Substance Use

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

National Variation in Opioid Prescription Fills and Long Term Use in Opioid Naive Patients After Urological Surgery

Jun. 5, 2019

Ian Berger, Marshall Strother, Ruchika Talwar, Justin Ziemba, Christopher Wirtalla, Leilei Xia, Thomas Guzzo, M. Kit Delgado, Rachel Kelz

Abstract [from journal]

Purpose: Prescription opioid use is increasing, leading to increased addiction and mortality. Post-operative care is often patients' first exposure to opioids, however little data exists on national prescription patterns in urology. We aimed to examine post-discharge opioid fills after urological procedures and their association with long term use.

Materials and Methods: We identified patients in a private national insurance database undergoing 15 urological procedures between October 1, 2010 and September 30,


Expanding Access to Naloxone: A Review of Distribution Strategies

Issue Brief
May. 29, 2019

Amidst an ongoing opioid crisis that claimed 47,600 lives in 2017, increasing the availability of the rescue medication naloxone is a high priority. Naloxone reverses an opioid overdose when given intranasally or intramuscularly. But to be effective, naloxone must be available at the time of overdose. Naloxone distribution to laypeople can save a life when first responders are not immediately available, or when people witnessing overdoses are unwilling or unable to call 911. Naloxone is increasingly available through some pharmacies under a standing order; however, even when available, cost and stigma barriers persist. This Issue Brief reviews recent evidence on the outcomes and cost-effectiveness of naloxone distribution strategies in community, pharmacy, and other health care settings.

Opioids and Hepatitis C: How OxyContin Fed a New Epidemic

Feb. 12, 2019

Purdue Pharma’s 2010 reformulation of OxyContin as an abuse-resistant pill was supposed to be a breakthrough in battling the burgeoning opioid epidemic. Purdue executives and policymakers touted the reformulation as a way to dampen the supply of abusable drugs, thereby reducing opioid addiction and death. Nearly a decade later, it appears that the policy had several serious unintended consequences.

Why Deaths Continue to Rise in the Opioid Epidemic

Jan. 22, 2019

Late last year, the Centers for Disease Control and Prevention (CDC) announced that more than 70,000 people died from drug overdoses in 2017, a 9.6% increase from 2016. Deaths continue to soar, even as states and health systems implement policies to curb the overprescribing of opioids that led to the epidemic in the first place. It’s hard not to be discouraged by these numbers and our failure to reduce overdose deaths.

Trends in Opioid Prescribing and Dispensing by Veterinarians in Pennsylvania

Jan. 17, 2019

Dana L. Clarke, Kenneth J. Drobatz, Chloe Korzekwa, Lewis S. Nelson, Jeanmarie Perrone

Abstract [from journal]

Importance: Veterinarians are a subset of opioid prescribers.

Objective: To assess the quantity and trends in prescribing and dispensing of several different opioids in the past 11 years in a large veterinary hospital in Philadelphia, Pennsylvania.

Design, Setting, and Participants: This cross-sectional study inventoried all opioid tablets and/or patches dispensed or prescribed by veterinarians practicing in a multispecialty academic veterinary teaching hospital in Philadelphia...

Cost-effectiveness of two opioid use disorder treatments

Dec. 18, 2018

[reposted from the CHERISH blog]

One key strategy in reducing deaths from the opioid epidemic is to improve access to existing evidence-based treatments. Two new economic studies by CHERISH Investigators Drs. Sean Murphy, Kathryn McCollister, and Bruce Schackman can help providers, patients, and payers sort through alternative pharmacotherapies to prevent opioid relapse.

Closing the gaps in opioid use disorder research, policy and practice: conference proceedings

Dec. 1, 2018

Matthew A. Miclette, Jared A. Leff, Isabella Cuan, Jeffrey H. Samet, Brendan Saloner, Gary Mendell, Yuhua Bao, Michael A. Ashburn, Marcus A. Bachhuber, Bruce R. Schackman, Daniel E. Polsky, Zachary F. Meisel

Abstract [from journal]

Drug overdose deaths involving opioids have surged in recent years and the economic cost of the opioid epidemic is estimated to be over $500 billion annually. In the midst of calls for declaring a national emergency, health policy decision makers are considering the best ways to allocate resources to curb the epidemic. On June 9, 2017, 116 invited health researchers, clinicians, policymakers, health system leaders, and other...