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Report
Medication-assisted Treatment for Opioid Use Disorder in Rhode Island: Who Gets Treatment, and Does Treatment Improve Health Outcomes?
Since the early 2000s Rhode Island has been among the states hardest hit by the opioid crisis. In response, the state has made it a priority to expand access to medication-assisted treatment (MAT) for opioid use disorder (OUD), which refers to the use of the FDA-approved medications methadone, buprenorphine, and/or naltrexone in conjunction with behavioral therapy. MAT is strongly supported by scientific evidence and endorsed by US public health officials and yet fails to reach many OUD patients. Using administrative data covering medical treatments and selected health outcomes for more than ...
Journal Article
Lessons from the Rhode Island banking crisis
The failure of the Rhode Island Share and Deposit Indemnity Corporation (RISDIC), a private insurance fund, and the closure of its 45 remaining member institutions froze the accounts of 300,000 individuals and 10 percent of all deposits in the state. While the closure of two institutions triggered RISDICs demise, flaws in both design and management had set the stage for failure and are the focus of this article. The authors group RISDICs problems into three categories: risk concentrations, control of the insurance fund by those it insured, and RISDICs inadequate regulatory oversight of ...
Journal Article
Will the tobacco settlement payments go up in smoke?
In December 1995, Massachusetts attorney general Scott Harshbarger filed a civil suit against the tobacco industry. The Commonwealths lawsuit charged that the tobacco industry had conducted research into the addictive properties of nicotine and used this research to willfully manipulate the nicotine level of cigarettes in order to addict smokers and increase cigarette sales. The lawsuit asked the court for damages to compensate the Commonwealth for expenditures paid to treat smoking-related illnesses. At the time this litigation was filed, Massachusetts was the fifth state in the nation to ...
Working Paper
Who Gets Medication-assisted Treatment for Opioid Use Disorder, and Does It Reduce Overdose Risk? Evidence from the Rhode Island All-payer Claims Database
This paper uses the all-payer claims database (APCD) for Rhode Island to study three questions about the use of medication-assisted treatment (MAT) for opioid use disorder (OUD): (1) Does MAT reduce the risk of opioid overdose; (2) are there systematic differences in the uptake of MAT by observable patient-level characteristics; and (3) how successful were federal policy changes implemented in 2016 that sought to promote increased use of buprenorphine, one of three medication options within MAT? Regarding the first question, we find that MAT as practiced in Rhode Island is associated with a ...
Journal Article
Art's economic power in New England
Working Paper
Did the Affordable Care Act Affect Access to Medications for Opioid Use Disorder among the Already Insured? Evidence from the Rhode Island All-payer Claims Database
Previous research suggests that state Medicaid expansions implemented under the Patient Protection and Affordable Care Act (ACA) helped large numbers of patients suffering from opioid use disorder (OUD) gain access to life-saving medications, including buprenorphine. However, Medicaid expansions could have impeded access to care among individuals already enrolled in Medicaid, as new enrollees would have placed added demands on a limited supply of buprenorphine providers. Using a panel data set of medical claims from Rhode Island, we estimate the causal effects of the state’s January 2014 ...
Journal Article
Comments on 2001 benchmark revisions to regional employment data
In March 2002, the U.S. Bureau of Labor Statistics (BLS) released revised state and regional employment data based on the 2001 benchmark, affecting data for 2000 and 2001. Contrary to the employment boost shown in last year's revisions, the 2002 revisions increased New England's measured employment levels slightly for 2000 and reduced them in nearly all states and industries for 2001. Furthermore, the revisions show that the recession that began in 2001 had a deeper impact on employment in the region than in the nation, as New England's year-end employment decreased for the first time in a ...
Report
Access to medication-assisted treatment for opioid use disorder: is Rhode Island different, and why?
This paper assesses the prevalence of medication-assisted treatment (MAT) among treatment episodes for opioid use disorder (OUD) in Rhode Island, as compared with the remaining New England states and the United States as a whole. Based on the Treatment Episode Data Set (TEDS-A), a national census of admissions into publicly funded treatment facilities for substance use disorders, we find that during the period beginning in 2000 through 2017, Rhode Island exhibited a greater tendency to use MAT as part of OUD treatment compared with the average state in the United States and compared with the ...
Report
Can Treatment with Medications for Opioid Use Disorder Improve Employment Prospects? Evidence from Rhode Island Medicaid Enrollees
The nation’s long-standing crisis of opioid abuse intensified during the COVID-19 pandemic, with opioid-related deaths rising to nearly 81,000 in 2021, an increase of more than 60 percent from just two years earlier. Also during the pandemic, the labor force participation rate in the United States fell precipitously, and as of September 2022 it remained depressed by more than a full percentage point relative to its February 2020 level despite record numbers of job openings in 2021 and 2022. The unfortunate confluence of labor shortages and record-setting opioid mortality highlights the need ...