Substance Use

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

The Origins of the Opioid Epidemic

Dec. 2, 2019

A state prescription drug policy first adopted in 1939, and last ended in 2004, appears to have influenced where Purdue Pharma chose to market its opioid drug OxyContin upon launch in 1996. The consequences of that decision reverberate to this day, according to a new NBER paper by LDI Senior Fellow Abby Alpert and colleagues, who estimate that states with the prescription policy had 11.4 fewer overdose deaths per 100,000 people in 2017. Let that sink in for a moment. In 2017.

Long-Term Use of Hydrocodone vs. Oxycodone in Primary Care

Dec. 1, 2019

Rebecca Arden Harris, Henry R. Kranzler, Kyong-Mi Chang, Chyke A. Doubeni, Robert Gross

Abstract [from journal]

Background: Hydrocodone and oxycodone are the Schedule II opioids most often prescribed in primary care. Notwithstanding the dangers of prescription opioid use, the likelihood of long-term use with either drug is presently unknown.

Methods: Using a retrospective cohort design and data from a commerical healthcare claims repository, we compared the likelihood of long-term use of hydrocodone and oxycodone in primary care patients presenting with acute back pain. Treatment


Online Reviews of Specialized Drug Treatment Facilities—Identifying Potential Drivers of High and Low Patient Satisfaction

Nov. 21, 2019

Anish K. Agarwal, Vivien Wong, Arthur M. Pelullo, Sharath Guntuku, Daniel Polsky, David A. Asch, Jonathan Muruako, Raina M. Merchant

Background: Despite the importance of high-quality and patient-centered substance use disorder treatment, there are no standardized ratings of specialized drug treatment facilities and their services. Online platforms offer insights into potential drivers of high and low patient experience.

Objective: We sought to analyze publicly available online review content of specialized drug treatment facilities and identify themes within high and low ratings.



When Patients Take Charge of Opioids: Self-Management Concerns and Practices Among Cancer Outpatients in the Context of Opioid Crisis

Nov. 8, 2019

Salimah H. Meghani, Jesse Wool, Jessica Davis, Katherine A. Yeager, Jun J. Mao, Frances K. Barg

Abstract [from journal]

Context: With concerns about opioid prescribing practices prominent in the professional and lay literature, there is less focus on patients’ self-management of opioids for cancer pain and potential safety risks.

Objectives: To investigate reports of opioid self-management practices and concerns among patients undergoing active cancer treatments—a group excluded from the scope of most policy initiatives on prescription opioids


Flavored E-cigarette Use and Progression of Vaping in Adolescents

Nov. 1, 2019

Adam M. Leventhal, Nicholas I. Goldenson, Junhan Cho, Matthew G. Kirkpatrick, Rob S. McConnell, Matthew D. Stone, Raina D. Pang, Janet Audrain-McGovern, Jessica L. Barrington-Trimis

Abstract [from journal]

Objectives: Electronic cigarettes (e-cigarettes) are available in nontraditional flavors (eg, fruit and candy) that are banned in combustible cigarettes in the United States. Whether adolescent use of e-cigarettes in nontraditional flavors prospectively predicts continuation of vaping and progression to more frequent vaping is unknown.

Methods: High school students in Los Angeles, California, completed 5 semiannual surveys (2014-2017 [10th grade to 12th grade]). Among past-6-month e-cigarette users at survey


Changes in Infective Endocarditis Admissions in Pennsylvania During the Opioid Epidemic

Oct. 20, 2019

Jessica A MeisnerJudith Anesi, Xinwei Chen, David Grande

Abstract [from journal]

Background: With the current opioid crisis in the US, infectious complications related to injection drug use are increasingly reported. Pennsylvania is at the epicenter of the opioid crisis with the third highest rate of drug overdose deaths in the US.

Methods: A retrospective cohort study was performed using the Pennsylvania Health Care Cost Containment Council database during 01/01/2013 to 03/31/2017 of all residents hospitalized for infective endocarditis (IE) in an acute care hospital. Patients were


Association of Opioids With Incisional Ocular Surgery

Brian L. Vanderbeek, MD, MPH
Sep. 19, 2019

Anton M. Kolomeyer, Yinxi Yu, Brian L. VanderBeek

Abstract [from journal]

Importance: Opioid abuse has been declared a public health emergency. Currently, little is known about the association between opioids and ocular surgery.

Objective: To characterize rates of filled opioid prescriptions after incisional ocular surgeries.

Design, Setting, and Participants: This cohort study included patients with incisional ocular surgeries within a large national US insurer's administrative medical claims database. All incisional ocular surgeries from January 2000 through


Fast-tracking Behavioral Health Care

Sep. 17, 2019

Imagine struggling with a behavioral health issue, searching for a local psychiatrist, and finding out the provider you’ve chosen doesn’t accept insurance. You wouldn’t be alone: most psychiatrists in the United States don’t. But let’s say your plan has some out-of-network benefits, which means you pay the full cost up front and request an itemized receipt for every appointment.

Opioid Prescribing After Surgery in the United States, Canada, and Sweden

Mark D. Neuman, MD
Sep. 4, 2019

Karim S. Ladha, Mark D. Neuman, Gabriella Broms, Jennifer Bethell, Brian T. Bateman, Duminda N. Wijeysundera, Max Bell, Linn Hallqvist, Tobias Svensson, Craig W. Newcomb, Colleen M. Brensinger, Lakisha J. Gaskins, Hannah Wunsch

Abstract [from journal]

Importance: Small studies and anecdotal evidence suggest marked differences in the use of opioids after surgery internationally; however, this has not been evaluated systematically across populations receiving similar procedures in different countries.

Objective: To determine whether there are differences in the frequency, amount, and type of opioids dispensed after surgery among the United States, Canada, and Sweden.

Design, Setting, and Participants: This cohort study included patients...