• Elizabeth A Bowen and Andrew Irish.
• School of Social Work, University at Buffalo, State University of New York, 685 Baldy Hall, Buffalo, NY 14260, United States. Electronic address: eabowen@buffalo.edu.
• Int. J. Drug Policy. 2019 Dec 1; 74: 90-97.

BackgroundThe U.S. Congress has proposed numerous bills and resolutions in response to the opioid epidemic unfolding over the past decade. Although this legislative response has been the subject of considerable media attention and commentary, very little research has systematically analyzed congressional opioid-related legislation in terms of primary goals, focal populations, and the extent to which it includes punitive mechanisms.MethodsTo address this gap in research, we conducted a policy mapping content analysis of all opioid-related bills and resolutions (N = 188) proposed in Congress between 2009-2017 (111th - 115th Congresses). Two researchers independently coded basic characteristics (e.g. type, status, sponsorship, funding); goals, using a taxonomy developed by the researchers; focal populations; and punitive intent. Researchers compared codes and addressed discrepancies through consensus.ResultsLegislation addressed a wide range of goals, but frequently did not advance beyond the introduction stage (80.3%). Goals most often centered on treatment (43.1% of legislation), research (36.7%), and supply reduction of licit (34.0%) and illicit opioids (21.3%). Relatively little legislation addressed long-term recovery, avenues of safer drug consumption, or stigma reduction. Youth (21.3%) and veterans (17.0%) were the most common population categories toward which legislation was directed. Explicit attention toward racial/ethnic minorities, low-income populations, and sexual minorities was rare to nonexistent. Legislation was largely coded as not directly punitive (91.0%).ConclusionThis study represents the first systematic analysis of key features of the U.S. congressional response to the opioid epidemic. Results indicate that the legislative response has largely focused on acute intervention, with limited attention to upstream social determinants and goal areas such as long-term recovery support. While the legislative response is primarily non-punitive, most opioid-specific policy does not explicitly address the intersection of opioid misuse and addiction with salient social factors such as economic disinvestment and social isolation.Copyright © 2019 Elsevier B.V. All rights reserved.

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