Mireille Jacobson, associate professor of Economics and Public Policy and director of the Merage School’s Center for Health Care Management and Policy, recently spent time visiting the White House as a participant in a conference titled, “A Convening on Pay for Success and the Opioid Crisis.” There, she gave a presentation on three interventions that show potential in addressing the growing opioid epidemic in the United States.
“Initially, I was asked by a research group out of MIT, called the Abdul Latif Jameel Poverty Action Lab, or J-PAL, to conduct a literature review suggested by the White House on the evidence behind a set of approaches to dealing with the opioid epidemic. The goal of the review was to provide policymakers at state and local levels with information on models that might be financed through government “Pay for Success” (PFS) programs,” said Jacobson. “The invitation to present at the White House came out of this work.”
The three options Jacobson presented included:
- Extended-release naltrexone (XR-NTX) for criminal-justice involved populations to prevent opioid (and alcohol) relapse
- Syringe service programs (SSPs) for people who inject drugs
- Emergency Department (ED) peer counselors for overdose patients
“These interventions were identified as promising options for PFS-funded programs, albeit each with a varying degree of evidence to support it,” said Jacobson.
Evaluation criteria applied by J-PAL included:
- Does it fill a defined, unmet need?
- To what extent is it evidence-based and scalable?
- Does it have the potential to generate economic benefit (e.g., government cost-savings)?
MD/MBA student Tiffany Cho joined Jacobson in Washington D.C. and was responsible for conducting some of the research and analysis on the literature review project.
The White House conference comes at a time, according to the New York Times, when more people die from overdoses in the United States than from car crashes, and most of the overdoses are from opioids.
“This conference couldn’t have been more timely,” said Jacobson. “The White House actually had to turn people away from the event because the response was so overwhelming.” More than 200 people registered for the event, including federal, state and local officials, and representatives from foundations like the Pew Charitable Trusts, the Robert Wood Johnson Foundation, the Laura and John Arnold Foundation, among others. “I think this reflects the very deep interest in dealing with this crisis,” said Jacobson.
Jacobson will continue her work addressing the overwhelming need from policymakers trying to deal with the opioid epidemic. Currently, she is working with the Louisville Metro Department of Corrections — through J-PAL – in developing a Pay for Success program that links individuals in the jail system to treatment upon release. Among other things, they hope to test approaches that leverage insights from behavioral economics to increase treatment adherence and to evaluate the impact of such adherence on a range of outcomes including recidivism and labor force participation.