Date of Award


Degree Type

Open Access Dissertation

Degree Name

Public Health, DPH


School of Community and Global Health

Advisor/Supervisor/Committee Chair

Deborah Freund

Dissertation or Thesis Committee Member

Bin Xie

Dissertation or Thesis Committee Member

Paula Palmer

Terms of Use & License Information

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

Rights Information

© 2020 Mofoluwake Adeniyi


Drug Addiction, Medication Assisted Treatment, Opioid Dependence, Opioid Use Disorder, Opioids, Treatment of Opioid Dependence

Subject Categories

Public Health


Americans make and use the most opioids in the world. Although comprising somewhat less than 5% of the world’s population, the United States (US) produces approximately 90% of the global supply of Hydrocodone and consumes an estimated 80% of the total international supply. It is not surprising, therefore, that the American opioid epidemic, particularly as it involves adults (those 18 years and older), is worsening—Indeed, President Trump declared it a national public health emergency. Many therefore anticipate that the US Congress will enact evidence-informed policies to address the opioid crisis. Opioid Use Disorder (OUD) is a pattern of opioid use that leads to such adverse consequences as hormonal dysfunction, immune-system suppression, overdose, and death. The gold standard for OUD therapy is medication-assisted treatment (MAT), best described as managing OUD using methadone, buprenorphine, or naltrexone in addition to counseling and behavioral therapy. MAT access is low in the US. This study investigates access to MAT by age group in the US. Its primary aim is to investigate barriers faced by adults diagnosed with OUD in accessing MAT by examining the constructs in a conceptual framework that includes the influence of policy, environment, population features, health behavior, and health outcomes on access to MAT. Given the huge burden of OUD, findings from this project have important implications for policy and practice. Results suggest that barriers for adults diagnosed with OUD in accessing MAT include being male, being a young adult, and having some post-high school education but not at a four-year school. Other barriers are being an Alaskan Native/ American Indian, Asian/ Pacific Islander/ Native Hawaiian, or having another single or multiple racial background. In light of the implications drawn from these findings, it is recommended that policymakers develop better policies aimed at addressing the identified MAT access issues. It is also recommended that US public health organizations and practitioners implement effective age-friendly and culturally competent MAT programs to lower these barriers. Findings from this study also provide guidance for future opioid research and OUD-management initiatives at a time when the opioid crisis will compete with the current COVID-19 pandemic for already- scarce resources.



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