[DRAFT] Prevention of Opiate Overdoses

[United Calanworie]

First time author please be gentle


Category: Health
Subcategory: Healthcare

The World Assembly,

Whereas opiate overdoses are a problem in all nations, even where recreational drug usage is prohibited;
Whereas medications, given in a timely fashion, can reverse, or counteract, the effects of some opiate overdoses;
Recognizing an inequal access to these lifesaving medications across the world;
Seeking to increase access to these medications and to drug education in order to reduce preventable deaths;
Therefore enacts the following into international law:

Article I – Definitions

1. Defines a “opiate overdose” as an accidental, or intentional, usage of opiates in an amount sufficient to cause respiratory arrest in an individual;
2. Defines an “overdose reversal agent” as a drug that restores respiratory drive in an individual suffering from opiate-induced respiratory arrest, such as naloxone;

Article II – Findings

1. Opiate-based overdoses induce respiratory depression leading to hypoxia, hypercarbia, and eventual death of the overdosed individual;
2. Timely administration of an overdose reversal agent has been shown to be efficacious in nature, reaching results of 75%+ efficacy upon administration by laypersons;
3. Overdose reversal agents are generally considered to be safe and efficacious to use by medical professionals, first responders, and laypersons alike;

Article III – Actions Taken by the Assembly
Understanding the findings established in Article II of this item of legislation, the following is directed:

1. That all police, fire and rescue agencies, and emergency medical services providers be mandated to carry no fewer than three doses of an overdose reversal agent in each of their official vehicles;
2. That all publicly owned buildings be equipped with overdose reversal kits, which should contain a dose of an overdose reversal agent, instructions on how to administer it, and a contact number for local emergency services;
3. That access to overdose reversal agents must be provided at local pharmacies, hospitals, and clinics upon the request of an individual with no need for a prescription;

Article IV – Funding
The World Assembly shall provide funding from the World Health Authority sufficient to fund the above mandates to nations who cannot afford to provide the above requirements.

The World Assembly,

Whereas drug overdoses are a problem in all nations, even where recreational drug usage is prohibited;
Whereas medications, given in a timely fashion, can reverse, or counteract, the effects of some drug overdoses;
Recognizing an inequal access to these lifesaving medications across the world;
Seeking to increase access to these medications and to drug education in order to reduce preventable deaths;
Therefore enacts the following into international law:

Article I – Definitions

1. Defines a “drug overdose” as an accidental, or intentional, usage of substances, controlled or otherwise, in an amount sufficient to cause respiratory arrest in an individual;
2. Defines an “overdose reversal agent” as a drug that restores respiratory drive in an individual suffering from opiate-induced respiratory arrest, such as naloxone;

Article II – Findings

1. Opiate-based overdoses induce respiratory depression leading to hypoxia, hypercarbia, and eventual death of the overdosed individual;
2. Timely administration of an overdose reversal agent has been shown to be efficacious in nature, reaching results of 75%+ efficacy upon administration by laypersons;
3. Overdose reversal agents are generally considered to be safe and efficacious to use by medical professionals, first responders, and laypersons alike;

Article III – Actions Taken by the Assembly
Understanding the findings established in Article II of this item of legislation, the following is directed:

1. That all police, fire and rescue agencies, and emergency medical services providers be mandated to carry no fewer than three doses of an overdose reversal agent in each of their official vehicles;
2. That all publicly owned buildings be equipped with overdose reversal kits, which should contain a dose of an overdose reversal agent, instructions on how to administer it, and a contact number for local emergency services;
3. That access to overdose reversal agents must be provided at local pharmacies, hospitals, and clinics upon the request of an individual with no need for a prescription;

Article IV – Funding
The World Assembly shall provide funding from the World Assembly General Fund sufficient to fund the above mandates to nations who cannot afford to provide the above requirements.

The World Assembly,

Whereas drug overdoses are a problem in all nations, even where recreational drug usage is prohibited;
Whereas medications, given in a timely fashion, can reverse, or counteract, the effects of some drug overdoses;
Recognizing an inequal access to these lifesaving medications across the world;
Seeking to increase access to these medications and to drug education in order to reduce preventable deaths;
Therefore enacts the following into international law:

Article I – Definitions

1. Defines a “drug overdose” as an accidental, or intentional, usage of substances, controlled or otherwise, in an amount sufficient to cause respiratory arrest in an individual;
2. Defines an “overdose reversal agent” as a drug that restores respiratory drive in an individual suffering from opiate-induced respiratory arrest, such as naloxone;

Article II – Findings

1. Opiate-based overdoses induce respiratory depression leading to hypoxia, hypercarbia, and eventual death of the overdosed individual;
2. Timely administration of an overdose reversal agent has been shown to be efficacious in nature, reaching results of 75%+ efficacy upon administration by laypersons;
3. Overdose reversal agents are generally considered to be safe and efficacious to use by medical professionals, first responders, and laypersons alike;

Article III – Actions Taken by the Assembly
Understanding the findings established in Article II of this item of legislation, the following is directed:

1. That all police, fire and rescue agencies, and emergency medical services providers be mandated to carry no fewer than three doses of an overdose reversal agent in their official vehicles;
2. That all publicly owned buildings be equipped with overdose reversal kits, which should contain a dose of an overdose reversal agent, instructions on how to administer it, and a contact number for local emergency services;
3. That access to overdose reversal agents must be provided at local pharmacies, hospitals, and clinics upon the request of an individual with no need for a prescription;

Article IV – Funding
The World Assembly shall provide funding from the World Assembly General Fund sufficient to fund the above mandates to nations who cannot afford to provide the above requirements.

[Tinhampton]

Aav is best Aav.

Healthcare has areas of effect, not strengths.

Article III.1: Some very large nations have a single, nationalised healthcare service with their own ambulances. Do you expect all of those ambulances to share three ORAs between them, or were you anticipating three ORAs per vehicle?

Article III.3: Are you sure that giving away ORAs to literally anybody who wants them - even if they don't need them - is a good idea?

[United Calanworie]

Aav is best Aav.

Healthcare has areas of effect, not strengths.

Updated, thank you for the catch.

Article III.1: Some very large nations have a single, nationalised healthcare service with their own ambulances. Do you expect all of those ambulances to share three ORAs between them, or were you anticipating three ORAs per vehicle?

Three per vehicle was my intent, OP updated with clarifying wording in red. (Original draft spoilered.)

Article III.3: Are you sure that giving away ORAs to literally anybody who wants them - even if they don't need them - is a good idea?

Going to break into RL studies here, but the answer is a clear and unambigious yes.

The distribution of these agents enables individuals who may be the first to encounter an overdosed individual to administer the ORA earlier, thereby increasing survival odds.

Courtesy of British Columbia Emergency Health Services and Toward the Heart

So yeah, I think distribution to anyone who requests the ORA is a reasonable choice, because even though they themselves may not be at risk of overdosing, they may live with somebody who is, be in an area where they are likely to come across an overdosed individual, etc.

[Tsaivao]

Delegate Manhu stares sideways at the proposal before yawning. "I would think that such procedures for mandating medical packages in emergency vehicles would, at the very least, already be an issue of local jurisdiction, not that of international law. Indeed, saving people from dying due to overdose is a noble goal, but I don't see why we need a resolution mandating that emergency vehicles must have them on-hand when there's no real conceivable reason for them not to, especially in the case of paramedics."

Manhu brightened slightly. "I think that if you just focused on the part for the publicly-accessible kits and fleshed that out more, that'd be better."

"As of right now, though, this seems to just be bureaucratic red tape for an issue that should have solved itself. We cannot support it in this state."

[Hulldom]

Couple general notes.

1. You definitely don't need Article II and indeed, it could possibly be illegal for RL references (at least points 1 + 2)
2. I'm sure there's a more specific body you can reference for this than the General Fund. The committees list by Merni (you can find it attached to the Passed proposals thread) can definitely help.

Going to hold off on further comments until later.

[United Calanworie]

Couple general notes.

1. You definitely don't need Article II and indeed, it could possibly be illegal for RL references (at least points 1 + 2)
2. I'm sure there's a more specific body you can reference for this than the General Fund. The committees list by Merni (you can find it attached to the Passed proposals thread) can definitely help.

Going to hold off on further comments until later.

I was thinking about illegality potentials, but considering that the GA rules say “Generic references, however, are permitted, such as religions, political philosophies, languages, general scientific terminology, and phenomena,” I’m assuming it’s fine under the “general scientific terminology” section. Being a first time author and all, I’m not entirely up to date on how the GA views science references in proposals.

I could probably find a more specific body than the general fund, so I’ll take a look. Thanks for cluing me into the thread.

Cheers.

[Araraukar]

OOC: Without reading this very thoroughly yet, it's odd respiratory arrest is required by definition as the thing to happen without help, instead of, you know, a whole host of issues such as permanent kidney damage, permanent liver damage, permanent brain damage, cardiac arrest, etc.

Also, alcohol counts. And WA has the stance that people should be allowed to kill themselves if they want to (actual suicide, not euthanasia).

[United Calanworie]

OOC: Without reading this very thoroughly yet, it's odd respiratory arrest is required by definition as the thing to happen without help, instead of, you know, a whole host of issues such as permanent kidney damage, permanent liver damage, permanent brain damage, cardiac arrest, etc.

It’s not odd, it’s because that’s how overdoses work. You take too many opiates, your CNS gets depressed, your lungs stop functioning, and you enter respiratory arrest. Eventually, if left untreated (~2 minutes), respiratory arrest leads to cardiac arrest, permanent brain damage, etc. All of those other things are irrelevant to the proposal, as it deals with prevention of opiate-based overdoses… which induce respiratory arrest. Permanent kidney and liver damage are outside the scope of overdose prevention, as they’re typically a result of drug usage, not overdosing. (With limited exceptions such as acetaminophen or nsaid ODs, which naloxone wouldn’t reverse anyway.)

Also, alcohol counts.

Yeah, but there isn’t really anything other than education that can be done for that, and I’d rather scope the proposal narrowly enough to avoid doing too many things at once, all in one go.

And WA has the stance that people should be allowed to kill themselves if they want to (actual suicide, not euthanasia).

Irrelevant, as most ODs occur by accident. Suicide rates aren’t that high… typically… I hope.

[Araraukar]

It’s not odd, it’s because that’s how overdoses work. You take too many opiates, your CNS gets depressed, your lungs stop functioning, and you enter respiratory arrest.

OOC: If you want to write a proposal about opiate treatment then you need to title it accordingly. If someone overdoses on digitalis, their heart is going to go haywire before their breathing stops. If I took too many of my non-opiate meds, my liver would be in the most danger, then my nervous system, then possibly other internal organs and my blood chemistry would get messed up, but my breathing would be about the last thing to go.

You're thinking too narrowly, if you're only worried about opiates.

[United Calanworie]

2. I'm sure there's a more specific body you can reference for this than the General Fund. The committees list by Merni (you can find it attached to the Passed proposals thread) can definitely help.

Updated to World Health Authority

It’s not odd, it’s because that’s how overdoses work. You take too many opiates, your CNS gets depressed, your lungs stop functioning, and you enter respiratory arrest.

OOC: If you want to write a proposal about opiate treatment then you need to title it accordingly. If someone overdoses on digitalis, their heart is going to go haywire before their breathing stops. If I took too many of my non-opiate meds, my liver would be in the most danger, then my nervous system, then possibly other internal organs and my blood chemistry would get messed up, but my breathing would be about the last thing to go.

You're thinking too narrowly, if you're only worried about opiates.

Scope of the proposal has been narrowed, see OP for draft 3, title updated to "Prevention of Opiate Overdoses."

[Araraukar]

Scope of the proposal has been narrowed, see OP for draft 3, title updated to "Prevention of Opiate Overdoses."

OOC: Why? You could easily have gone the other way and widened it into applying to more things.

Opiate overdoses are so narrow a focus that I'm not entirely certain it fits the "minimum of Significant effect" requirement for the AoEs (their effect on stats is Strong, so their verbal effect needs minimum of Significant).