Andres Roman-Urrestarazu

2021/2022 Recent Returners

Andres Roman-Urrestarazu, M.D., Ph.D., M.Sc

Andres Roman-Urrestarazu, M.D., Ph.D., M.Sc., is a 2021–22 U.K. Harkness Fellow in Health Care Policy and Practice, where he studied at Stanford University.  The focus of his study was Health System Responses to the Opioid Epidemic in the United States

Andres is an academic psychiatrist, public health doctor, and Senior Research Associate at the University of Cambridge. He is also an Assistant Professor at Maastricht University and an Honorary Consultant Clinical Academic Staff at Office for Health Improvement and Disparities. He was previously a Gillings Fellow in Global Public Health (2016–2020). He is a Member of the Faculty of Public Health and a Board Member of the International Society for the Study of Emerging Drugs (ISSED), and worked as Civil Servant in the Centre for Health Technology Evaluation (CHTE) at the National Institute for Health and Care Excellence (NICE). His research lies at the intersection of health policy and public mental health, with a focus on the intersection of health inequalities and the economic determinants of adverse mental health outcomes in the field of substance use and addiction. His work has been published in leading health policy and medical journals, including JAMA Pediatrics, BMJ, and Health Policy, and has directly informed policy. In 2016, he submitted evidence to the House of Commons for the UK Psychoactive Substances Act. He has a Ph.D. in Psychiatry from the University of Cambridge, M.D. from the University of Santiago in Chile, and M.Sc. in International Health Policy from the London School of Economics and Political Science.

The opioid epidemic is among the most pressing public health problems in the United States. According to the Centers for Disease Control and Prevention, between 1999 and 2019 nearly 500,000 people died of opioid overdose, with deaths increasing 28.8 percent in 2020. Despite the urgent need for improving the accessibility and uptake of opioid misuse treatment, systemic barriers persist, particularly with respect to the type and mode of treatment available. Opioid agonist treatments (OATs), such as methadone or buprenorphine, are cost-effective and evidence-based, especially when compared to abstinence-based treatments. Nevertheless, OATs have historically been subject to heightened scrutiny in the U.S. and are strictly regulated by the Drug Addiction Treatment Act (DATA).

The primary aim of Andres’ project was to investigate how Opioid Treatment Programs (OTPs) have been implemented at the federal and state levels, and how recent policy reform has dealt with this public health challenge.  The key findings were a model of assessing effective coverage for mental health and substance abuse services and a quantitative analysis in the role that private equity and venture capital play in provider responses. His work as Harkness Fellow has already been published in JAMA Pediatrics and Lancet Child and Adolescent Health. He also used his time in Palo Alto to expand his skills in machine learning and artificial intelligence methods.