# Opioid policy scales: Developing composite measures to account for heterogeneous design and implementation of state opioid policies

> **NIH NIH P50** · RAND CORPORATION · 2021 · $302,453

## Abstract

PROJECT ABSTRACT
Opioid abuse is a public health crisis in the United States. In response, policymakers and community officials
have launched range of policies and initiatives, including efforts to a) advance better pain management
practices to reduce opioid analgesic prescribing likely to lead to overuse, misuse, and opioid use disorders; b)
improve access to treatment and recovery services, and c) promote use of naloxone to reduce opioid overdose
mortality. While recent research has contributed to our understanding of the impacts of some policies, studies
have generally relied on dichotomous policy exposure variables (e.g., any PDMP vs. none) that fail to account
for often dramatic between-state differences in nominally identical policies. Thus, we have little empirical
evidence for which components and aspects of implementation of specific policies are most effective in
reducing the public health consequences of opioid misuse. The goal of this project is to use established
methods to develop and assess standardized composite policy scales that quantify variation in the specific
components of opioid policies and characteristics of policy operationalization. For each of three key policies,
we will begin by surveying the literature and COPR’s policy database to comprehensively catalogue policy
components and aspects of how such components were implemented by states. We will then develop
composite policy scales that account for the specific components of state policy as well as for the way in which
the components have been put in place, using two alternative strategies: 1) using evidence on effectiveness
from a systematic review of the literature, and 2) using online modified-Delphi processes that use established
iterative survey-based methods to elicit expert feedback on policy component impact and implementation. We
will then use large secondary data sets to separately estimate the association of the policy scales with
measures of opioid outcomes, and to test how our composite policy scales compare to each other and to
dichotomous measures in terms of explanatory power and estimated effects. Findings will also help to identify
the key components that determine the strength of the policy environment. By developing policy scales, we
also allow for future research to statistically account for aspects of the opioid policy environment when
examining the impact of other policies that may also influence opioid use and outcomes. Ultimately, this
research agenda will inform public health and policy by providing evidence of how the multidimensional nature
of state policy implementation influences opioid-related health consequences.

## Key facts

- **NIH application ID:** 10220924
- **Project number:** 5P50DA046351-04
- **Recipient organization:** RAND CORPORATION
- **Principal Investigator:** Rosanna Smart
- **Activity code:** P50 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $302,453
- **Award type:** 5
- **Project period:** 2018-08-15 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10220924

## Citation

> US National Institutes of Health, RePORTER application 10220924, Opioid policy scales: Developing composite measures to account for heterogeneous design and implementation of state opioid policies (5P50DA046351-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10220924. Licensed CC0.

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