Opioid Use Disorder Treatment and Mortality: Evidence from Variation in Services Offered
Working Paper. In this study, I examine the impact that treatment facilities are having on the opioid related death rate within the counties they are located in. I utilize variation in the location of substance abuse treatment facilities and variation in the services offered and insurance type accepted by those facilities to generate causal estimates of the impact of these services on opioid overdose mortality.
Medicaid Expansion and the Opioid Epidemic: How does increasing health insurance impact the crisis?
Revise and Resubmit, Journal of Policy Analysis and Management.
This study examines the impact of expanded health insurance coverage, resulting from the Patient Protection and Affordable Care Act of 2010, on opioid related mortality. I utilize variation in states’ decisions to expand Medicaid, in the timing of expansion and in the pre-policy uninsured rate at the state and county level. Opioid related mortality data are examined from 1999-2016 using the multiple cause of death files obtained from the Centers for Disease Control. My findings suggest the implementation of Medicaid expansion resulted in about a 30% reduction in heroin deaths, a 26% reduction in other unspecified narcotics deaths and a 14.5% increase in methadone related deaths. My study builds on recent work that shows increases in prescriptions to treat opioid use disorder in expanding states relative to non-expanding states.
The Earned Income Tax Credit, Poverty, and Health
Health Affairs Policy Brief,
With David Simon and Sarah Goodell
The Introduction of Abuse-Deterrent Opioids and Rates of Viral Infection
Working Paper. Along with the many deaths that have been attributed to opioid overdose and the substantial economic impact of the epidemic, the increasing prevalence of opioid use disorder has been associated with new viral infections. Powell et al. (2019) find that states with higher prevalence of OxyContin misuse prior to the introduction of abuse-deterrent OxyContin experienced substantially higher growth in the hepatitis C infection rate since 2010. In this study, I find that increases in hepatitis C infections have coincided with increases in hepatitis B infections in states with higher rates of OxyContin misuse prior to the introduction of abuse-deterrent OxyContin in 2010. I apply this analytical framework to HIV infections but face data limitations.