Substance Use

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

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...

Towards Automating Location-Specific Opioid Toxicosurveillance from Twitter via Data Science Methods

Aug. 21, 2019

Abeed Sarker, Graciela Gonzalez-Hernandez, Jeanmarie Perrone

Abstract [from journal]

Social media may serve as an important platform for the monitoring of population-level opioid abuse in near real-time. Our objectives for this study were to (i) manually characterize a sample of opioid-mentioning Twitter posts, (ii) compare the rates of abuse/misuse related posts between prescription and illicit opiods, and (iii) to implement and evaluate the performances ofsupervised machine learning algorithms for the characterization of opioid-related chatter, which can potentially automate social media based monitoring in the future.. We annotated


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.