A Framework for Understanding Mechanisms of Policy Change: The Opioid Policy Taxonomy

政策项目摘要 政策制定者已经启动了多项举措，以减少阿片类镇痛药的不适当处方， 预防阿片类药物滥用，改善对阿片类药物使用障碍的循证治疗， 阿片类药物过量相关的发病率和死亡率。在各级作出了努力， 政府，在不同的系统，在危机的不同阶段。这些层面的政策采纳 和实施带来的挑战，以确定哪些战略，或“捆绑”的战略，可能是最 有效减少阿片类药物相关危害。越来越多的阿片类药物政策数据资源已成为 这些政策都是现成的，但都是依靠零敲碎打的办法来选择所涵盖的具体政策。该项目将 制定阿片类药物政策监督的组织分类框架，并利用该框架 改善现有的成瘾政策数据基础设施，并提高我们对 政策通过和执行的决定因素。利用实施过程中确立的最佳做法 科学和法律的流行病学，我们将制定一个分类描述，报告，并组织 阿片类药物政策格局，并评估分类学对更广泛的成瘾政策监督的相关性。我们 还将在分类中绘制现有阿片类药物政策数据资源，以确定哪些地方需要 新的或改进的阿片类药物政策监督。在分类法的三个类别中，我们将确定 各国正在采取相关政策，目前的政策办法存在差距; 在这三个类别中，我们将评估哪些因素影响国家采取特定政策的决定， 接近。该项目将有助于解决现有阿片类药物政策数据集的局限性;为阿片类药物政策提供信息 在药物使用和社会政策的更全面框架内发展;并为 将该项目扩展到更广泛的应用，最终目标是开发一个政策监督系统 可以表征成瘾政策环境（地方，州和联邦）的不同组成部分， 应对未来的毒品危机。研究结果将有助于促进确定战略的进展，或 这些策略的组合在减少阿片类药物相关危害方面最为有效。

Policies Project Abstract Policymakers have launched multiple initiatives to reduce inappropriate prescribing of opioid analgesics, prevent opioid misuse, improve access to evidence-based treatment for opioid use disorder, and decrease rates of opioid-related overdose morbidity and mortality. The efforts have been taken at various levels of government, across different systems, and at different stages of the crisis. These layers of policy adoption and implementation create challenges for identifying which strategies, or “bundle” of strategies, may be most effective in reducing opioid-related harms. A growing number of opioid policy data resources have become available, but all rely on a piecemeal approach to select the specific policies covered. This project will develop an organizing classification framework for opioid policy surveillance and use the framework to improve the existing addiction policy data infrastructure and enhance our scientific understanding of the determinants of policy adoption and implementation. Using established best-practices from implementation science and legal epidemiology, we will develop a taxonomy for describing, reporting, and organizing the opioid policy landscape and assess the taxonomy’s relevance for broader addiction policy surveillance. We will also map existing opioid policy data resources within the taxonomy to identify where there are needs for new or improved opioid policy surveillance. Within three categories of the taxonomy, we will identify where states are adopting relevant policies and where there are gaps in current policy approaches; within each of the three categories, we will assess what factors influence states’ decisions to adopt particular policy approaches. The project will help address limitations of existing opioid policy datasets; inform opioid policy development within a more holistic framework of substance use and social policy; and lay the groundwork for extending this project to broader application, with the ultimate goal of developing a policy surveillance system that can characterize distinct components of the addiction policy environment (local, state, and federal) with applicability to future drug crises. Study findings will help spur progress toward identifying strategies, or combinations of strategies, most effective in reducing opioid-related harms.