Factors associated with state legislators’ support for opioid use disorder parity laws

Katherine L. Nelson, Jonathan Purtle

Research output: Contribution to journalArticlepeer-review


Background: In the United States, state behavioral health parity laws play a crucial role in ensuring equitable insurance coverage and access to substance use disorder treatment and services for people that need them. State legislators have the exclusive authority to adopt these laws. The purpose of this study was to identify legislator beliefs independently associated with “strong support” for opioid use disorder (OUD) parity. Methods: Data were from a 2017 cross-sectional, state-stratified, multi-modal survey of state legislators (N = 475). The dependent variable was “strong support” for OUD parity. Primary independent variables were beliefs about state parity laws. Bivariate analyses and mixed effects logistic regression were conducted. Results: Legislators who “strongly supported” OUD parity were significantly more likely than legislators who did not “strongly support” OUD parity to be female (64.1% vs. 46.5%, p<.001), Democrat (76.2% vs. 29.3%, p<.001), and have liberal, compared to conservative, ideology (85.6% vs. 27.1%, p<.001). After adjusting for legislator demographics and state-level covariates, beliefs such as agreeing that state parity laws do not increase health insurance premium costs (aOR=6.77, p<.01) and that substance use disorder treatments can be effective (aOR=5.00, p<.001) remained associated with “strong support” for OUD parity. These state legislators’ beliefs were more strongly associated with “strong support” for OUD parity than political party, ideology, and other demographic and state-level characteristics. Conclusions: Dissemination materials and communication strategies to cultivate support for OUD parity laws among state legislators should focus on the fiscal impacts of parity laws and the effectiveness of substance use disorder treatments.

Original languageEnglish (US)
Article number102792
JournalInternational Journal of Drug Policy
StatePublished - Aug 2020


  • Behavioral health parity laws
  • Opioid use disorder
  • State legislators
  • Cross-Sectional Studies
  • United States
  • Humans
  • Opioid-Related Disorders
  • Female
  • Logistic Models
  • Politics

ASJC Scopus subject areas

  • Health Policy
  • Medicine (miscellaneous)


Dive into the research topics of 'Factors associated with state legislators’ support for opioid use disorder parity laws'. Together they form a unique fingerprint.

Cite this