Date of Conferral

8-20-2025

Degree

Ph.D.

School

Public Policy and Administration

Advisor

Augusto Ferreros

Abstract

In the United States, opioid deaths posed a significant public health crisis with profound social and economic implications. The opioid crisis continued despite the implementation of state-level prescription drug monitoring programs (PDMP), naloxone access laws (NALs), and Medicaid expansion programs. Existing research demonstrated opioid deaths and nonfatal overdose patterns highlight the need for targeted harm reduction strategies, but there remained a lack of quantitative studies that addressed the effectiveness of opioid harm reduction policies. The purpose of this quasi-experimental quantitative research was to evaluate the relationship between state-level PDMPs, NALs, Medicaid expansion programs, and the COVID-19 global pandemic period (2020-2023), for the reduction of opioid overdoses and deaths using the theoretical framework of Theodoulou and Kofinis’ theory of policy design. Quantitative statistical and econometric panel data analysis were used to analyze the collected data. The results of this study included NALs and Medicaid expansion were associated with an increase in opioid deaths and non-fatal overdoses, and PDMPs did not have a significant effect on the reduction of opioid deaths and non-fatal overdoses. The association of the COVID-19 pandemic period showed a significant rise in opioid-related harm. The results of this study have the potential to advance positive social change by informing the development of more strategic and equitable public health policies aimed at addressing the ongoing opioid epidemic. By providing an evidence-based assessment of state-level policy interventions, this research provides increased knowledge on how these policies can be leveraged to reduce opioid-related harm effectively.

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