Walden University HLTH-8300 Report: Executive Order 16-09 and Opioids

This report examines the implications of Executive Order 16-09, addressing the opioid crisis in Washington State. It delves into the legal, ethical, and policy ramifications of the order, particularly focusing on the challenges faced by healthcare providers in prescribing opioids and heroin. The report discusses the potential for restricted opioid supplies to impact chronic pain treatment and explores the ethical dilemmas faced by doctors. It analyzes the policy's alignment with existing healthcare regulations and its efforts to promote awareness and regulate illegal drug practices. Furthermore, the report considers ethical theories such as Deontology and Utilitarianism to evaluate the order's ethical validity, weighing the pros and cons of action-based approaches. The conclusion suggests recommendations for balancing action and desired outcomes, including controlled supply and prescription requirements. The paper utilizes various sources to support its findings and conclusions.

Running head: IMPLICATION OF EXECUTIVE ORDER 16-09
Implication of Executive Order 16-09
Phuong Phan
Walden University

IMPLICATION OF EXECUTIVE ORDER 16-09 1
Part 1
Washington is currently facing the opioid overdose and abuse issue which involves
prescribed opioids and heroin. The death rates resulting from opioid overdose has
significantly increased in the past years. As much as 700 deaths were reported in the year
2015 for overdose (Governor.wa.gov. 2019). Also, it has been observed from a survey that
57% of those syringe exchange clients who inject heroin claimed that they were subjected to
prescription opiates before they started using heroin. The purpose of this project is to
understand the legal, ethical and policy implication of the Executive Order 16-09 addressing
the Opioid Use Public Health Crisis, which was developed to combat the issue of overdose of
inappropriate opioid prescribing and its abuse. This project analyses the legal, ethical and
policy implication of this policy. The policy maker is Jay Inslee (Doh.wa.gov 2018)
Legal and ethical implications
The doctors will be facing more challenges before prescribing opioid and heroin as a
result of Executive Order 16-09. As opioid and heroin are used to treat chronic pain, the
resources of the medical treatment for the health care agencies will be limited to treat the
issue. If the supply of opioids is restricted and reduced, the general people, as a result of this
issue, will be exposed to the difficulties of treating the chronic pain issues. The reduction in
the availability of opioids will not ensure its misuse or abuse. The policy lacks the measure to
restrict the chances of overdose of such drugs, rather it discusses the measures to recover
from such overdose. The health care agencies may also face the chilling effect of the policy
and might refrain from prescribing opioid as a measure to treat chronic pain. It directly makes
the health care organisations responsible for any prescription drug overdose. In addition to
this, to decide when to use and when not to use opioid may become an ethical dilemma for
the doctors.

IMPLICATION OF EXECUTIVE ORDER 16-09 2
Policy implications
However, the effort to reduce opioid and heroin abuse are well intended in the policy
as it may help in preventing the overdose death and associated risks. The objectives of this
policy also comply with the Patient Safety and Quality Improvement Act of 2005 as well as
the Healthcare Quality Improvement Act of 1986. The policy has also helped in spreading
awareness of the best practices of opioid prescribing. The consequences of opioid overdose
have been promoted through the policy. The illegal practices of drug supply will be regulated
with the help of the proposed strategies. The strategies of Executive Order 16-09significantly
makes available the medication for the opioid abused (Stopoverdose.org. 2018). The policy
provides an access to utilize the opioid use disorder medication in criminal justice system.
Pregnant women are made aware of the opioid misuse and the process to recognise a victim
of opioid overdose are also spread through this policy.
Conclusion
Hence, apart from the ethical, legal issues of implementing restriction on opioid use,
Executive Order16-09 is an effective way to reduce illegal dealing of opioid and heroin
overdose. An actual implementation of this policy will help in reducing the emerging concern
of issue resulting from heroin and opioid overdose will be addressed.

IMPLICATION OF EXECUTIVE ORDER 16-09 3
Part 2:
Ethical Issues in Public Policy
The Executive Order 16-09 has been the epicentre of the rise of innumerable
controversies. The controversies majorly revolve around the various ethical factors that are
involved in the implementation of the Executive Order 16-09. The implementation of the
Executive Order 16-09 might lead to the restrictions in the use of the opioids for the medical
purposes as a measure to bring forth a reduction in the misuse of the opioids. A considerable
amount of questions has arisen regarding the ethical validity of this order. A thorough
discussion of this order under the light of different ethical theories is a need for examining the
ethical validity of this order. Ethics implies the moral ethnicity of a person, inflicted on his
conduct. The ethical theories under which this executive order needs to be discussed are
namely Deontology and Utilitarianism. This paper discusses the ethical issues with respect to
the policy along with advantages and disadvantages of ethical approaches.
The Ethical Theories
One of the theories of ethics that has surfaced in this discussion is Deontology.
Deontology implies the correctness of an action. It emphasises on the cause rather than on the
consequences (Paquette, Sommerfeldt & Kent, 2015). Under the principles of Deontology, an
action must define the morality and not the result. On the other hand, the theory of
Utilitarianism focuses more on the consequences than on the action (Mill, 2016). Under
Utilitarianism, the actions are regarded as right as long as it yields right results. Hence, it can
be stated that Utilitarianism deals with the rightness or wrongness of the consequences while
Deontology is concerned about the rightness of an action.

IMPLICATION OF EXECUTIVE ORDER 16-09 4
Ethical Issues
The Executive Order 16-09 is concerned about reduction of opioids by stopping its
supply, that would firstly bring an inconvenience for the doctors to treat chronic pain and
secondly it would not ensure a stoppage to its misuse. This order aims at curbing the
excessive use of opioid and heroin by bringing a check in the supply of the same. Opioid and
heroin are also used as a treatment of chronic pain and putting a check in the supply of same
will became a hindrance in the same. The reduced supply in opioid would pose a threat to the
treatment of chronic pain but whether it brings the misuse down would be a questionable
issue. The order focuses more on an action-based method for its implementation (Robinson,
Xu & Plaks, 2017). The order is silent about the results yield strives to yield. The implication
of this order is mostly based on the theory of Deontology. Unlike Utilitarianism, it focuses
more on the actions than what consequences those actions would bring (Mill, 2015). A
reduction in the supply of opioid will, to some extent reduce the use of opioid, but that does
not necessarily imply a reduction of its misuse. Therefore, it can be stated that a control over
the action would not always ensure a control over the results.
Pros-Cons
The Executive Order 16-09 is targeted on the use of the opioid and thus strives to
diminish its misuse and abuse. It applies an action-based technique to curb the supply of the
opioid. This would to some extent reduce the use of opioid, but the question that arises is
would it be really effective for reducing the misuse and overdose or not. The main objective
of the order is to bring down the misuse and abuse of opioid overdose, that is to stop its
negative use. However, the implication of the order emphasises mainly in the control and
reduction in the supply of opioid and heroin.
Opioid and heroin has a positive purpose as a pain-relieving medicine in case of
patients with chronic pain issues, but its misuse and overdose lend a negative essence to

IMPLICATION OF EXECUTIVE ORDER 16-09 5
them. Therefore, the reduction of supply of opioid and heroin would have a two-fold effect.
In a way, it might diminish the misuse and abuse to a certain level, but it will also impact the
use of the same by the doctors for treating the patients with chronic pain. That will raise an
inconvenience in the medical science.
However, it would not be justified to focus on the negative results it will yield. The
order is developed keeping in mind the overuse and misuse of opioid and it adopted an
action–based technique to address it by reducing its supply. Although reducing the supply
would amount to an inconvenience in the medical science but it could not be claimed that it
would not impact the misuse.
Legal Consideration
The Executive Order 16-09 was developed to prohibit the unregulated supply opioid
and heroin with a view to control the misuse and abuse regarding the same. It strives to check
the unauthorised use of opioid and heroin. The order focuses on the prohibition of the use of
opioid and heroin in areas other than the medical science. It puts a restriction on the supply of
opioid and heroin to any unauthorised user. It will render the unauthorised use of opioid and
heroin illegal. The order targets mostly on the supply of opioid rather than on its misuse and
abuse. The order strives to reduce the supply of opioid with a view to reduce its misuse as a
result. The main objective of the order is to bring down the misuse and abuse of opioid
overdose that is to stop its negative use. The implication of the order emphasises mainly in
the control and reduction in the supply of opioid and heroin. The order is developed keeping
in mind the overuse and misuse of opioid and it adopted an action–based technique to address
it by reducing its supply.

IMPLICATION OF EXECUTIVE ORDER 16-09 6
Recommendation
It can be concluded from the above discussion that, although the order puts the
medical science in inconvenience, but it also resolves the issues it was developed to address.
The authorities should strive to check the actions as well as ensure the desired result. This
could be ensured:
 Firstly, by checking the use of opioid and heroine by limiting its supply, and
 Secondly, by restricting the use of that limited supply for the purpose of
medical science. The supply of opioid and heroin which is available would be
ensure to have been used only by the presenting a doctor’s prescription.
The authorities should focus on the actions and make sure that the implementation is
bringing the desired results for which the policy was initially developed.
Conclusion
It can be concluded that, it would not be justified to focus on the negative results the
order would yield. The order has been prepared keeping in mind the overuse and misuse of
opioid and it strives to adopt an action–based technique to address the misuse and abuse of
opioid and heroin by reducing its supply. Although reducing the supply would pose an
inconvenience in the medical science but it would not be justified to claim that it would not
impact the misuse. It will also result in the reduction of the misuse to a certain level.

IMPLICATION OF EXECUTIVE ORDER 16-09 7
References
Doh.wa.gov. (2018). Opioid Misuse and Overdose Prevention: Washington State Department
of Health. [online] Available at:
https://www.doh.wa.gov/YouandYourFamily/PoisoningandDrugOverdose/OpioidMisusea
ndOverdosePrevention [Accessed 5 Dec. 2018].
Governor.wa.gov. (2019). Washington State Is Taking Action On The Opioid Epidemic.
Retrieved 07 January 2019 from
http://www.governor.wa.gov/sites/default/files/exe_order/OpioidEpidemic.pdf
Healthcare Quality Improvement Act of 1986.
Mill, J. S. (2015). On Liberty, Utilitarianism, and other essays. Oxford University Press,
USA.
Mill, J. S. (2016). Utilitarianism. In Seven Masterpieces of Philosophy (pp. 337-383).
Routledge.
Paquette, M., Sommerfeldt, E. J., & Kent, M. L. (2015). Do the ends justify the means?
Dialogue, development communication, and deontological ethics. Public Relations
Review, 41(1), 30-39.
Patient Safety and Quality Improvement Act of 2005
Robinson, J. S., Xu, X., & Plaks, J. E. (2017). Disgust and Deontology: Trait Sensitivity to
Contamination Promotes a Preference for Order, Hierarchy, and Rule-Based Moral
Judgment. Social Psychological and Personality Science, 1948550617732609.
Stopoverdose.org. (2018). Retrieved from
https://stopoverdose.org/docs/StateODResponsePlan2017.pdf