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Policy Mapping Trauma-Informed Care with the Opioid Epidemic

By Laura Braden Quigley, CTIPP's Director of Communications and Outreach


A new study (Psychological Trauma: Theory, Research, Practice, and Policy, 14(7), 1158–1166) is the first to use trauma-informed policy analysis to systematically assess the U.S. Congressional response to the opioid epidemic.


The opioid epidemic was declared a national public health emergency in 2017. Given the strong and bidirectional relationship between trauma and substance misuse, policy responses to this crisis that reflect principles of trauma-informed care are especially salient.


The authors used policy mapping methods to build and analyze a dataset of all opioid-related bills and resolutions proposed in Congress between 2009 and 2017 (N = 188).


Following an established trauma-informed policy analysis framework, the researchers reviewed these policies and coded their incorporation of trauma-specific language and the principles of safety; choice; trust and transparency; collaboration and peer support; empowerment; and intersectionality. They also calculated coding frequencies in these categories and rates of intercoder agreement.


RESULTS: A minority of policies (10.6%) directly mentioned trauma and 55% of policies incorporated at least one trauma-informed principle. Safety was the most commonly coded principle (38.3%), while intersectionality was the least (6.9%).


CONCLUSIONS: Their analysis found "limited attention to trauma in opioid-related federal legislation. Based on these findings and following the example of coalitions such as the Campaign for Trauma-Informed Policy and Practice, advocates can mobilize for better inclusion of trauma-informed principles in opioid policy. Further, this study demonstrates the feasibility of applying the trauma-informed policy analysis framework to code Congressional policies using publicly available data, a replicable methodology with potential application at federal and state levels."


In 2017, CTIPP released a policy brief reviewing the evidence linking trauma and Adverse Childhood Experiences (ACEs) to opioid addiction. It also provided examples of effective prevention and treatment programs, and described innovative approaches being used by communities to address the current epidemic.


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