Substance Use

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

HIV and Suicide Risk

Sep. 14, 2020

In recent years, remarkable achievements in HIV testing and antiretroviral therapies have improved the detection, management, and care of persons living with HIV (PLWH). In the 1980s and 90s, patients with HIV infection faced a devastating prognosis. But now, with proper medications and support, PLWH can enjoy long and fulfilling lives. Thus, when the topic of suicide among PLWH is raised, many physicians are surprised. They often ask me, “wasn’t suicide an issue of a time before we had access to antiretroviral therapies?”

These Key Telehealth Policy Changes Would Improve Buprenorphine Access While Advancing Health Equity

Sep. 11, 2020

[Original post: Utsha Khatri, Corey S. Davis, Noa Krawczyk, Michael Lynch, Justin Berk, Elizabeth A. Samuels, These Key Telehealth Policy Changes Would Improve Buprenorphine Access While Advancing Health Equity, Health Affairs Blog, September 11, 2020. Copyright ©2020 Health Affairs by Project HOPE – The People-to-People Health Foundation, Inc.]

Prevalence Of Psychotropic And Opioid Prescription Fills Among Community-Dwelling Older Adults With Dementia In The U.S.

Aug. 18, 2020

Donovan T. Maust, Julie Strominger, Julie P. W. Bynum, Kenneth M. Langa, Lauren B. Gerlach, Kara Zivin, Steven C. Marcus

Abstract [from journal]

This pharmacoepidemiology study uses Medicare data to estimate US prescription fills for antidepressants, anxiolytics, antipsychotics, opioids, and antiepileptics among community-dwelling older adults with dementia in 2014-2015, and identifies the most commonly prescribed medications.

Screening To Identify Signals Of Opioid Drug Interactions Leading To Unintentional Traumatic Injury

Jul. 30, 2020

Charles E. Leonard, Colleen M. Brensinger, Thanh Phuong Pham Nguyen, John R. Horn, Sophie Chung, Warren B. Bilker, Sascha Dublin, Samantha E. Soprano, Ghadeer K. Dawwas, David W. Oslin, Douglas J. Wiebe, Sean Hennessy

Abstract [from journal]

Background: Efforts to minimize harms from opioid drug interactions may be hampered by limited evidence on which drugs, when taken concomitantly with opioids, result in adverse clinical outcomes.

Objective: To identify signals of opioid drug interactions by identifying concomitant medications (precipitant drugs) taken with individual opioids (object drugs) that are associated with unintentional traumatic injury DESIGN: We conducted pharmacoepidemiologic screening of Optum Clinformatics Data


Hepatitis C and The Layering of Disease-Related Stigma

Jul. 28, 2020
“That's exactly how I feel like they look at you. Like, ‘You on drugs, you dirty, you homeless, you don't got nowhere to take yourself, staying yourself and take yourself.’ Why should they try to help you and give you the best care possible? For what? They could save it for somebody else that's doing all the right things versus give it to the people that's doing all the wrong things.” – HIV/HCV-coinfected study participant

Trends in Muscle Relaxant Prescribing

Jul. 21, 2020

As the opioid epidemic rages on, clinicians are looking towards safer medication alternatives for patients with acute and chronic pain. Skeletal Muscle Relaxers (SMRs) are a common opioid substitute for patients with musculoskeletal conditions. Although their use has grown at a rate similar to that of opioids, little is known about their safety and efficacy in treating long-term, chronic pain, particularly for older patients and patients with simultaneous opioid use.

Association Between Mothers' Postoperative Opioid Prescriptions and Opioid-Related Events in their Children: A Population-Based Cohort Study

Jul. 15, 2020

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

Abstract [from journal]

Background: Postoperative opioid prescriptions may be associated with risks of unintentional poisoning and drug diversion in other household members. The objective of this study was to explore the association between mothers' postoperative opioid prescriptions and incidence of opioid-related events in their children (aged 1 to 24 years).

Data and methods: This retrospective cohort study used individually linked administrative health data from Ontario, Canada. A population-based sample of 170,


Incidence Rates Of And Risk Factors For Opioid Overdose In New Users Of Prescription Opioids Among US Medicaid Enrollees: A Cohort Study

Jul. 10, 2020

Young Hee Nam, Warren B. Bilker, Francesco J. DeMayoMark D. NeumanSean Hennessy

Abstract [from journal]

Purpose: To measure incidence rates of and risk factors for opioid overdose among new users of prescription opioids in the Medicaid population.

Methods: A cohort study using Medicaid claims from four states (1999-2012) among adults continuously enrolled in Medicaid for ≥3 years free of opioid prescriptions and opioid overdose before cohort entry. Exposure and outcome of interest were prescription opioid use and apparent incident opioid overdose identified in inpatient and outpatient claims (


The Predictive Validity Of The Progress Assessment, A Clinician Administered Instrument For Use In Measurement-Based Care For Substance Use Disorders

Jul. 5, 2020

Deborah H. A. Van Horn, Jessica Goodman, Kevin G. Lynch, Marcel O. Bonn-Miller, Tyrone Thomas, A. C. Del Re, Kimberly Babson, James R. McKay

Abstract [from journal]

We tested the predictive validity of the Progress Assessment (PA), a brief counselor administered tool for use in measurement-based care for substance use disorders. The PA includes 5 items assessing relapse risk and 5 items assessing factors protective against relapse. Data were drawn from a completed study of continuing care for cocaine dependence (McKay et al., 2013) and includes 12 months of follow-up on158 participants (76% male) who received brief telephone or face-to-face sessions. Each session began with the administration of


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


Youth and Young Adult Use of Pod-Based Electronic Cigarettes From 2015 to 2019

Jun. 1, 2020

Stella Juhyun Lee, Vaughan W. Rees, Noam Yossefy, Karen M. Emmons, Andy S. L. Tan

Abstract [from journal]

Importance: The use of electronic cigarettes (e-cigarettes) has rapidly increased among youth and young adults, but knowledge gaps exist on the potential health effects of using recently introduced pod-based e-cigarettes.

Objective: To conduct a systematic review of recent peer-reviewed scientific literature on pod-based e-cigarettes.

Evidence Review: A search of online databases, including PubMed, Web of Science, Embase, and EBSCO HOST, was conducted to identify pod-based e-cigarette–...