Date of Award
8-2026
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Policy Studies
Committee Chair/Advisor
Dr. Lori Dickes
Committee Member
Dr. William Bridges
Committee Member
Dr. Rachel Mayo
Committee Member
Dr. Natan Teklemariam
Abstract
The drivers of the opioid epidemic in the United States include the oversupply of prescription opioids, the availability of illicit drugs, under-resourced healthcare settings, and several socio-economic factors. Federal and state-level initiatives, including policy interventions to curb the oversupply of prescription opioids, providing access to healthcare, prevention and recovery support services, and community-level engagement, have been adopted to combat the opioid epidemic. Motivated by the need to better understand the policy and recovery efforts to address the epidemic, this dissertation examines opioid prescription limit policy diffusion, evaluation, and treatment utilization patterns. This dissertation comprises three manuscripts that offer a comprehensive understanding of the diffusion of opioid days’ supply limit (ODSL) legislation in state governments, changes in opioid prescription volume during the COVID-19 pandemic among Medicaid beneficiaries, and treatment utilization patterns among individuals with co-occurring opioid use disorder (OUD) and infectious diseases. The first manuscript examines the diffusion mechanisms of ODSL, based on diffusion of innovation theory, while using a systematic legal review to understand the provisions of ODSL legislation and dyadic event history analysis to examine the factors associated with its diffusion. The second manuscript examines the changes in opioid prescription volume during the COVID-19 pandemic among Medicaid beneficiaries in the states with and without prescription limit policies. This manuscript uses a comparative interrupted time series framework to examine immediate and long-term changes, and differences in change, between the policy and non-policy states. The third manuscript examines patterns of OUD treatment utilization among individuals with co-occurring OUD and infectious diseases. The manuscript uses descriptive statistics to examine what proportions of individuals across various demographic groups received treatment, and logistic regression to identify factors associated with treatment utilization. Based on the findings from the three manuscripts, this dissertation offers policy implications and directions for future scholarly inquiry.
Recommended Citation
Rab, Md Ashiqur, "Essays on Opioid Prescription Limit Policy Diffusion, Evaluation, and Opioid Use Disorder Treatment Utilization" (2026). All Dissertations. 4302.
https://open.clemson.edu/all_dissertations/4302
Included in
Health Policy Commons, Health Services Research Commons, Substance Abuse and Addiction Commons