interesting and now our facilitator for the night, Tom Watral. Thank you Dr. Cleveland. I’m Tommy Watral, the incoming student body president for Kent State. And also a proud nursing major in our great college. I’m a junior. I’m set to graduate in May 2019. I’m really passionate about relating to others on the heartbreaking discussions on issues that occur to society today for example, the opioid epidemic. All great issues need time, proper awareness, and honest education. This evening goes a long way in asking ourselves the question: what is the government’s most important goal in the opioid epidemic? This debate will assist us in moving forward in the right direction. Two teams are competing against one another to discuss whether better pain management or a focus on rehabilitation and recovery is the government’s greatest priority at this point in time. Thank you to everybody participating this evening. Our debaters right behind me and thank you to Emilia and Kim for organizing this event. So representing the better pain management argument, we have Kody Elsayed and Inola Howe, and representing rehabilitation and recovery we have Brianna Sharp and Nick Denman Commencing the debate will be for better pain management This speech constructs arguments advocating better pain management. You have four minutes. Please indicate judge ready to start. One minute sign and 30-second signs will be held up to remind you. Resolve. The government’s most important role in the opioid epidemic is better pain management. We define pain management broadly as to encompass all aspects of physical and psychological discomfort. With this in mind, I move on to our first contention. Contention 1. Legislation currently restricts medical professionals from prescribing alternative methods for pain management and wants it to be abolished. Sub point A. Complimentary alternative methods, known as CAMs, provide an alternative to pain medicine. CAMs include methods such as Reiki, herbal remedies and meditation. Unfortunately, current legislation prohibits healthcare providers from prescribing such alternatives. When we acknowledge that medical detox and treatment are key stops on the road to recovery, we focus on only treating physical pains of withdraw. Moving forward with such treatment, patients are likely to encounter daily struggles, both mental and physical. Without the proper tools to combat these obstacles, relapse is likely. The National Institute on Drug Abuse found people were more receptive to therapeutic interventions compared to medication. But many colleagues found that patients who were working a 12-step program and were in cognitive behavioral therapy, were more likely to be abstinent from drugs after one year, compared to those who would only receive medical detox. Sub point B. The pain management approach through CAMs has been proven to work. Success of similar models has been seen internationally. According to the European Monitoring Center for drugs and drug addiction, half of the Italian rehabilitation system is centered on better psychological approaches to pain management. In Italy, this has cut their overdose deaths rates in half since 2007. Portugal famously decriminalize drugs in 2001 and has seen a drastic decrease in HIV rates and overdose deaths. The country has taken a heavily pain management approach, with several programs to reconnect those in recovery with jobs, stable housing and coping skills. One project manager, Riley Marcus, said, “We know that only treating people is not enough. The demotivation that comes after treatment from not having opportunities might lead them to start using again. Contention 2. Treatment programs fail to solve the overarching issues of pain management through medication in our current opioid epidemic. Sub point A. Medical professionals lack legal ability to prescribe CAMs, which results in increased rates for its pharmaceutical drugs as a resource to pain management. In the 1990s, the American Pain Society became the fifth vital sign, along with temperature, pulse and respiration. Failure to manage such pain requires legal action, loss in accreditation, and loss of insurance contracts. This led to the _____ opioid pain medicines, which has brought us here today. Treatment can help those in active addiction, but does nothing to prevent an even like this from reoccurring. By enacting multidiscipline committees, to further fund CAMs and other pain management programs, we can both alleviate the current epidemic and establish the framework to prevent another such epidemic. Treatment is important and necessary, but health care providers are unable, under current legislation, to prescribe their patients pain management options without pharmaceuticals. To tackle this epidemic, the government’s main role is to help educate and foster pain management solutions. You must occur. Thank you. The team of rehabilitation and recovery funding is up next. This constructs arguments showing the affirmation of the rehabilitation and recovery being the most important role for government to play into within the opioid epidemic. You have four minutes present your contentions. Please indicate judge ready. Nick and I affirm the most important role for The United States government in the opioid epidemic is rehabilitation of addicts. Picture this. A father, son, and friend had a difficult childhood, that spiraled into self-medication and eventual heroin use. He no longer cared about watching the Cowboys play on Sunday, and his morning cup of sugar with a drop of coffee became less and less important to him. That man no longer had a choice of what he did each day. The need to eat, laugh, and love was overpowered by the sickness he felt each time he lost his high. That man was my uncle and he has struggled with addiction for nearly 18 years. I am overwhelmed with joy when I say, as of January he was released from Oriana House and is clean with the help of Oriana’s medically assisted treatment facility that administers his Vivitrol shots. I hope you keep in mind my uncle and all the addicts we have struggling right now as I move on to my first contention. My first contention is the government has already committed to improving pain management. The U.S. Department of Health and Human Services and The National Institute of Health currently considers “advancing better practices for pain
management” as one of their top 5 priorities. This emphasis on prevention has led to
incredible breakthroughs in the surgical relm. Physicians now how the opportunity to give patients a cocktail before surgery, commonly containing Tylenol and Gabapentin, an anti-seizure medicine used for nerve pain. Cocktails such as this decrease the need for opioids post op significantly. Secondly, opioid free anesthesia is making its way into more hospitals for high-risk surgeries. Continuous infusions are used in these cases to replace anesthesia containing Fentanyl, a drug 50 times more dangerous than heroin. My second contention is that the government has a huge responsibility in making Naltrexone available to addicts. Medically assisted treatment programs are largely underused in rehabilitation
currently. These programs involve an opioid antagonist called Naltrexone, or more commonly, Vivitrol. Vivitrol contains no opioids, and unlike suboxone and methadone, will not get users high or create dependency. This eliminates the scrutiny of replacing one addiction for another. During a 24-week study conducted by the Center on Addiction, participants who used Vivitrol were
abstinent from from Opioids 90% of the time. Those same participants were determined to be abstinent long term 65% of the time. Each dosage of Vivitrol is administered by a shot once monthly, conveniently eliminating the need to take medication daily. Unfortunately, these shots can be up to
$1,000 a dose without insurance, and up to $50 with insurance. The government in this case needs to work to better increase availability of this life saving drug. Now on to the third contention. Ohio is currently dealing with stagnant job growth and the opioid epidemic at once. Lethal heroin overdoses have increased by 533% from 2002 to 2016. In 2013, heroin deaths exceed traffic deaths for the first time. Ohio specifically is the worst state
for addiction, ranked by the number of lethal overdoses annually. Ohio is facing a lack of job creation. In a conversation my partner, Brianna, had earlier this month with Kathleen Clyde, an Ohio representative for the 72nd district, Clyde informed her that the funding for rehabilitation and detox facilities has been cut in order to combat infrastructure damage and increase jobs. This shows how economic sustainability is tied in with opiate epidemic. Nearly all rehab and detox facilities require 24/7 access and management. By instead opening up more facilities, the government has the opportunity to increase jobs while combating opioids. We concede the rest of our time. Now we will begin the crossfire session for speech 1. This questioning period gives the debater interactivity and can change the bill discussion. In crossfire, both debaters have equal access to the floor, but the first question must be asked to the debater who just finished speaking by their opponent debater from the other team. Please indicate judge ready to start time. So you mentioned that there is funding for alternatives for opioids, but the funding seems to be mainly geared towards medical treatments. Do you know if there is funding towards CAMs? I actually do not know that, but I do know that Trump’s administration has given us 26 million dollars towards fighting the opioid epidemic and as of right now, I am working extensively with Oriana House and we’re not seeing any increase in help with our medically assisted patients at all. Ohio was within that 26 million, they were actually the third highest funded state. Do you know where the money is going? I actually don’t. You mentioned comparing how we treat the opioids with Italy and Portugal, Would you say that Italy and Portugal have the same opioid laws that we do? You mentioned you can see that Portugal had legalized all drugs, is it safe to say that our policy should based on how theirs is? I think it’s radically different. Portugal is a much smaller nation and therefore things work differently. Also they didn’t legalize, they decriminalized, which means that drug dealers still go to jail. Drug traffickers still go to jail. The only difference is that they’re not treating addicts as criminals, they are treating them as patients. And treating this as a medical issue. Are opioids decriminalized in the U.S.? No. So you also mentioned that 12-step programs are part of what you would like to be seeing, but actually Oriana House does instill 12-step programs. It is actually a part of what we do. So I was an intern there and I actually sit in and assist in some of those. I’m actually a Nicotine Anonymous coach, so I did do some of these 12-step programs, so I understand that it’s essential, but is is something we already do in rehabilitation so, saying that it is a part of pain management might be true, but it’s also a huge part of our end on rehabilitation and they also have to do psychological classes in order to be released. They have to have so many hours or else, like I’ve had people that won’t finish a class at Oriana House and they’ll have to stay for a few more extra months. The problem with that is that a healthcare professional cannot prescribe that if it’s not in the books. So while it is part of the rehabilitation system, that’s great, the doctors can’t prescribe that. They can only prescribe a pain medication, for example, to a patient. Do you all concede your time? Thank you. Now it’s time for an impromptu speech written in regards of their opponents as a rebuttal. The second speakers of each team will now give their original four minute speech in response to the discussion of the contentions. Please indicate judge ready. To start the discussion, I’d like to point out that your main focus for the government’s perspective on the opioid crisis is for rehabilitation of addicts. As we agree with you, that taking care of those who are suffering from this disease is a high priority, we must discuss that this is not the answer, it is merely a band-aid on the issue at hand. The cycle will continue to go on and on. We cannot focus on the problems that are bigger than just the opioid epidemic and those who are suffering from the disease. So, you got to name your contention 1. We went with this idea that rehabilitation the money from the Care Act was being used for treatment. When we asked you if you could classify this helping CAMs, so those are alternative methods to dealing with the crisis, you’re unable to clarify with me if money is going towards this as a life-saving option to stop those from becoming addicted and becoming part of this disease. And you’re unable to tell me if that’s the part that’s part because you’re more focused on saving those who are already addicted. How is this a solution to our epidemic and how can we go forward knowing that we aren’t focusing on how to stop those from becoming addicted and to stop those from getting into this disease and coming to that point where they need to go to treatment? The next thing that you’re talking about is not a logical approach to the solution by having more pills. Pills to solve pills. But we are continuing to feed medical substances into those who are already facing addiction with this medical crisis. How is this solving the solution? We have these legislations that are enact right now that are stopping our professionals from being able to do their jobs. They are not able to prescribe CAMs for patients who need them. If you go into these different remedies that are herbal or meditation or going to someone who can help with chiropractor needs and pain in that sense, we are not going. We are not allowing it. It’s not certified. We cannot allow our professionals who have known for years and years as a profession to go out and give their patients what they need. And you can’t even answer if that’s happening. You are so focused on the deaths of addicts. We agree. Treatment is so important. Lives matter. We’re not saying that we should not be doing treatment. We have adequate treatment. We need to focus on this problem that is a wildfire. You are trying to squirt a spray bottle on a blaze. This is not something we can solve by just continuing to treat and treat the treat those who are already in this disease. We must figure out what is wrong. So moving forward, we’d like to propose new solutions. So, the Care Act has now given Ohio millions of dollars. We have the third highest funded state when it comes to this act to help solve the epidemic. The two above us are Florida and Texas. Texas and Florida have to deal with pushers coming through their states. They have to focus on trafficking to stop illegal drugs from getting into our nation and to our consumers. With that being said, we have a lot of money. Why is this being pushed on the treatment when we have other solutions that should be the forefront? We should be setting an example in our nation on how to combat this epidemic. Going further, my solutions that me and Inola have discussed, we have decided that our best option is going to be putting the money, using the money to provide the solutions of CAMs, allowing our medical professionals the time they need to give the answer to the government. Instead of regulatory rules, we need to use focus groups on a multi-disciplinary terms to help those figure out what exactly we need. Is it going to be water therapy? Is it going to be herbal remedies? We need to know what is best for these people who are suffering from the disease and continue to fund this instead of just simply treat their withdraw symptoms. Thank you, team. Opposing team, you have four minutes. Please indicate judge ready. All right firstly I’d like to say that the Care Act money is not going into CAMs, however, there is money going to other therapies, and I would like to move on to my primary contention which is the feasibility and the viability of what my opponent has proposed. The pharmaceutical agency is massive in the United States and It’s not going to go away overnight. Just by looking at physical therapy over “pills,” but we are looking at the better drug. Not all drugs are the same. Vivitrol is better than Suboxone. It’s better than Methadone. These drugs are not going to go away by CAMs. My next contention: both of ours are solutions but ours should be prioritized over theirs.That is the whole point of this debate. There has to be a balanced scale. My final contention would be that CAMs are not going to solve the Opioid Crisis. We don’t entertain that our product will, but it is more feasible and I concede the rest of my time. Thank you. Now is time for our second crossfire. The two speakers now have three minutes to ask questions with one another based on the discussion each of you have raised with your speeches. Please indicate judge ready. So you said that CAMs won’t solve the crisis and I want to know where your stats are on that, that show CAMs are ineffective. Uh, history. I would say. No, I can’t site the source. Okay, so you can’t site the source that you are talking about. In part, Methadone is primarily prescribed. Do you know if it has a high success rate? Is Vivitrol? Does Vivitrol have a high success rate? So I did have a stat. It is, let me pull it up right here. So, the Center on Addiction Studies has done extensive Studies on Vivitrol. Vivitrol is not meant to be an addiction replacing an addiction. What Vivitrol is, is it blocks the receptors in your brain and make it so you cannot get high. So you might really, really wanna get high, but reality of it is you’re not going to be able to get high. So these are people who are, might not want to be going through these rehab facilities because, as I know at Oriana House, they are mandated by the government, or a jail for instance. But these people are given the chance over a six-month period, that’s how long Vivitrol is given as a shot for, a six-month period. They showed 90 percent of the time, they are not even attempting to use during that period But then long-term, 65 percent of the time, they’ve been successful keeping them long-term as in approximately 18 months. So while Vivitrol actually prevents you from getting high, it’s only on the same substance. So Vivitrol can block your other receptors in the brain So it’s not uncommon for a heroin addict to turn to a different substance. and further their addiction. The psychological dependency of someone who is on a depressive is different than someone who is on a stimulate. But I would like to say that the difference between each vivitrol and CAMs is that you conceded in your debate that CAMs are not easily accessible, but Vivitrol is easily accessible. Well, they are not currently accessible under current legislation, which is why we would like to change that legislation. Also, you couldn’t provide stats on whether CAMs are effective or not. That’s because there’s not research, because the government isn’t funding it. They currently are funding treatment, and that’s not working. So if there’s no research, how do you know it works? Well, treatment. There is research, and it doesn’t work. You said that CAMs are unfeasible and you’re saying that Vivitrol is your answer, but the problem that we’re having is the government has a soul in solving our epidemic and right now treatment is not solving the problem. It is kind of putting a band-aid on a wound that needs time to heal and needs a new option. Vivitrol is not our answer. You say that it’s unfeasible. The problem is that we have legislation that is blocking professionals that have known for years and years that CAMS could be a useful, beneficial way to solve this epidemic and they’re not allowed to because they will lose their jobs or license or possibly be unaccredited. You have to understand that your solution does not fix a problem. It is a band-aid and will only continue this vicious cycle. It’s possibly enabling it by preventing the research that needs to be done. I would like to say that… We are out of time. Thank you, both teams. Now we move into our the third crossfire. Here in the next four minutes, each side will question the other on the issues raised this evening. Please indicate judge ready. We discussed in our second crossfire that right now it is uneasy for those to obtain access to CAMs. We have shot back to you on multiple occasions that legislation is the only barrier between us and a better solution towards this epidemic. We are asking the government to simply remove this legislation. My question to you is why do you believe that treatment is the solution to this epidemic? Why is, if I quote that I remember you saying that this is not going to fix the problem. We’re here to discuss what’s going to fix it and we are here to make a change. So can you explain to me how your treatment will ultimately solve the epidemic and why the government needs to make it its sole purpose? The whole point of this course is to find the truth and the balanced scale of this debate is not which one will solve it. Let’s be honest, either one is a quick fix. There’s no magical solution to the problem. But the balance scale of this debate is that Vivitrol should be prioritized over CAMs. The end. So I assume okay, so I understand imagine is a huge portion of it, but the reality is, we should have demanded much much earlier, and we just didn’t. 533 percent is how much the opioid deaths increased from 2002 to 2016. Saying that, we cannot ignore the men and women dying right now. If someone would come to you and say hey look, I’m really start about your uncle, but the reality is let’s stop other people, I’m gonna agree. But the fact is that I can’t discount my uncle’s life, my aunt’s life, five of my cousins’ lives and my mom’s best friend because it might be what you think is band-aiding. It’s not a band-aide. What you’re doing is you’re helping thousands, millions of people right now that have an issue and I propose that we open more rehabilitation facilities by opening these facilities for creating jobs. If you don’t know right now the Senate is currently trying to make more jobs, so that’s where our focus has been as Ohio state. We are trying to create more jobs and improve infrastructure. I propose we open up more rehabilitation facilities. We open up more detox facilities, and we’re providing jobs, which is also up at the top three on what Ohio wants to do right now. So we open those facilities and you might say we only need doctors, we can’t have many more nurses. But having doctors and nurses is one portion of it. This is a 24-hour rehabilitation facility I’m proposing and these facilities take funds to labor, they take security workers, they take people to just watch it over the night. They take unskilled labor and now increase our workforce exponentially. So, there are people that are already addicted, but what about my boyfriend, my mom, my dad, all the audience tonight, who could become addicted unless we put legislation in place for this to not happen. You said we needed pain management a long time ago, why don’t we put it into place now to prevent people from getting there? Because if we are only focusing on treatment, we are absolutely ignoring everyone that could become addicted. All of the loved ones that aren’t affected are at risk. Why don’t we put pain management in place now? It is in place now. No it’s not. It’s not practically in place now. It is absolutely not effectively in place. Or we could be affected. There are people that are already affected and there are treatment programs in place but there is no secret that people might become affected. Sorry You will know that one of our biggest issues is over prescribing avoid with opioids and what we’re trying to give is our doctors a chance to stop putting pills into our system. Stop allowing risk to be spread and to not have us to have to open 10,000 treatment centers. We have treatment, it is working. We have facilities. It is working. We need to focus now on what is going to stop this cycle, because it is spiralizing out of control. And we need the government to step in and start removing legislation that is not allowing professionals the chance to save lives. Period, end of story. But I stated history earlier. Doctors are trying to stop driving pills. And we have time. So now Let’s give a round of applause for them. [Clapping] Now each team will have the opportunity to conclude their position with a two-minute final focus in regard to the overall content discussed, and why that position is more superior than the other. Please indicate judge ready when you’re ready to begin the final focus. So imagine you’re riding a bicycle and you decided that your helmet wasn’t comfortable. So you don’t want to wear it. You don’t want to be that kid, right, to be a cool kid and not wear the helmet. You’re going really fast and all of a sudden crash over your handlebars, right? You have brain damage. You’re on life support. Yes, there is treatment, but what if we have a solution? What if we have the helmet? Right now, people who are becoming addicted, who are facing this disease do not even have a helmet available because of legislation that our government is not working to fight; not working to abolish. We need to have society work together to make sure that our professionals, who know the best, who have the experience, who are in the room with these patients, have the ability to give them what they know is best for them and right now they do not with fear of losing their jobs, losing their accreditation. Without the removal of this legislation, there is no hope to cure this epidemic. Period, end of story. We do not need more pills, we do not need shots, we do not need treatment centers to solve the problem at hand. We have those to help those who are in an active addiction in this disease. We will continue to help those, but we must solve this legislation issue. We are proposing to you that we remove the legislation, we work with focus groups on a multi-platform with different jobs, different professionals. Ask them what they believe works. Have them take control of the situation and help them support the patients and help end this epidemic. Thank you. Next team, please indicate judge ready when you are ready to begin the final focus position before closing this issue. So we completely understand the need for pain management, but the issue is that’s not where we are right now. We have 26 million people right now addicted. So saying that we have this substantial amount of people that we just cannot ignore it saying that, I’m not saying we should just treat these people in the facilities we have, but I’m proposing a solution that takes out two of Ohio’s most prominent issues right now, so Ohio’s job standing. We can increase jobs by opening more facilities, more detox facilities, have people in a regulated environment, saving themselves, as well as increasing jobs. So if your stance might be that we don’t need to have more pills, which Vivitrol is not a pill, Vivitrol is a shot, it’s also not addictive. But the point here is not that. It is the fact that we could take out two of Ohio’s two issues right now, which is lack of jobs and we can also save the lives of so many people. If it wasn’t for Oriana House, I can’t tell you how many people in my family would be left and saying that, I do see where you’re coming from for pain management because it is huge, but I think that we just have such a substantial amount and we let it get such out of hand and we do need to focus on who is being affected right now because their lives are not discounted just by the fact that they’re already there and we should try to save who might become addicted later on. Also I would like to say, that this has not been tried in America. The research they cited was for Italy and Portugal where drugs are decriminalized. It’s not the same place. And Vivitrol has been tried and saves lives. We concede our time. Both teams, thank you very much. Now the audience has four minutes to ask questions of the debate participants. Please raise your hand to be acknowledged for questioning. I’ll come around with the microphone. All right, so, my question is earlier you were mentioning how the majority of, this is for y’all over there, earlier you mentioned how the majority of the funding goes to Florida and Texas to combat the opioid epidemic and you were referring to trafficking in that circumstance. However, most trafficking does not come, for heroin specifically, does not come from the southern border. Rather, it comes from over in eastern Europe, as well as, the Middle East and goes in through New York City and Baltimore. Two cities that have no connection, or very little infrastructure, for funding. As a follow up for that what you are proposing is very much an issue that does not relate to the idea of addictive personality or a person who gets put into this. Economic systems are what opioid addiction have played largely. Disenfranchisement leads to addiction more often than an Oxycontin prescription. That’s a purely upper class narrative for what develops and what you are proposing does nothing to combat the economic and social structures that lead to the majority of heroin users in the Rust Belt. So what I would like to ask you is if you’re focusing on prescribing, the only people who you are helping are the upper class of Oxycontin addicts, where the middle class who then are into heroin addiction, rather than those who enter it from a lower-class standpoint and never have that access. On the other hand, things such as Vivitrol, Methadone, and Suboxone, do offer a relief to the lower-class people, as well as, community based organizations such as Narcotics Anonymous, where many of the things you’re talking about are already in place, such as 12-step programs. Then again, further going from there, when you look at the idea of a drug based rehabilitation, that does in a sense actually, help the form of disenfranchisement that comes, such as Vivitrol because these people are no longer seeking the same sense of immediate relief, which is what leads a lot of these people into drug addiction rather than, you know, basically medical error or prescription. A couple of things. So you mentioned that heroin is not coming into the southern border, it is getting shipped in from China to Mexico and the majority of it is coming through legal ports of entry on the southern border. That’s a fact. Secondly, you mentioned addictive personalities. There is no such thing as an addictive personality That is also a fact. No, you said addictive personalities. We’re not addressing that. I said so called addictive personalities is what you’re not addressing. Yeah, that’s what I said. It’s not what you said. CAMs are not a solution to addictive personality. No where in our argument did we discussed that someone is predisposition to be an addict. We’re discussing that we are all at risk to drug addiction because drug addiction is coming from the use of opioids. Anyone can use an opiate. Anyone has brain receptors, so that being said, everyone is at risk, it’s not a specific personality, it is a science fact. Hopefully there can be more research into that, but you discussed we’re not working for those who are in the middle class. I come from lower middle class and my brother who is an active addict, he has now been clean; he is in active recovery, he’s going to meetings this year, has been put on things such as Vivitrol and Suboxone and neither have worked for him and many of people in Trumbull County who are overdosing are on these shots and are using trying to get higher and higher and that are dying from overdoses. A lot of your information seems a little bit construed, we’d love for you to to a little more research because you seem very passionate. We appreciate everything you’ve added with us today, but definitely check in to those sources because drug trafficking is for sure coming from our southern border, as well as China. Yes, it is coming through the mail, we agree with you there. That is a known fact as well and when it comes to addictive personality, we agree that you understand that it is not part of our proposal as we are all at risk. Sorry if my lack of formal education did not appeal to you. No, no, you’re fine. I’m sorry, I didn’t mean to make my remarks sound so harsh. When you said CAMs will not treat the lower class, they will, because we are looking at a max legislative change that will affect health care, that will affect health insurance in general. You know, that’s looking at community incentive programs, Medicaid, Medicare, and things such as CAMs being provided under that as well. It’s not just you know the rich white kid whose parents have good insurance, it’s everybody. We want this to be accessible to every single person. Trust that concern, what we’re proposing is right now legislation does not allow our professionals in the medical field to prescribe these options. What they can do is continue to give pills for management. We are trying to evolve that legislation and allow everyone to access to these medical treatments to help solve pain in their daily lives, so we no longer need to continue to push pills. So you mentioned that physicians are limited by the legislation as to, that they can’t prescribe CAMs or the more holistic approach, but do you have research that supports like we’re serving, the supports the amount of physicians who would take that route or are you not generalizing that all physicians would choose to do that, because I’m sure there are some who would support prescribing or doing the rehabilitation. That’s an awesome question. Thank you. So right now we do not have research or surveys that are conducted to see how many professionals are wanting and willing for this. But what we can offer you is that the understanding of this legislation right now is blocking them from even exploring this option because it will remove their right to practice; it can take their accreditation; and they can lose their license. Literally, it’s illegal. It’s like asking a chef’s to undercooked chicken. They’re not going to do, even if they told us it was going to be a great chicken recipe. Time. Thank you. Any more questions or we can conclude the question time. All right, judges, you now have three minutes to discuss your consideration of the arguments and make a decision as to who has won this debate. We will have Robert Speaks, the Senator of the College of Nursing, announce the winner of this debate. So, if the judges are ready. Robby, if you want to come up and announce the winner, that would be fantastic. Both teams did a very good job and there was a lot of fire and passion between the two teams. I really appreciated that. More facts that I felt came from a specific team and reliable sources that backed up a lot of information that was given was the left side, Inola and Kody. And that is who we chose to be the winner today. [Clapping] If any of you are interested in looking at our debate for fall, please talk to Tommy or or see me. You’re welcome to send either of us an email or, just come and visit or give me a call. We’d love to start to work with you now so you know what to expect for next semester. Thank you, everybody and thank you to our debate team. You all did a great job.

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