Substance Use

The use or misuse of substances such as alcohol, tobacco, cannabis (marijuana), stimulants, hallucinogens, and opioids.

Substituting Heroin for Prescription Opioids

Mar. 20, 2017

It seems self-evident: one way to address the epidemic of opioid deaths is to make prescription opioids harder to misuse. OxyContin, for example, is especially dangerous when it is crushed for ingestion, inhalation, or injection. In 2010, the FDA approved a reformulated, abuse-deterrent version of OxyContin that made the pill difficult to crush or dissolve. The new version immediately replaced the old one, marking a substantial reduction in the supply of abusable prescription pain relievers.

What Factors Affect Physicians’ Decisions to Prescribe Opioids in Emergency Departments?

Feb. 16, 2017

Lauren E Sinnenberg, Kathryn J Wanner, Jeanmarie Perrone, Frances K Barg, Karin Rhodes, Zachary Meisel

In MDM Policy & Practice, LDI Senior Fellows Zachary Meisel, Jeanmarie Perrone, Karin Rhodes, and colleagues assess the factors physicians consider when treating pain with opioids in the emergency department (ED).  With 42% of all ED visits in the United States related to pain, the ED is an ideal setting to target to curtail the current opioid overdose epidemic and develop opioid prescription guidelines and policies. The researchers interviewed 52 physicians at a national emergency medicine conference. They identified three main domains that contributed to the participants’...

Pennsylvania Launches its Prescription Drug Monitoring Program

Aug. 25, 2016

Prescribers are drawing a lot of attention as a key target of initiatives to combat the opioid crisis. This week, the US Surgeon General, Vivek Murthy, took the unprecedented step of sending 2.3 million clinicians a letter calling for a national movement to turn the tide on the opioid crisis.

Primary Care: On the Front Lines of the Opioid Crisis

Issue Brief
Aug. 9, 2016

This issue brief discusses the role of primary care teams in identifying illicit drug use disorders in their patients, the continuum of treatments that they can offer, and opportunities for successful collaboration and integration with specialists. The authors find opportunities exist for increased patient screening and delivering medication-assisted treatment as well as established models for collaboration and integration of opioid treatments. 

The Effect of a Sunday Liquor-Sales Ban Repeal on Crime: A Triple-Difference Analysis

Jun. 21, 2016

SeungHoon Han, Charles BranasJohn MacDonald

In Alcoholism: Clinical and Experimental Research, SeungHoon Han, Charles Branas and John MacDonald investigate whether alcohol availability in state-run liquor stores affects a neighborhood’s crime rates, and if the relationship between alcohol availability and crime differs based on a neighborhood’s socioeconomic status (SES).  In 2003, Pennsylvania repealed the Sunday alcohol-sales ban for a portion of its state-run stores. The authors utilized this policy change for their analysis. They find that the repeal was associated with a significant increase in total and property-crime...

Show Me the Money: Economic Evaluations of Opioid Use Disorder Interventions

Issue Brief
May. 25, 2016

This Issue Brief discusses treatments for opioid use disorders and summarizes a new systematic review of economic evaluations of these interventions. The review reveals strong evidence that methadone maintenance therapy is an economically advantageous form of treatment; the economic evidence for buprenorphine and naltrexone treatments is more limited.

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