Executive Order 16-09: Implications on Opioid Crisis in Washington

This project delves into the implications of Executive Order 16-09, addressing the opioid crisis in Washington State. The analysis encompasses legal, ethical, and policy considerations, examining the order's impact on healthcare practices, patient outcomes, and the regulation of opioid prescriptions. The project explores the history of the opioid crisis, the ethical frameworks applicable to the order, and the potential consequences of its implementation, including both benefits and drawbacks. The document highlights the challenges faced by healthcare providers and the importance of balancing the need to reduce opioid misuse with the necessity of providing adequate pain management. Furthermore, it discusses the order's goals, the ethical issues surrounding it, and recommendations for effective implementation, including strategies to limit opioid supply while ensuring responsible medical use. The project concludes by emphasizing the need for a multifaceted approach to tackle the opioid crisis, taking into account both the legal and ethical dimensions of the policy.

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
Title of Paper
Part 1
Washington is currently facing the opioid overdose and abuse issue, which includes
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 of opioid (Governor.wa.gov., 2019). Also, it has been observed from a
survey that 57% of the clients who inject heroin with the help of syringe 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 practical 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 while 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. 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 opioids as a measure to treat
chronic pain. The healthcare organizations have a major role to play in the context of
increased overdose of opioid. This is so because the policies and procedures are not in place
and apart from this, any strict action is not taken against the chemist or the agents who

IMPLICATION OF EXECUTIVE ORDER 16-09 2
provide these drugs without any valid prescription. Also, there are no stated guidelines on
when and how much to use opioids which pose a challenge in front of the doctors.
Policy Implications
However, the efforts to reduce opioid and heroin abuse are well intended in the policy
as it may help in preventing overdose deaths 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 regarding 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 16-09
spread awareness regarding the medication that can be used by persons who are victims of
opioid abuse (Stopoverdose.org. 2018). This policy makes provision for the use of opioid in
order to treat the disorder in the criminal justice system. Pregnant women are made aware of
the opioid misuse and the process to recognise a victim of opioid overdose is 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 the illegal dealings of opioid as well as
the overdose of heroin. An actual implementation of this policy will help in reducing the
emerging concern of issue resulting from heroin and opioid overdose.

IMPLICATION OF EXECUTIVE ORDER 16-09 3
Part 2:
Ethical Issues in Public Policy
There have been innumerable controversies related to the Executive Order 16-09. A
considerable amount of questions have been raised regarding the ethical validity of this order.
A thorough discussion of this order in the light of different ethical theories is a need, in order
to examine the ethical validity of this order. Ethics implies the moral behaviour of a person,
inflicted on his conduct. The ethical theories under which this executive order needs to be
discussed are namely Deontology or 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 the cause rather than 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 they yield 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.
Ethical Issues
The Executive Order 16-09 is aimed at reduction of opioid by reducing its supply,
however, firstly, it would cause inconvenience to the doctors in treating chronic pain and
secondly, it would not ensure the complete elimination of its misuse. This order aims at
curbing the excessive use of opioid and heroin by keeping a check on the supply of these

IMPLICATION OF EXECUTIVE ORDER 16-09 4
drugs. . The main issue related to this is that, heroine and opioid is also used as medication to
treat chronic pain and hence, there are chances that the strict regulation over its supply may
also impact the people who are using these drugs for their treatment purposes. The reduced
supply of opioid would pose a threat to the treatment of chronic pain but, whether it brings
the bill decreases opioid misuse is questionable. The order focuses more on an action-based
method for its implementation (Robinson, Xu & Plaks, 2017). 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 the 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 effective for reducing the misuse and overdose. The main objective of the order is
to bring down the misuse and abuse of opioid overdose. However, the implication of the
order emphasises mainly on the control and reduction in the supply of opioid and heroin.
Opioid and heroin are utilized positively as a pain-relieving medicine in the case of
patients with chronic pain issues however, its misuse and overdose lends a negative result.
Therefore, the reduction in 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 and it may also impact the use
of the same by the doctors for treating the patients with chronic pain.

IMPLICATION OF EXECUTIVE ORDER 16-09 5
However, it would not be fully justified to focus only on the negative results it will
yield. The order is developed keeping in mind the overuse and misuse of opioid and has
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 of
opioid and heroin with a view to control misuse and abuse. It strives to check the
unauthorised use of opioid and heroin. Apart from this, the main aim of this legal procedure
is to create awareness among the youth regarding the risks associated with the excessive use
of this drug. It also aims to work with the state agencies in order to find any gaps in the
criminal justice system that may impact the availability as well as utilization of the drugs
used for treatment. This order also aims to explore policies and procedures that are important
to enhance the prescription drug monitoring program (Inslee, 2016). The order majorly
revolves around four goals: Goal 1: This is related to the prevention of inappropriate
prescription as well as reduction of the use of opioid. Goal 2: This goal is related to the
treatment of the patients that are affected because of the use of opioid and also linking them
with the support services. Goal 3: This aims to intervene in the cases of opioid overdoses in
order to prevent death. Goal 4: This goal is majorly developed in order to use the data and
information that will help in detecting the misuse or abuse of opioid (DOH, 2016).
Recommendation
It can be concluded from the above discussion that, although, the order puts
challenges in front of the medical science, but it also resolves the issues it was developed to

IMPLICATION OF EXECUTIVE ORDER 16-09 6
address. The authorities should strive to check the actions as well as ensure the desired result.
This could be ensured by:
 checking the use of opioid and heroine by limiting its supply, and
 Restricting the use of that limited supply for the purpose of medical science.
The opioid and heroin would be only supplied against 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 a
challenge in front of the medical science, but it has the ability to impact the opioid misuse or
abuse. The Bill may also result in the reduction of the misuse of opioids 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