Author ORCID Identifier

Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)


Public Health

First Advisor

Daniel Whitaker

Second Advisor

Therese Pigott

Third Advisor

Barbara Andraka-Christou


The opioid crisis has continued relentlessly throughout the twenty-first century. In order to reduce negative impacts of the opioid crisis, we must increase use of highly effective, FDA-approved medications for opioid use disorder (MOUDs) – including formulations of buprenorphine, methadone, and naltrexone. A better understanding of the benefits of and barriers to MOUDs could inform strategies to increase use of MOUDs in the future. Thus, this dissertation aims to improve knowledge about the benefits of and barriers to MOUDs, with a particular focus on buprenorphine.

Study 1 synthesized findings from 21 peer-reviewed studies to assess the impact of buprenorphine treatment on quality of life (QoL) for individuals with opioid use disorder (OUD). Study 1 indicated that buprenorphine likely improves overall, physical, psychological, and social QoL, and may improve environmental QoL. Study 2 examined how the Patient Protection and Affordable Care Act (ACA) Medicaid expansion influenced income and rural-urban disparities in buprenorphine utilization. Study 2 showed that ACA Medicaid expansion reduced income disparities in buprenorphine utilization in urban, but not rural, communities. Study 3 described news media portrayals of MOUD benefits, while exploring differences in benefits described by medication type, time period, news source, and persuasion method. Study 3 found that fewer than half of articles about MOUDs discussed MOUD benefits, and news media attention toward methadone and naltrexone benefits was especially limited.

These findings highlight areas for improvement in health communication and health policy related to MOUDs. First, future health communication should emphasize improvements in QoL as a benefit of buprenorphine treatment to individuals with OUD, who often experience poor QoL. Moreover, communication of MOUD benefits in the news media may be improved through public health professional and journalist partnerships, which could in turn encourage MOUD treatment seeking and policymaker support for expanding MOUD access. Lastly, health policies may need to be tailored toward low-income rural areas to achieve more equitable buprenorphine access in the future. A summary of future research directions is also discussed.


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