Governing Addiction: The Role of the Government in Responding to the Opioid Crisis

In light of the growing frequency of health emergencies and epidemics, state and local governments are beginning to take a more active role in response efforts. This role used to be exclusively held by health-related agencies such as health departments. Although public health has made significant progress in the study of these emergencies, they often ignore the existing strategies in the field of emergency management. Thus, limited research exists on the effectiveness of emergency management strategies within the context of public health emergencies. This research fills this gap by examining the impact of emergency management strategies used within the opioid epidemic, a pervasive and growing health crisis. The main contributions of this research to the field of public administration are three-fold. First, it contributes to the literature on emergency management and planning by analyzing the impact of opioid response plans and emergency declarations on policy enactment. Results from a plan quality assessment (n=69) and legislative scan (n=2,110) revealed that the presence and quality of a plan impacted the number and speed of policies enacted. Second, it adds to the literature on collaborative governance by examining the relationship between power and policy capture. Using a case study of a cross-sector task force in West Palm Beach, FL, quantitative and qualitative discourse network analysis revealed that policy capture was present within the network. Strategies were identified that facilitated and inhibited this process. Third, this study adds to the literature on organizational culture and change by examining first responder role changes caused by implementing opioid-related polices. Using interviews (n=30), secondary sources (n=161) and virtual observations (n=10), findings reveal that first responder roles are actively changing to meet growing community needs, but these changes are welcome if they align with their life-saving role. Overall, this study highlights the role that government agencies play in providing solutions to the opioid epidemic, an overlooked topic in both public administration and public health. More importantly, the information produced from this study can be used to design better statewide and local responses to the opioid epidemic