Substance Use

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

Pain Catastrophizing as a Predictor of Suicidal Ideation in Chronic Pain Patients with an Opiate Prescription

Feb. 21, 2020

Lily A. Brown, Kevin G. Lynch, Martin Cheatle

Abstract [from journal]

Chronic pain and opioid use are associated with increased risk for suicidal ideation and behaviors (SIB) in cross-sectional studies, particularly among individuals who catastrophize about their pain. This study examined the longitudinal association between two styles of pain coping, catastrophizing and hoping/praying, as predictors of subsequent SIB, as well as possible mediators of this association among patients with chronic pain receiving long-term opioid therapy. Participants (n = 496) were adults with chronic nonmalignant pain on long-term opioid


Drug Enforcement Agency 2014 Hydrocodone Rescheduling Rule and Opioid Dispensing After Surgery

Feb. 19, 2020

Mark D. Neuman, Sean Hennessy, Dylan S. Small, Craig Newcomb, Lakisha J. Gaskins, Colleen M. Brensinger, Duminda N. Wijeysundera, Brian T. Bateman, Hannah Wunsch

Abstract [from journal]

Background: In 2014, the U.S. Drug Enforcement Agency reclassified hydrocodone from Schedule III to Schedule II of the Controlled Substances Act, resulting in new restrictions on refills. The authors hypothesized that hydrocodone rescheduling led to decreases in total opioid dispensing within 30 days of surgery and reduced new long-term opioid dispensing among surgical patients.

Methods: The authors studied privately insured, opioid-naïve adults undergoing 10 general or orthopedic surgeries between 2011 and


Age and Postoperative Opioid Prescriptions: A Population-Based Cohort Study of Opioid-Naïve Adults

Feb. 13, 2020

Jennifer Bethell, Mark D. Neuman, Brian T. Bateman, Andrea D. Hill, Karim S. Ladha, Duminda N. Wijeysundera, Hannah Wunsch

Abstract [from journal]

Purpose: Opioids are commonly prescribed for acute pain after surgery. However, it is unclear whether these prescriptions are usually modified to account for patient age and, in particular, opioid-related risks among older adults. We therefore sought to describe postoperative opioid prescriptions filled by opioid-naïve adults undergoing four common surgical procedures.

Methods: This retrospective cohort study used individually linked surgery and prescription opioid dispensing data from Ontario, Canada to create


Should Physicians “Prescribe” Cannabis?

Jan. 21, 2020

Over the last decade, medical cannabis has moved from the fringe to the mainstream—at least in some states. Nearly 900,000 Americans were registered cannabis patients in 2017, which is more than a ten-fold increase since 2009. By the end of 2020, over two-thirds of states and the vast majority of Americans will live in a state with legal access to either medicinal or recreational marijuana.

Offering Payment in Clinical Research: Enrolling Individuals With or at Risk for Opioid Use Disorder

Jan. 10, 2020

Candace Wickliffe, Holly Fernandez Lynch, Emily A. Largent

Abstract [from journal]

Offering payment is an important means of facilitating research participation. Yet, offers of payment raise ethical challenges that may be heightened when prospective participants suffer from or are at risk for opioid use disorder (OUD). We surveyed principal investigators (PIs) conducting research in this population to characterize the relative importance they assign to various ethical and practical factors when designing offers of payment and also analyzed descriptions of payment in both their study advertisements and consent forms. Overall, we


Hospital Financial Incentives to Improve Care After Opioid Overdose

Jan. 6, 2020

Two patients are treated for opioid overdose at two different hospitals, just a few miles apart. The first hospital provides life-saving treatment to reverse the overdose and watches the patient for an hour, discharging them when deemed “medically stable.” The second hospital also provides life-saving treatment but then offers counseling, medication to prevent recurrent overdose and treat opioid withdrawal, and assistance navigating to outpatient treatment for the next day.

Impact of the Young Adult Dependent Coverage Expansion on Opioid Overdoses and Deaths: a Quasi-Experimental Study

Kit Delgado, MD, MS
Jan. 2, 2020

Edouard Coupet Jr, Rachel M. Werner, Daniel Polsky, David Karp, M. Kit Delgado 

Abstract [from journal]

Background: Several policymakers have suggested that the Affordable Care Act (ACA) has fueled the opioid epidemic by subsidizing opioid pain medications. These claims have supported numerous efforts to repeal the ACA.

Objective: To determine the effect of the ACA's young adult dependent coverage insurance expansion on emergency department (ED) encounters and out-of-hospital deaths from opioid overdose.

Design: Difference-in-differences analyses comparing ED encounters and out-of-hospital


Exposure to Intravenous Opioids is Associated With Future Exposure to Opioids in Hospitalized Patients With Inflammatory Bowel Diseases

Shivan J. Mehta, MD, MBA
Dec. 27, 2019

Rahul S. Dalal, Sonali Palchaudhuri, Christopher K. Snider, James D. Lewis, Shivan J. Mehta, Gary R. Lichtenstein

Abstract [from journal]

Backgorund & Aims: Opioid use is associated with increased mortality in patients with inflammatory bowel diseases (IBD). Hospitalized patients with IBD often receive high-potency intravenous opioids (IVOPIs). It is not known whether exposure to IVOPIs affects post-discharge opioid use or complications. We investigated the association between inpatient administration of IVOPIs and a post-discharge opioid prescription (OPIRx) in patients with IBD.

Methods: We performed a retrospective cohort study of 862