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Federalism, Opioids, Fiscal fragmentation, Regulatory failure, Substance Use Disorder


One thing we have seen today that we talk about in health law all the time is how the policy, the laws and institutions up at the 10,000 foot level, can so dramatically influence the personal, people’s lived experiences. Our speakers today have done a really great job of drawing out abstract institutional questions and also showing us how those questions have influenced the lives of real people in often tragic ways. Another thing we have seen that we talk about in administrative law all the time is the importance of expertise, especially given how hard it is to trace the impact of laws and institutions on real life. Thank you to our amazing experts who have come a long way to share with us great insights about the really important issue of substance use disorder, and showing us that there really are good answers and bad answers, and maybe even right answers and wrong answers. We have heard important insights about causes, effects, and real solutions that they and other researchers have produced by studying incredibly complicated problems in depth. These problems are nuanced and they are complicated and that is part of what makes expertise so valuable.

Before we walk away, I would like to take a moment to dwell on a third theme, which is that knowing the right answer or having the expertise is not necessarily enough to get that answer executed in policy and then to have it impact people on a personal level. Experts certainly can and should try to persuade—and we have talked a bit about how best to do so—to figure out the answers and just go tell the people the answers and get them to vote, or tell policymakers the best way to handle the problem they face. But we have seen throughout the day that persuasion is often not enough, in part because of structural barriers that inhibit the ability of those with power or authority to be persuaded, or otherwise constrain or impede their choices even when they are persuaded.

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Dickinson Law Review