Journal of Public Management & Social Policy


Over 300,000 Americans depend on opioid treatment programs (OTPs), commonly known as methadone clinics, as the sole source of substances used to reduce their addictive cravings for prescription opioid and heroin. Though considered creatures of the federal regulatory process, OTPs are also regulated by state and local authorities and are required to maintain accreditation. The result of this complex and multi-layered regulation is a focus on rule and process, not on client outcomes or program performance. This research explores the effectiveness of state regulation within the context of “regulatory fog” in which the very regulations intended to standardize provision of services may obscure the true value of policies.



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