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

政策项目摘要 政策制定者发起了多项举措，以减少阿片类止痛药的不当处方， 防止阿片类药物滥用，改善对阿片类药物使用障碍的循证治疗，并减少 阿片类药物相关过量发病率和死亡率。这些努力是在不同层面上进行的 政府，跨越不同的系统，在危机的不同阶段。这些策略采纳层 和实施带来的挑战是确定哪些战略或“捆绑”战略可能是最重要的 有效地减少与阿片类药物相关的危害。越来越多的阿片类药物政策数据资源成为 可用，但都依靠零敲碎打的方法来选择承保的具体保单。这个项目将 制定阿片类药物政策监测的组织分类框架，并利用该框架 完善现有成瘾政策数据基础设施，提高我们对成瘾政策的科学认识 政策采纳和执行的决定因素。使用实施过程中已建立的最佳实践 科学和法律流行病学，我们将开发一个分类来描述、报告和组织 阿片类药物政策格局，并评估分类对更广泛的成瘾政策监测的相关性。我们 还将映射分类中现有的阿片类药物政策数据资源，以确定哪里需要 新的或改进的阿片类药物政策监测。在分类的三个类别中，我们将确定 各国正在采取相关政策，在当前政策方法存在差距的情况下；在每个 在这三个类别中，我们将评估哪些因素会影响各州采取特定政策的决定 接近了。该项目将帮助解决现有阿片类药物政策数据集的局限性；告知阿片类药物政策 在更全面的物质使用和社会政策框架内发展；并为 将这个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 这可以用来描述成瘾政策环境的不同组成部分(地方、州和联邦) 对未来毒品危机的适用性。研究结果将有助于推动在确定战略方面取得进展，或者 战略组合，在减少阿片类药物相关危害方面最有效。

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.