Browsing by Subject "Substance use disorder treatment"
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Item Essays on health economics and public policy(2023-04-26) Kim, Bokyung (Ph. D. Economics); Cabral, Marika; Geruso, Michael; Tuttle, Cody; Olmstead, ToddSubstance use disorders (SUDs) are a major public health concern both in the United States and worldwide. The three chapters of this dissertation examine the intended and unintended consequences of public policies designed to tackle SUDs. Chapter 1 explores the short- and long-run impacts of SUD treatment on human capital accumulation and labor market outcomes among at-risk adolescents. Specifically, I study the effect of treatment center schools, which provide residential SUD treatment and have a school on site. Using administrative data that link individual-level records across multiple government agencies in Texas, I examine within-individual changes in outcomes around the time of SUD treatment with a difference-in-differences design. I find that treated students experience declines in chronic absenteeism, disciplinary action, and course failure in the first two years following SUD treatment relative to a matched comparison group. I also find positive long-term impacts on college enrollment and employment at ages 17–20. My findings suggest that SUD treatment among adolescents may have lasting consequences and is a promising tool to promote human capital development among at-risk youth. Chapter 2, previously published in the Journal of Health Economics, investigates the consequences of “mandatory access” prescription drug monitoring programs (MA PDMPs). MA PDMPs legally require providers to access a state-level database with a patient's prescription history before prescribing controlled substances under certain circumstances. Using a difference-in-differences specification, I find strong evidence that MA PDMPs have increased heroin death rates. My results suggest that even if MA PDMPs reduce prescription opioid deaths, the decrease is offset by a large increase in illegal opioid deaths. Chapter 3, coauthored with David Beheshti, examines the effect of MA PDMPs on non-opioid-related outcomes. While many policies exclusively target prescription opioid misuse, PDMPs are designed to monitor the use of a wider range of prescription drugs. Using a difference-in-differences design, we show that MA PDMPs led to decreases in stimulant prescribing. In contrast, we find suggestive evidence that these policies resulted in increases in benzodiazepine prescriptions. Our findings highlight that MA PDMPs do have effects on non-opioid drug prescribing, but these effects differ substantially across drug types.