Answer all questions in complete English sentences and use proper APA citation when appropriate

Paper 2 (Cicero et al., 2018)

Cicero, T. J. et al. (2018). Increased use of Heroin as an Initiating Opioid of Abuse: Further

Considerations and Policy Implications. Additive Behaviors, 87, 267-271.

Instructions: Answer all questions in complete sentences and use proper APA citation

when appropriate. Each question is worth 11.1 points. Question/Answer format is

required.

PURPOSE OF RESEARCH AND THE ‘TREATMENT GAP’

1. State the purpose of the Cicero et al. (2018) research. How is the 2018 paper an elaboration of the 2017 paper?

The research conducted by (CIcero, Kasper, & Ellis, 2018) is a follow-up a previously by the same scholars on heroin for first-time opioid abusers. In the follow-up research, the scholars aim to explain further the impact of heroin being the gateway option for opioid addicts. In the 2018 study, policy implications instituted to curb opioids abuse are tested to determine the impact they have on the overall opioid pandemic. In the study (Cicero, Ellis, & Kasper, 2017), the methodology employed to obtain data involved qualitative research. A sample size of five thousand, eight hundred and eighty-eight respondents were interviewed about the specific type of opioid product they regularly used and made them sink into addiction. All of the respondents were former users who had approached a rehabilitation institution for substance abuse treatment. In the following year, 2018, the same scholars aim to obtain more intensive data by selecting a sample size of people seeking substance abuse help. Still, their first experience with opioids must be within the last five years (2013-2017).

2. What is the ‘treatment gap’ that Cicero et al. (2018) mentions? How did the ‘treatment gap’ manifest itself in Figure 1 (Cicero et al., 2018, p. 268)?

The treatment gap is the period from when an individual begins abusing a certain until the time when they acknowledge to be having a problem and seek help. On considering the line characteristic curve for heroin as the opioid initiator to the number of individuals coming out to seek help from substance abuse, heroin use as the initiator has grown steadily but constantly. From the year 2005, the percentage of individuals seeking help admitted to having been introduced to opioids through heroin rose from 8.7% to 31.6%. As reflected from the results, people who get introduced into opioid regular use from an initial prescription from oxycodone, hydrocodone, and other opioid family medications take longer before asking for help. As the rate of heroin initiation gets larger, the time from first use to rehabilitation is significantly reduced.

(Cicero, Kasper, & Ellis, 2018, p. 268)

To adjust for the treatment gap, the scholars (CIcero, Kasper, & Ellis, 2018), since the accuracy of the results could be greatly affected if the respondents' sample is not large enough, the researchers examine the number of patients who are recruited into the substance abuse recovery center from the SKIP program. SKIP stands for, nationwide Survey of Key Informants' Patients program. It is an essential player for the RADARS system. RADARS system stands for; Researched Abuse, Diversion, and Addiction-Related Surveillance protocol. It is a set of programs that obtain and process information on the abuse of opioids through street heroin opioid-based pain reliever prescriptions.

HYPOTHESES

3. If the main research hypothesis, in stylized form, for this trend study, is

The annual percentage of SKIP respondents who indicated initiating regular opioid use with heroin exhibited a steadily increasing trend relative to the yearly percentage of those SKIP respondents who indicated initiating regular opioid use with prescription opioids over the 2005-2015 time period.

State the corresponding null hypothesis.

(HINT: dependent variable is “opioid of first regular use” with levels – heroin versus prescription opioids (hydrocodone and/or oxycodone) – and independent variable is time or more specifically, “year beginning regular use of opioid.” Figure 1 may be helpful.)

The relative increase in Heroin availability compared to hydrocodone/oxycodone prescription is not why it's the opioid of choice for first-time regular use, from 2013 to 2017.

SAMPLING AND SURVEY

4. As best you can, describe the sample design for the SKIP Program.

SKIP's sample design is a distributed sampling that utilizes one hundred and fifty public and private substance abuse recovery centers.

5. What is the data-collection mode of administration used by SKIP Program? What sort of

interview format was employed in SKIP Program survey? (HINT: cf, Dixon et al., 2019,

pps. 215-216 and pps. 221- 229).

The questionnaire design involves bounded questions. The interview type adopted for the study is the semi-structured type.

FINDING AND LIMITATIONS

6. Discuss the construction of variable named year beginning regular opioid use and how

Cicero et al. (2018) used it in the analysis of the SKIP Program data.

The variable named 'year beginning opioid use' was a variable since the opioid-based pain killer prescription policies directly impact hydrocodone and oxycodone.

7. What are the study’s main findings?

Unlike the study conducted in 2017, the follow-up research reflects the impact of installed policies towards opioids abuse. While controlling opioid prescription has reduced hydrocodone and oxycodone abuse, it has created a niche for heroin on opioid-dependent individuals. In the data obtained from the recovering individuals, people who had admitted to having at least abused heroin or opioid prescribed medication were also interviewed to observe the correlation and comparison of illegal and legal drug abuse and the treatment gap. While the study conducted in 2017 aims to determine the percentage of individuals introduced into opioids through heroin, the follow-up 2018 research focuses on establishing a correlation between the initiation opioid (heroin or prescription) and the treatment gap. Although the treatment gap for people who get initiated through heroin is considerably smaller, it is the most fatal due to overdose risk since street drugs don't feature a piece of quantifiable, empirical potency information. For instance, heroin can be mixed with compounds such as fentanyl that pose more danger to overdose.

8. What are the limitations of the study? (HINT: Do not forget to consider the nature of the sample.)

The national data obtained from the RADARS’ SKIP platform is owned by Denver Health which has all exclusive rights for the information. Users who have not participated in the data collection or analysis cannot access the unprocessed data. Such a setting restricts pure data acquisition even for the subscribers. Since all the scholars didn’t have direct access to the unprocessed information, the research was based on already processed information.

References

Dixon, J. C., Singleton, R. A., & Straits, B. (2019). The Process of Social Research, (2nd ed.). NY: OUP.

Cicero, T. J. et al. (2017). Increased use of Heroin as an Initiating Opioid of Abuse. Additive Behaviors, 74, 63-67.