Prevalence of HIV Preexposure Prophylaxis Prescribing Among Persons with Commercial Insurance and Likely Injection Drug Use
The United States has made important strides to reduce the incidence and negative outcomes of HIV, including increasing the availability of effective treatment and prevention in the form of pre-exposure prophylaxis (PrEP). While the incidence of new HIV infections fell significantly from 130,000 in 1985, progress has stalled at approximately 39,000 new infections per year […]
Evidence for Supportive Prenatal Substance Use Policies
Increased prevalence of illicit substance use during pregnancy in the past decade has renewed national attention to prenatal substance use policies (PSUPs). Currently, there are punitive policies that criminalize drug use during pregnancy or define prenatal substance use as child maltreatment in child welfare statutes. If newborns are found to have prenatal exposure to substances […]
Providing Naloxone in the Emergency Department Can Save Lives
Overdose deaths continue to be a national tragedy. More than 800,000 Americans died from an overdose between 1999-2019, and the annual rate of overdoses has increased dramatically during the pandemic, according to the latest data from the Centers for Disease Control and Prevention. Roughly 7 in 10 current overdose deaths involve opioids, which means that […]
Targeting Emergency Department Resources to Address the Opioid Epidemic
In a new study in the American Journal of Emergency Medicine, my colleagues and I estimate the number and distribution of emergency visits for opioid use disorder (OUD) across the country. We found that nearly 2/3 of all emergency visits for OUD occurred in 25% of EDs nationwide. Why is this important? Patients with OUD come to the […]
The Impact of Recreational Cannabis Laws and Cannabis Use Disorder Among Pregnant Patients
To date, the American College of Obstetricians and Gynecologists advises pregnant patients not to use cannabis because of the increased risks of health complications to the pregnant individual and the newborn. However, as states expand access to recreational or medical cannabis, there is growing evidence of increased cannabis use and positive perceptions of cannabis among pregnant patients. […]
Hepatitis C Treatment by Non-specialist Providers in the Direct-acting Antiviral Era
After direct-acting antiviral agents to treat hepatitis C were introduced, most of those who prescribed treatment was gastroenterology specialists but there was an increasing proportion of non-specialists. Treatment completion rates were similar between specialists and non-specialists. Direct-acting antiviral agents (DAAs), highly effective treatments for hepatitis C virus infection (HCV), transformed HCV therapy and made it […]
Prescription Drug Monitoring Program Mandates Affect Use of Opioids to Treat Acute, Severe Pain
Prescription drug monitoring programs (PDMP) have been crucial tools to address unsafe opioid prescribing. High rates of prescribing stoked the flames of the opioid crisis in the early 2000s, but opioid prescriptions have steadily decreased over the past decade. Unfortunately, opioid-related deaths have continued to rise each year. Many states have enacted comprehensive mandates that all clinicians consult the PDMP […]
Characterizing Initiation, Use, and Discontinuation of Extended-Release Buprenorphine in a Nationally Representative United States Commercially Insured Cohort
Medications for opioid use disorder (MOUD) are evidence-based treatments that help people reduce or stop using opioids. However, high discontinuation rates of MOUD pose a barrier to reducing opioid-related overdoses. Extended-release buprenorphine (XR-BUP) is a relatively new MOUD, approved in late 2017, that has the potential to increase retention because of its monthly dosing schedule. Currently, there is […]
Inpatient care versus outpatient MOUD treatment for individuals with OUD
In a new study in JAMA Network Open, CHERISH investigators Jake Morgan, Sean Murphy, Alexander Walley, Benjamin Linas and Bruce Schackman and colleagues, examined whether rates of opioid-related overdose and all-cause hospitalization differed after outpatient medication treatment or inpatient care for opioid use disorder. They studied individuals who had received one of three federally- approved medications […]
Patients Get More Opioids Than They Need After Knee Arthroscopy
Study Finds Wide State Variation in Opioid Prescribing, Dosages In our new study in BMJ Open, we show that in 2015-2019 more than 70% of U.S. opioid-naive patients received an opioid prescription after knee arthroscopy. They received an average of 40 tablets, despite recent studies showing most patients end up taking less than 5 tablets. The take-home message? Despite […]
After Opioid Overdose Emergency, Few Patients Receive Timely Follow-up
Easing regulatory restrictions due to Covid-19 may provide solutions An opioid overdose is significantly more than an isolated event. Patients who present to the emergency department (ED) with overdose have a 6 percent risk of dying in the following year. As with other high-risk acute conditions, we expect patients who survive overdose to receive evidence-based treatment after leaving […]
Will Eliminating Waiver Requirements Improve Access to Buprenorphine for Treating Opioid Use Disorder? Evidence From Increasing the Patient Treatment Cap
The Drug Addiction Treatment Act of 2000 (DATA 2000) permits qualified physicians to obtain a waiver to treat patients with opioid use disorder (OUD) with buprenorphine in office-based practices. In 2016, 47% of all US counties and 72% of rural counties lacked a buprenorphine waivered physician. That year, the Comprehensive Addiction and Recovery Act extended buprenorphine prescribing […]
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