Dissertation/Thesis Abstract

Imperfect substitutes: Examining whether and to what extent offering Opioid Substitution Therapy (OST) may be increasing regional polydrug use
by Ringger, Devin Charles, M.P.P., Georgetown University, 2016, 57; 10105486
Abstract (Summary)

Opioid Substitution Therapy (OST) attempts to curb opioid addiction by substituting a treatment opioid (i.e. methadone, buprenorphine, naltrexone, etc.) for an addict’s primary drug of abuse (i.e. heroin, oxycodone, etc.). However, insofar as patients continue abusing their preferred drug during treatment, OST programs may be increasing the absolute number of drugs patients are abusing. To the extent that some OST patients “divert” their treatment drugs into illicit markets, OST programs may also be increasing the absolute number of opioids abused by the surrounding population, as well. If corroborated, these trends would indicate a connection between OST treatments and the phenomenon most correlated with drug overdoses— “polydrug use”, or the concurrent use multiple drugs by one person.

To ascertain whether and to what extent OST treatment provisioning may be affecting regional polydrug use, this study models the annual number polydrug treatment episodes reported in a state as a function of that state’s OST patient population. The study relies primarily on two administrative datasets—the National Survey of Substance Abuse Treatment Services (N-SSATS) and the Treatment Episode Data Set-Admissions (TEDS-A)—collected between 2002 and 2006.

Using a two-way fixed-effects model that controlled for both state and annual fixed-effects, as well as for state populations and population densities, this study discovered a statistically significant positive correlation (p<.002) between a state’s OST patient population and the number of polydrug treatment episodes reported in the state. The model predicts that a doubling of a state’s OST patient population will be correlated with a 6.16-percent increase in polydrug episodes. These results suggest that OST treatment may be producing a dangerous side effect. At the very least, they suggest that, when considering potential expansions to OST programs, circumspect policymakers should also consider simultaneous expansions to services that address the predicted increase in polydrug use.

Indexing (document details)
Advisor: Bednarzik, Robert W.
School: Georgetown University
Department: Public Policy and Policy Management
School Location: United States -- District of Columbia
Source: MAI 55/04M(E), Masters Abstracts International
Subjects: Statistics, Public health, Public policy
Keywords: Addiction, Drugs, Heroin, Methadone, Opioid, Substitution
Publication Number: 10105486
ISBN: 978-1-339-68952-4
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