While solutions for addressing the opioid crisis often involve either beefing up law enforcement or widening the scope of health services, West Virginia University researchers said they believe the best approach is a synergistic mix of both.
To illustrate which policies and strategies have been successful and to generate ideas for addressing the epidemic, they’re setting out to collect data from all 55 counties and 233 municipalities throughout West Virginia.
“The novelty of this project is that rather than have one conversation in health care and another in law enforcement, the policy data we have will bring those two sides together to determine the right mix,” said Sam Workman, director of the WVU Institute for Policy Research and Public Affairs in the John D. “Jay” Rockefeller School of Policy and Politics.
With funding from the National Science Foundation, the study focuses on two areas — supply and demand. The supply side involves law enforcement efforts to curtail drug activity. Demand centers on health care and social services aimed at raising awareness of the pitfalls of substance use and providing emergency medical care and support to families.
Researchers will compare the amount of funds and other resources local governments have invested over at least the last decade with hopes of shedding light on whether the entities are moving in the right direction or if they need to modify their plans. While the study focuses on the use of opioids, health and criminal justice outcomes for most substance use issues will also be reflected in the report.
Workman, who is leading the study, said he expects to see differences in county approaches depending on geographic location.
“If you’re a county that borders or has Interstate 79 running through it, you’re going to need a lot more on the law enforcement side of things because those are the arteries by which the drugs come,” Workman explained. “If you’re a county that’s not along the interstate, maybe it’s better for you to spend money on emergency services and public health infrastructure.”
Recognizing how to combine the two aspects to best serve residents of each county is something Workman would like to see come together in public policy.
“We can look at how counties spent money and be able to say that some mixes of public investments are better than others at ameliorating the effects of substance use,” Workman said. “What we want to be able to do is arrive at a place where they are at least making those choices from an informed perspective.”
Dr. Gordon Smith, Stuart M. and Joyce N. Robbins Distinguished Professor in the WVU School of Public Health and adjunct professor in the WVU School of Medicine, is a co-investigator on the project.
“There are wide variations on drug overdose rates by county and we hypothesize that this represents a natural experiment that we can learn from to better understand why some counties do better than others,” he said.
Workman and Smith will be assisted by James Nolan and Henry Brownstein of the WVU Eberly College of Arts and Sciences Department of Sociology and Anthropology, and researchers with the University of Minnesota and Binghamton University, State University of New York.
The research will be used to provide data-driven guidance on how policymakers can allocate resources to effectively address the opioid problem in their communities. Researchers will also consider factors like policymaker preferences, health and safety outcomes of budget decisions and the adaptability of opioid networks when faced with policy changes.
“This is part of the broader mission of the Institute for Policy Research and Public Affairs,” Workman said. “It’s also part of the University’s land-grant mission in which we work on problems that improve the quality of life for citizens of West Virginia.”
Workman said a final report will be sent to the West Virginia Legislature, the West Virginia Municipal League and the West Virginia Association of Counties. While local governments will have access to the documents through those entities, Workman and Smith plan to make presentations in local communities to help public officials compare ideas.
“I think we would like to arrive at a situation where local governments can learn from themselves over time because they will see their own historical patterns of spending, and also from their neighbors both near and far,” Workman said. “We often think about counties in similar geographic space facing similar problems, but counties may learn more from a county far away than one near them. It just depends on what problems they face.”
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