This research will explore the influence of laws in three different states, Connecticut, Kentucky, and Wisconsin, selected to represent differences in PDMPs, Medicaid restrictions on opioid prescription, and pain clinic regulation. We will also examine the effects of the local context (drug use networks, syringe availability, harm reduction services, relative price and quality of heroin) on the transition to injecting non-prescription opioids and /or heroin injection in three local areas, an urban area, a smaller metropolitan area or suburb, and a rural town and surrounding county, chosen to reflect areas with higher rates of opioid prescription and opioid overdoses. Specific aims include the following: 1) Identify state laws and policies that have been established to decrease opioid misuse and diversion to establish or refute their association with transition to opioid or heroin injection; 2) Identify how local implementation of state laws and policies may contribute to the transition from nonmedical prescription opioid use to injecting prescription opioids or injecting heroin; 3) Compare local factors in urban, suburban and rural areas that affect the riskiness of injection practices such as the availability of clean syringes, density of drug-using networks and accessibility of drug treatment programs.
The purpose of this R01 project is to examine the effects of state laws designed to reduce opioid diversion and misuse on the transition to injection drug use and how they vary in implementation across three states.
Margaret R. Weeks, Ph.D.
Jianghong Li, MD, MSc.
Danielle Green, Ph.D.