Ideas and Opinions2 April 2020An Epidemic in the Midst of a Pandemic: Opioid Use Disorder COVID-19FREEG. Caleb Alexander, MD, MS, Kenneth B. Stoller, Rebecca L. Haffajee, JD, PhD, MPH, Brendan Saloner, PhDG. MSJohns Hopkins Bloomberg School Public Health Johns Medicine, Baltimore, Maryland (G.C.A.), MDJohns University (K.B.S.), MPHRAND Corporation, Boston, Massachusetts, Michigan, Ann Arbor, Michigan (R.L.H.), PhDJohns Health, (B.S.)Author, Article, Disclosure...

Thinking Globally, Acting Locally The defining feature of the U.S. response to Covid-19 has been localized action against a global threat. Under our federalist system, what more can federal gov...

Opioid overdose deaths in the United States continue to increase, reflecting a growing need treat those with opioid use disorder (OUD). Little is known about counties high rates of mortality but low availability OUD treatment.

At least 2.3 million people in the U.S. have an opioid use disorder, less than 40% of whom receive evidence-based treatment. Buprenorphine used as part medication-assisted treatment has high potential to address this gap because its approval for non-specialty outpatient settings, effectiveness at promoting abstinence, and cost effectiveness. However, 4% licensed physicians are approved prescribe buprenorphine approximately 47% counties lack a buprenorphine-waivered physician. Existing...

Our website uses cookies to enhance your experience. By continuing use our site, or clicking "Continue," you are agreeing Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications Network Open Cardiology Dermatology Health Forum Internal Medicine Neurology Oncology Ophthalmology Otolaryngology–Head & Neck Surgery Pediatrics Psychiatry Archives of (1919-1959) JN Learning /...

The evidence for cannabis's treatment efficacy across different conditions varies widely, and comprehensive data on the which people use cannabis are lacking. We analyzed state registry to provide nationwide estimates characterizing qualifying patients licensed medically. also compared prevalence of medical recent from National Academies Sciences, Engineering, Medicine report in treating each condition. Twenty states District Columbia had available patient numbers, fifteen patient-reported...

Background: Cannabis policy liberalization has increased cannabis availability for medical or recreational purposes. Up-to-date trends in licensure can inform clinical and care. Objective: To describe recent the United States. Design: Ecological study with repeated measures. Setting: State registry data via state reports requests on from 2016 to 2020. Participants: Medical patients (persons licenses) Measurements: Total patient volume, per 10 000 of total population, patient-reported...

State prescription drug monitoring programs (PDMPs) aim to reduce risky controlled-substance prescribing, but early had limited impact. Several states implemented robust features in 2012–13, such as mandates that prescribers register with the program and regularly check its registry database. Some allow fulfill latter requirement by designating delegates registry. The effects of PDMP have not been fully assessed. We used commercial claims data examine implementing PDMPs four on overall...

Suicide deaths are a leading cause of maternal mortality in the US, yet prevalence and trends suicidality (suicidal ideation and/or intentional self-harm) among childbearing individuals remain poorly described.To characterize individuals.This serial cross-sectional study analyzed data from medical claims database for large commercially insured population US January 2006 to December 2017. There were 2714 diagnoses 1 year before or after 698 239 deliveries 595 237 aged 15 44 years who...

Even as the U.S. government, among others, pursues civil and criminal actions against physicians pharmacies to address inappropriate prescribing dispensing of opioids, a variety lawsuits are being filed opioid manufacturers distributors.

<h3>Importance</h3> Since the Centers for Disease Control and Prevention published opioid prescribing guidelines in March 2016, 31 states have implemented legislation to restrict duration of prescriptions acute pain. However, association these policies with amount prescribed following surgery remains unknown. <h3>Objective</h3> To examine limits postoperative Massachusetts Connecticut, first 2 implement after 2016. <h3>Design, Setting, Participants</h3> This interrupted time series analysis...

In March, Governor Deval Patrick declared the Massachusetts opioid-addiction epidemic a public health emergency, move that allows governors and officials to take extraordinary legal action. This unusual invocation of emergency powers raises important questions.

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Background: Limited research has examined how states have changed policies for treatment of substance use disorder (SUD) during the COVID-19 pandemic.

Virtually every U.S. state has implemented a PDMP to address high-risk opioid-prescribing and opioid-seeking behaviors. Many stakeholders, however, have expressed doubts about their utility concerns regarding potential unintended consequences.

Abstract Background Evidence demonstrates that medications for treating opioid use disorder (MOUD) —namely buprenorphine, methadone, and extended-release naltrexone—are effective at (OUD) reducing associated harms. However, MOUDs are heavily underutilized, largely due to the under-supply of providers trained willing prescribe medications. Methods To understand comparative beliefs about MOUD barriers MOUD, we conducted a mixed-methods study involved focus group interviews an online survey...

Interview with Dr. Rebecca Haffajee on the conflict between federal and state marijuana laws. (09:40)Download As marijuana-policy terrain in United States shifts, it's important to consider potential public health benefits of closing divide policies those individual states, which are increasingly legalizing at least medical use.

Behavioral health conditions in pregnant women are often associated with negative outcomes. But there has been an alarming trend among states to punish substance use disorders, rather than ensure that they receive appropriate care.

The Centers for Disease Control and Prevention's 2016 Guideline Prescribing Opioids Chronic Pain aimed to reduce unsafe opioid prescribing. It is unknown whether the guideline influenced prescribing in target population: patients with chronic, noncancer pain, who may be at particular risk opioid-related harms. To study this question, we used 2014–18 data from a commercial claims database examine associations between release of dispensing national cohort more than 450,000 four common chronic...

To evaluate whether pain management clinic laws and prescription drug monitoring program (PDMP) prescriber check mandates, two state opioid policies with relatively rapid adoption across states, reduced dispensing more or less in Black versus White patients.Pharmacy claims data, US sample of commercially insured adults, 2007-2018.Stratifying by race, we used generalized estimating equations an event-study specification to estimate time-varying effects each policy on dispensing, comparing the...

Families of children with mental health conditions face heavy economic burdens. One the objectives Mental Health Parity and Addiction Equity Act (MHPAEA) is to reduce financial burden for those intensive service needs. Few researchers date have examined MHPAEA's effects on particularly high expenditures.A difference-in-differences approach was used compare commercially insured ages 3 18 years (in 2008) who were continuously enrolled in plans newly subject parity under MHPAEA never parity....

Opioid litigation continues a growing public health trend in which governments seek to hold companies responsible for population harms related their products. The can serve address gaps regulatory and legislative policymaking market self-regulation pervasive the prescription opioid domain. Moreover, prior settlements have satisfied civil tort objectives of obtaining compensation injured parties, deterring harmful behavior, holding certain manufacturers, distributors pharmacies accountable...