U.S. State Opioid Policy Taxonomy Delphi Study, 2020-2021 (ICPSR 39342)

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Study Purpose View help for Study Purpose

The purpose of the study is to develop a validated taxonomy of opioid laws that will allow researchers to measure variation in key aspects of each policy as well as the overall opioid policy environment, in particular focusing on laws that regulate the prescription opioid supply, criminalize or de-criminalize opioid use, and expand access to treatment and harm reduction for opioid use disorder. By collecting the opinions of experts in the field, this study aims to identify which opioid laws are perceived by experts as the most helpful and impactful in reducing fatal overdose, and to develop a taxonomy and annual state opioid policy scores for the United States.

Study Design View help for Study Design

This study uses a modified Delphi process to gather experts' opinions on the impacts of opioid legislation on opioid-related harm. First, a panel of twelve opioid policy experts from different U.S. academic and medical centers convened to review an initial list of state opioid legislation to refine the scope of laws included in the study, and to collect broad feedback on proposed domains into which the laws could be classified as a taxonomy.

Next, an anonymous online survey was developed to collect ratings of the helpfulness or harmfulness of 8 types of opioid laws and 50 specific provisions across a larger pool of U.S. experts. An anonymous follow-up survey was also developed to collect ratings on the impact of the 8 types of opioid laws and 50 specific provisions on opioid overdose rates, in practice, regardless of whether the impact was perceived to be helpful or harmful.

Results were shared with the panel of 12 experts for final feedback on the scoring approaches.

Sample View help for Sample

A target population was identified, consisting of 150 experts practicing in the fields of policy research, public health and behavioral health administration, health care, criminal legal system, and harm reduction. The sample pool was designed to achieve representation from each of the different sectors of interest as well as four different regions of the country (West, Midwest, South, and Northeast), however it was not designed to have statistical validity within each subgroup.

Experts were identified using internet research into peer-reviewed publications and conference proceedings on opioid policy and overdose, state listings of opioid overdose prevention task forces, public health and behavioral health agency websites, and harm reduction organization websites.

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Universe View help for Universe

Opioid policy experts practicing in the fields of policy research, public health and behavioral health administration, health care, law enforcement and the criminal-legal system, and harm reduction.

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Description of Variables View help for Description of Variables

The initial survey contains questions about the impact of 8 types of opioid laws, including categories such as prescription legislation, criminalization of opioid usage, advocacy and harm reduction, and other legislation in the context of fatal overdose due to opioids. The first survey also includes qualitative opinions on synergy or conflict between different types of opioid laws, the timing of opioid laws with respect to overdose trends, and mechanisms or domains of action to help guide the classification of different opioid laws. The follow up survey contains questions on the ratings on the impact of the 8 types of opioid laws and 50 specific provisions on opioid overdose rates, in practice, regardless of whether the impact was perceived to be helpful or harmful.

Response Rates View help for Response Rates

The survey was sent to a target population of 150 experts. A total of 56 experts completed the first survey and a subset of 40 experts completed the follow-up survey.

Presence of Common Scales View help for Presence of Common Scales

Several likert scales were used. Participants were asked to rate the harmfulness or helpfulness of opioid policy on the following scale: Very harmful (0), somewhat harmful (1), neither helpful nor harmful (2), somewhat helpful (3), and very helpful (4). Participants were asked to rate the impact of opioid policy on a scale of 0 (no impact) to 4 (very large impact).

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Original Release Date View help for Original Release Date

2025-06-24

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Weight View help for Weight

Unweighted and weighted mean ratings were calculated. The sample size was allowed to vary by question, and the R survey() package was used to produce weighted means for each response based on a target sample population size of 25 for each of the five areas of expertise: opioid policy research, health care practice, public health and behavioral health administration, harm reduction, and the criminal legal system. Sample code is provided.

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