Social and Behavioral Sciences Commons^™

The Effect Of The Affordable Care Act On Opioid Overdose Mortality, Caleb Jordan

All Theses

The opioid epidemic is an ongoing health crisis in the United States, claiming the lives of thousands over the past two decades. In 2014, provisions of the Affordable Care Act expanding Medicaid officially came in effect, extending healthcare to millions of people in the United States. However, Medicaid expansion was optional for states, so some states greatly expanded healthcare to low-income people while others did not. People in expansion states gained more affordable access to prescription drugs and treatment centers, making opioids easier to obtain and addictions more affordable to treat. This makes the effect of the Affordable Care Act …

The Effects Of Recreational Marijuana Dispensaries On Local Opioid Mortality, Patrick Morrison

Honors Theses

This study examines how recreational marijuana dispensaries in Colorado affect opioid mortality at the county level. Using a difference-in-difference model with county and year fixed effects, I estimate the impact of recreational marijuana dispensary access on fatal opioid overdoses. Additionally, I employ distance from a major roadway and border as two instrumental variables to help limit the endogeneity associated with the location of dispensaries. Previous studies have shown that medical and recreational marijuana dispensary access decreases opioid mortality at the state level. Still, no study has explored the connection between recreational marijuana dispensaries and overdoses at the county level. Using …

Establishing Peer Recovery Support Services To Address The Central Appalachian Opioid Epidemic: The West Virginia Peers Enhancing Education, Recovery, And Survival (Wv Peers) Pilot Program, Stephen M. Davis, Amanda Stover, Herb Linn, Jon Dower, Dan Mccawley, Erin Winstanley, Judith Feinberg

Journal of Appalachian Health

Introduction: Central Appalachia has been disproportionately affected by the opioid epidemic and overdose fatalities. We developed West Virginia Peers Enhancing Education, Recovery, and Survival (WV PEERS), a program based on peer recovery support, to engage individuals using opioids and link them with a range of services.

Methods: Community partners providing services to individuals with opioid use disorder (OUD) were identified and collaborations were formalized using a standardized memorandum of understanding. The program was structured to offer ongoing peer recovery support specialist (PRSS) services, not just a one-time referral. A website and cards describing the WV PEERS program were developed and …

Review Of: From The Front Lines Of The Appalachian Addiction Crisis Healthcare Providers Discuss Opioids, Meth And Recovery, Carl G. Leukefeld

Journal of Appalachian Health

The Journal of Appalachian Health is dedicated to reviewing various types of media related to contemporary concepts that affect the health of Appalachia. As the opioid-related overdose deaths ravish Appalachia, now more than ever, we each must devote energy to understanding addiction and pathways to recovery. Dr. Carl Leukefeld reviews the book From the Front Lines of the Appalachian Addiction Crisis: Healthcare Providers Discuss Opioids, Meth and Recovery.

In Their Own Words: How Opioids Have Impacted The Lives Of “Everyday” People Living In Appalachia, Patricia Nola Eugene Roberson, Gina Cortez, Laura H. Trull, Katherine Allison Lenger

Journal of Appalachian Health

Introduction: The opioid epidemic is ravaging people, families, and communities in Appalachia. However, limited research has examined how “everyday” people (e.g., not chronic pain patients, not medical professionals) living in these communities how opioids have impacted their lives.

Objective: Identify the perception of the opioid epidemic on individuals, families, and communities from people living in region most impacted regions.

Methods: Patients were recruited at Remote Area Medical clinics throughout Central and Southern Appalachia to complete interviews online (N = 169) or over the phone (N = 26), including one open-ended question about how opioids have impacted their lives.

Results: Using …

Drug-Overdose Death Rates: The Economic Misery Explanation And Its Alternatives, Barbara Blake Gonzalez, Richard Cebula, James V. Koch

Economics Faculty Publications

‘Deaths of despair’ is the most commonly cited explanation for the 151% increase in drug-overdose deaths that occurred in the USA between 2010 and 2018. We use panel data describing 84 Virginia cities and counties to assess the validity of the deaths of despair hypothesis and alternate explanations that focus on disability rates, travel time to work, urban vs. rural location, educational attainment, racial and ethnic characteristics, the influence of other health conditions such as obesity, and supply-side factors that include pill availability and pharmacy market shares. We find deaths of despair to be only a partial explanation for the …

Listening To Voices In Appalachia: Gathering Wisdom From The Field About Substance-Abuse Recovery Ecosystems, Bruce Behringer

Journal of Appalachian Health

New qualitative data collected through six regional community-based listening sessions and community meetings are presented that describe elements of the Appalachian Regional Commission’s Recovery Ecosystem Model. These data informed the Model, which was used in formulating the new ARC Recovery-to-Work initiative. Input was intentionally solicited from multiple sectors, including persons recovering from substance abuse disorder, treatment and recovery service providers, workforce development agencies, employers, and community advocacy groups.

Responding To Appalachian Voices: Steps In Developing Substance-Use Recovery Ecosystems, Bruce Behringer

Journal of Appalachian Health

A description is presented of the four-step process used by the Appalachian Regional Commission to develop a new Recovery to Work initiative. The Commission identified, defined, and described issues facing individuals who complete substance abuse disorder treatment and who seek reentry into the workforce. Key elements were identified for resources and supports to develop and maintain community-based substance abuse recovery ecosystems. The steps included conceptualization, data collection, analysis, and review to formulate recommendations for program and policy development. The full process of development was accomplished in twelve months.

Naloxone Access And Opioid Use: A Theoretical Analysis, Caroline Dunsby

Honors Theses

Naloxone, commonly known by the brand name Narcan, is a medication that reverses the potentially fatal effects of an opioid overdose. Amidst the opioid epidemic that has taken tens of thousands of lives each year, many policies have been enacted to increase the public's access to naloxone, allowing non-medical personnel to save lives. There have been two distinct reactions to these policies. Those that support the policies state that harm reduction measures are necessary to save lives. Those that oppose the policies claim that by providing naloxone, states may be increasing risky opioid use - suggesting that naloxone leads to …

Three Essays In Applied Econometrics: Understanding Population Changes, Samuel P. Taylor

Graduate Theses, Dissertations, and Problem Reports

This body of work consists of three research projects developed around a central theme – what might cause a person to leave the place where they live? As a native and resident of West Virginia, this question is not a purely academic one. My region has long struggled with how to retain our “best and brightest” in the face of challenging socio-economic conditions. Looking at the question differently, understanding what negative influences may exist to cause a person that might otherwise have remained in a place to leave, could provide large influences on policy and strategy for retention of residents …

Drug Policy: The Effect Of Medical Marijuana On Opioid Consumption During The Us Opioid Epidemic, Jonathon David Knudson

Graduate Student Theses, Dissertations, & Professional Papers

The introduction and subsequent over-prescribing of extended-release opioids in the United States resulted in a large rise in both addiction and overdose. Recognition and regulation of these new drugs as addictive did little to control the supply of opioids to Americans while Prescription Drug Monitoring Programs and Abuse Deterrent reformulations had limited effect to control the problem. Simultaneously, states like Michigan and Rhode Island legalized medical marijuana through voter referenda opening the door for a new approach to pain management. Recent research has found medical marijuana has proven an effective treatment for conditions such as chronic pain and PTSD and …

The Effects Of Opioids On Kentucky's Workforce, Michael W. Clark, Jenny A. Minier, Charles J. Courtemanche, Bethany L. Paris, Michael T. Childress

CBER Research Report

From the executive summary:

Opioid abuse represents a significant and growing public health issue for both the nation and Kentucky. In 2016, opioids contributed to more than 62,000 deaths nationally and 1,406 deaths in Kentucky. National studies have placed the societal costs of opioid abuse at $55.7 billion in 2007 and $78.5 billion in 2013 (Birbaum et al. (2011) and Florence et al. (2016)). These costs included increased health care expenditures, higher criminal justice costs, and lost earnings due to reduced employment and premature deaths. The While House Council of Economic Advisors (2017) estimated the societal costs of opioid abuse …

Improving Access To Addiction Recovery Care In Central Appalachia Through Organizational Collaboration, Katy Stigers

Journal of Appalachian Health

Fahe, a Network of 50+ members throughout Appalachia based in Berea KY, has brought together a coalition to finance, build, and manage several addiction recovery care centers across Kentucky and West Virginia, increase access to employment, and deploy vouchers for supportive services.

Investigating The Impact Of The Diseases Of Despair In Appalachia, Michael Meit, Megan Heffernan, Erin Tanenbaum

Journal of Appalachian Health

Introduction: Appalachia is one of the regions most significantly impacted by the opioid crisis. This study investigated mortality due to diseases of despair within the Appalachian Region, with an additional focus on deaths attributable to opioid overdose.

Methods: Diseases of despair include: alcohol, prescription drug and illegal drug overdose, suicide, and alcoholic liver disease/cirrhosis of the liver. Mortality data from the National Center for Health Statistics (NCHS) National Vital Statistics System (NVSS) Multiple Cause of Death database were analyzed for this study, focusing on individuals aged 15–64.

Results: Over the past two decades, the mortality rate due to diseases of …

Three Essays In Applied Econometrics, Collin Dean Hodges

Graduate Theses, Dissertations, and Problem Reports

The body of work presented here consists of a collection of research projects developed during my time as a graduate student at West Virginia University. As will soon become apparent, this collection of research topics is quite eclectic. This is, in part, due to the to the nature of the research process itself--where one often begins by asking one question and ends by answering a completely different one--but also due to the fact that my time at West Virginia University has provided me the opportunity to gain insight into a wide variety of economic fields as well as work on …

Do Medical Marijuana Laws Reduce Addictions And Deaths Related To Pain Killers?, David Powell, Rosalie Pacula, Mireille Jacobson

David Powell

Opioids And Unemployment, David Robinson

Williams Honors College, Honors Research Projects

There has been a ton of research in economics about the effects of drugs on the employment status of individuals. These papers have looked at the effects mainly pertaining to Marijuana and Cocaine, however this paper will be examining the effects of the opioid Heroin. As a first of its kind paper I will examine the relationship between employment and heroin use. To test this connection I have compiled data from the National Survey on Drug Abuse and Health. Through the use of two econometric models: OLS and Two Stage Least Squares models I will uncover the connection we can …

Ethics And Cost-Effectiveness Of Naloxone, Allison Groch

Augustana Center for the Study of Ethics Essay Contest

This essay discusses the ethical components involved with using, distributing, and making naloxone readily available for reversing opioid overdoses. The cost-effectiveness of naloxone is also discussed as a reason why naloxone should be widely used in order to help fight the opioid epidemic.

Out-Of-Pocket Cost For Individuals Being Treated For Opioid Dependence In Rutland County, Vermont, Christopher T. Veal

Family Medicine Clerkship Student Projects

Each day more than 140 Americans die from drug overdoses, 91 specifically due to opioids. In Vermont, more than 50 people die each year from opioid poisoning. With insurance coverage being a critical component of Opioid Dependence Recovery, many people seeking treatment are unaware of the financial barriers to recovery- namely the out-of-pocket costs associated with treatment. This study sought to provide insight on the financial impact of Opioid Dependence Treatment on the patient, and provide financial assistance information to the Rutland County community.

Part 5: The Scourge Of Opioids, Center For Economic Analysis And Policy, Old Dominion University

State of the Region Reports: Hampton Roads

The number of opioid-induced deaths has skyrocketed in Hampton Roads. Approximately three-quarters of opioid addicts began their fall from grace with a legitimate prescription from a knowledgeable physician. We estimate the costs.

The Impact Of Regulatory Changes On The Providers Of Treatment For Opioid Dependence, Paul Aaron Fisher

Wayne State University Dissertations

In 2000, changes in federal law allowed physicians to receive waivers to use narcotic medications, such as buprenorphine, for treatment of opioid dependence. As of 2006, physicians have been allowed to treat up to 100 patients after spending one year at a 30-patient limit. Physicians may choose to discontinue use of buprenorphine after the patient has successfully discontinued use of the substance of abuse ("withdrawal"), or physicians can keep patients on buprenorphine indefinitely ("maintenance"). The model in this dissertation assumes that demand for treatment of opioid dependence is exogenous but that demand for maintenance treatment can be induced by the …