Substance Use

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

Parent Preferences For Pediatric Clinician Messaging To Promote Smoking Cessation Treatment

Jun. 22, 2020

Brian P. Jenssen, Mary Kate Kelly, Jennifer Faerber, Chloe Hannan, David A. Asch, Justine Shults, Robert A. Schnoll, Alexander G. Fiks

Abstract [from journal]

Background and objectives: Insights from behavioral economics suggests that the effectiveness of health messages depends on how a message is framed. Parent preferences for smoking cessation messaging has not been studied in pediatrics, warranting further exploration to maximize benefit. We sought to assess parents' perceptions regarding the relative importance of distinct message framings to promote their smoking cessation.

Methods: We conducted a cross-sectional discrete choice experiment in


Providing Incentive for Emergency Physician X-Waiver Training: An Evaluation of Program Success and Postintervention Buprenorphine Prescribing

May. 25, 2020

Sean D. Foster, Kathleen Lee, Christopher Edwards, Arthur P. Pelullo, Utsha G. Khatri, Margaret Lowenstein, Jeanmarie Perrone

Abstract [from Journal]

Study objective: Emergency department (ED) initiation of buprenorphine for patients with opioid use disorder increases treatment engagement but remains an uncommon practice. One important barrier to ED-initiated buprenorphine is the additional training requirement (X waiver). Our objective is to evaluate the influence of a financial incentive program on emergency physician completion of X-waiver training. Secondary


Preadmission Cannabis Use Is Positively Correlated With Inpatient Opioid Dose Exposure In Hospitalized Patients With Inflammatory Bowel Diseases

Shivan J. Mehta, MD, MBA
May. 22, 2020

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


Background: Opioid use is associated with excess mortality in patients with inflammatory bowel disease (IBD). Recent data have highlighted that inpatient opioid exposure is associated with postdischarge opioid use in this population. It is unknown if preadmission use of cannabis, which is commonly used for symptom relief among patients with IBD, increases the risk for inpatient opioid exposure when patients lack access to cannabis for symptom management. We sought to determine the association between preadmission


Receipt Of Substance Use Counseling Among Ambulatory Patients Prescribed Opioids In The United States

May. 22, 2020

Kirk E. Evoy, Charles E. Leonard, Jordan R. Covvey, Leslie Ochs, Alyssa M. Peckham, Samantha Soprano, Kelly R. Reveles

Abstract [from journal]

Background: As opioid-related overdose deaths climb in the U.S., risk reduction measures are increasingly important. One such measure recommended involves provision of proactive substance use counseling regarding the risks of opioid analgesics. This is particularly important in patients at increased risk of overdose, such as those with substance use disorders (SUD) or those receiving concomitant medications that further increase the overdose risk (eg, benzodiazepines, gabapentinoids, or Z-hypnotics). However, previous


Valence of Media Coverage About Electronic Cigarettes And Other Tobacco Products From 2014-2017: Evidence From Automated Content Analysis

Robert C. Hornik, PhD
May. 19, 2020

Kwanho Kim, Laura A Gibson, Sharon Williams, Yoonsang Kim, Steven Binns, Sherry L Emery, Robert C Hornik

Abstract [from journal]

Introduction: As media exposure can influence people's opinions and perceptions about vaping and smoking, analyzing the valence of media content about tobacco products (i.e., overall attitude toward tobacco, cigars, electronic cigarettes, etc.) is an important issue. This study advances the field by analyzing a large amount of media content about multiple tobacco products across six different media sources.

Methods: From May 2014 to December 2017, we collected all English-language media items about...

Incidence Of Treatment For Opioid Use Disorder Following Nonfatal Overdose In Commercially Insured Patients

May. 1, 2020

Austin S. Kilaru, Aria Xiong, Margaret LowensteinZachary F. MeiselJeanmarie PerroneUtsha KhatriNandita MitraM. Kit Delgado

Abstract [from journal]

Importance: Timely initiation and referral to treatment for patients with opioid use disorder seen in the emergency department is associated with reduced mortality. It is not known how often commercially insured adults obtain follow-up treatment after nonfatal opioid overdose.

Objective: To investigate the incidence of follow-up treatment following emergency department discharge after nonfatal opioid overdose and patient characteristics associated with receipt of follow-up treatment.


Persistent Postoperative Opioid Use: A Systematic Literature Search of Definitions and Population-based Cohort Study

Mar. 31, 2020

Naheed K. Jivraj, Faizal Raghavji, Jennifer Bethell, Duminda N. Wijeysundera, Karim S. Ladha, Brian T. Bateman, Mark D. Neuman, Hannah Wunsch

Abstract [from journal]

Background: While persistent opioid use after surgery has been the subject of a large number of studies, it is unknown how much variability in the definition of persistent use impacts the reported incidence across studies. The objective was to evaluate the incidence of persistent use estimated with different definitions using a single cohort of postoperative patients, as well as the ability of each definition to identify patients with opioid-related adverse events.

Methods: The literature was reviewed to


Neonatal Opioid Withdrawal Syndrome (NOWS): A Transgenerational Echo of the Opioid Crisis

Mar. 30, 2020

Andrew E. Weller, Richard C. Crist, Benjamin C. Reiner, Glenn A. Doyle, Wade H. Berrettini

Abstract [from journal]

The incidence of neonatal opioid withdrawal syndrome (NOWS) has increased substantially in the setting of the opioid epidemic, a major public health problem in the United States. At present, NOWS has commonly used assessment and treatment protocols, but new protocols have questioned old practices. However, because of limited access to opioid use disorder (OUD) treatment and socioeconomic factors, many pregnant (and postpartum) women with OUD do not receive treatment. The pathophysiology of NOWS is not completely understood, although limited research


Local Health Departments and the Implementation of Evidence-Based Policies to Address Opioid Overdose Mortality

Carolyn Cannuscio, ScD
Mar. 26, 2020

Rachel Feuerstein-Simon, Margaret Lowenstein, Meghana Sharma, Roxanne Dupuis, Xochitl Luna Marti, Carolyn C. Cannuscio

Abstract [from journal]

Background: In the context of the opioid overdose crisis, local health departments are on the front lines, coordinating programs and services and translating state and federal policies into community action. While media reports describe growth of Overdose Education and Naloxone Distribution (OEND) programs among local health departments, little is known about program features, scope, and target populations. 

Methods: We surveyed health departments in 180 United States counties with high overdose mortality rates


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