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Recovery Support Services for Opioid Use Disorder in Maryland: A Mixed Methods Study with a Two-Paper Dissertation

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2024
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dissertation
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The alarming fatality rates associated with opioid use disorder (OUD) in the United States have triggered an increased level of public concern and awareness. Recognizing the urgency of addressing this crisis, adopting a fundamental proactive approach becomes imperative. Offering recovery support services (RSS) for individuals with OUD, in addition to treatment, emerges as a strategic pathway to guide society away from the opioid crisis. This two-paper dissertation is dedicated to comprehensively exploring RSS for individuals with OUD within Maryland. The first paper investigated the provision status of RSS across the local jurisdictions in Maryland. This investigation involved virtual interviews with key informants, examination of pertinent written documents, and online searches. While all jurisdictions had at least one service provider offering services for Mutual Support Groups, Care Coordination/Case Management, Medical Assistance Transportation, Harm Reduction, and Peer Support Services, considerable disparities in provision were observed among the twenty-four jurisdictions for the remaining RSS categories, RCC, WRC, Recovery Housing, Homeless Shelters, and Supported Employment Services. The second paper examined the associations between the provision of RSS, county-level covariates, and opioid overdose admission among jurisdictions in Maryland. In the second paper, the analysis incorporated the provision of RSS, the results from the first paper and secondary data including the Maryland State Emergency Department Database, Healthcare Cost and Utilization Project (2016-2020). Counties with more RSS were positively associated with opioid overdose admissions, compared to counties with fewer RSS. Drug overdose death rate, patient capacity rate, single-parent household rate, and non-Hispanic White rate were also positively associated with opioid overdose admissions. Notably, a significant reduction in opioid overdose admissions was observed in the year 2020 compared to the reference year, 2016.

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University of Maryland, Baltimore, School of Social Work, Ph.D. 2024
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