Date of Completion

8-2-2019

Embargo Period

8-2-2019

Keywords

Opioid epidemic, Medicaid expansions, Treatment, Substance Use Disorder

Major Advisor

David Simon

Associate Advisor

Kenneth Couch

Associate Advisor

Resul Cesur

Field of Study

Economics

Degree

Doctor of Philosophy

Open Access

Open Access

Abstract

Over the past 20 years, the opioid epidemic has driven large increases in poisoning deaths throughout the United States. These three essays address unanswered questions within the economics and public health literature focused on the opioid epidemic. In the first chapter, I examine the relationship between health insurance and opioid related mortality. The Medicaid expansions enabled under the Affordable Care Act are used as a natural experiment to generate causal estimates of the impact of public insurance expansion on opioid related mortality. In the second chapter, I explore the relationship between treatment for opioid use disorder and opioid related mortality. Changes in access to treatment are identified using the opening and closing of treatment facilities. This strategy enables a comparison of the estimated effect of different types of treatment centers based on the services offered and payment type accepted by those facilities. In the third chapter, I examine the unintended consequences of policies designed to curb misuse of opioids. I test how the introduction of abuse-deterrent prescription opioids has impacted rates of viral infection.

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