Statewide efforts to address the opioid epidemic: Results from a national survey of single state agencies

BACKGROUND

Single State Agencies (SSAs) are at the forefront of efforts to address the nation's opioid epidemic, responsible for allocating billions of dollars in federal, state, and local funds to ensure service quality, promote best practices, and expand access to care. Federal expenditures to SSAs have more than tripled since the early years of the epidemic, yet, it is unclear what initiatives SSAs have undertaken to address the crisis and how they are financing these efforts.

METHODS

This study used data from an internet-based survey of SSAs, conducted by the University of Chicago Survey Lab from January to December 2021 (response rate of 94 %). The survey included a set of 14 items identifying statewide efforts to address the opioid epidemic and six funding sources. We calculated the percentage of SSAs that supported each statewide effort and the percentage of SSAs reporting use of each source of funding across the 14 statewide efforts.

RESULTS

Treatment of opioid-related overdose figured most prominently among statewide efforts, with all SSAs providing funding for naloxone distribution and all but one SSA supporting naloxone training. Recovery support services, Project ECHO, and Hub and Spoke models were supported by the vast majority of SSAs. Statewide efforts related to expanding access to medications for opioid use disorder (MOUD) received somewhat less support, with 45 % of SSAs supporting mobile methadone/MOUD clinics/programs and 70 % supporting buprenorphine in emergency departments. A relatively low proportion of SSAs (54 %) provided support for syringe services programs. State Opioid Response (SOR) funds were the most common funding source reported by SSAs (57 % of SSAs), followed by block grant funds (19 %) and other state funding (15 %).

CONCLUSION

Results highlight a range of SSA efforts to address the nation's opioid epidemic. Limited adoption of efforts to expand access to MOUD and harm reduction services may represent missed opportunities. The uncertainty over reauthorization of the SOR grant post-2025 also raises concerns over sustainability of funding for many of these statewide initiatives.

How self-determination of scholars outclasses shrinking public research lab budgets, supporting scientific production: a case study and R&D management implications

The main purpose of this study is to analyze how reorganization of public research organizations and shrinking public research lab budgets affect the evolution of research activity and scientific productivity. This study focuses on a case study of National Research Council of Italy (CNR), one of largest European public research organizations, to identify evolution of research activities and dynamics of scientific production from 2000 to 2019. The statistical analysis suggests that, in line with the origin of the CNR, scientific research focuses mainly on research fields of natural sciences, such as chemical, life and physical sciences, with an increasing role of scientific research in energy, engineering and mathematics. The study also shows a high intensity of collaboration of the CNR within international research networks. A key finding of this study is to show, for the first time, that although uncertain reforms and reductions of public funds, scientific productivity is growing. This novel result can be explained with self-determination of scholars as a vital determinant supporting scientific production that outclasses shrinking public research lab budgets and organizational deficiencies. The management and research policy implications of this study can be generalized to support an efficient organizational and managerial behavior, and higher scientific productivity of public research institutes in contexts of reduced public funding and market turbulence.