Cannabis Laws and Utilization of Medications for the Treatment of Mental Health Disorders.

Importance: Mental health disorders are prevalent yet undertreated health conditions in the US. Given perceptions about the potential effect of cannabis on individuals with mental health disorders, there is a need to understand the association of cannabis laws with psychotropic use.

Objective: To investigate the association of medical and recreational cannabis laws and dispensary openings with the dispensing of psychotropic medications used to treat mental health disorders in the US.

Concurrent Prescription Fills of Opioids and Benzodiazepines Among Postpartum Women During COVID-19.

Introduction: Concurrent prescribing of opioids and benzodiazepines is associated with increased risk of emergency department visits and overdose. Postpartum women commonly receive opioids for pain after delivery and are at risk for postpartum depression/anxiety. Although prior research finds increases in opioid prescribing and symptoms of depression/anxiety during COVID-19, concurrent prescribing among postpartum women has not been examined in the context of COVID-19.

Most States Allow Medicaid Managed Care Plans Discretion To Restrict Substance Use Disorder Treatment Benefits.

Managed care plans, which contract with states to cover three-quarters of Medicaid enrollees, play a crucial role in addressing the drug epidemic in the United States. However, substance use disorder benefits vary across Medicaid managed care plans, and it is unclear what role states play in regulating their activities. To address this question, we surveyed thirty-three states and Washington, D.

Increases in benzodiazepine prescribing for postpartum anxiety during COVID-19.

Purpose: Postpartum mood disorders affect many women following childbirth. Prescribing medication for depression and anxiety is one strategy for the effective treatment of postpartum mood disorders. Left untreated, mothers experiencing these disorders and their infants face increased risks of adverse health outcomes.

Effect of Milk Protein-Polyphenol Conjugate on the Regulation of GLP-1 Hormone.

Modern functional foods are designed to provide health benefits beyond basic nutrition. They are enriched with bioactive ingredients like probiotics, vitamins, minerals, and antioxidants. These foods support overall health, enhance immune function, and help prevent chronic diseases.

Substance use disorder treatment carve outs in Medicaid managed care.

Introduction: Medicaid managed care organizations (MCO) play a major role in addressing the nation's epidemic of drug overdose and mortality by administering substance use disorder (SUD) treatment benefits for over 50 million Americans. While it is known that some Medicaid MCO plans delegate responsibility for managing SUD treatment benefits to an outside "carve out" entity, the extent and structure of such carve out arrangements are unknown. This is an important gap in knowledge, given that carve outs have been linked to reductions in rates of SUD treatment receipt in several studies.

State Medicaid Initiatives Targeting Substance Use Disorder in Criminal Legal Settings, 2021.

To document state Medicaid pre- and postrelease initiatives for individuals in the criminal legal system with substance use disorder (SUD). An Internet-based survey was sent in 2021 to Medicaid directors in all 50 US states and the District of Columbia to determine whether they were pursuing initiatives for persons with SUD across 3 criminal legal settings: jails, prisons, and community corrections. A 90% response rate was obtained.

The Impact of State Medicaid Eligibility and Benefits Policy on Neonatal Abstinence Syndrome Hospitalizations.

Rates of neonatal abstinence syndrome (NAS) resulting from opioid misuse are rising. However, policies to treat opioid misuse during pregnancy are unclear. We apply a difference-in-differences design to national pediatric discharge records to examine the effects of state Medicaid policies on NAS.

Statewide efforts to address the opioid epidemic: Results from a national survey of single state agencies.

Background: Single State Agencies (SSAs) are at the forefront of efforts to address the nation's opioid epidemic, responsible for allocating billions of dollars in federal, state, and local funds to ensure service quality, promote best practices, and expand access to care. Federal expenditures to SSAs have more than tripled since the early years of the epidemic, yet, it is unclear what initiatives SSAs have undertaken to address the crisis and how they are financing these efforts.

Methods: This study used data from an internet-based survey of SSAs, conducted by the University of Chicago Survey Lab from January to December 2021 (response rate of 94 %).

Medicaid Managed Care Prior Authorization For Buprenorphine Tied To State Partisanship And Health Plan Profit Status, 2018.

Buprenorphine is among the most effective drugs for treating opioid use disorder, yet only a quarter of Americans who need it receive it. Requiring prior authorization has been identified as an important barrier to buprenorphine access. However, the practice remains widespread in Medicaid-the largest insurer of Americans with opioid use disorder.

Introduction of Medicare coverage in opioid treatment programs: Findings from the first three years.

Background: Prior to January of 2020, there was no Medicare reimbursement for services delivered in opioid treatment programs (OTPs). OTPs are the only authorized providers of opioid use disorder (OUD) treatment with methadone, a critical tool to address the opioid overdose crisis. While prior research has examined the availability of MOUD other than methadone for Medicare beneficiaries, research has not identified organizational and local Medicare beneficiary characteristics associated with Medicare insurance acceptance among OTPs.

Changes in Medicaid Fee-for-Service Benefit Design for Substance Use Disorder Treatment During the Opioid Crisis, 2014 to 2021.

Importance: Medicaid is the largest payer of substance use disorder treatment in the US and plays a key role in responding to the opioid epidemic. However, as recently as 2017, many state Medicaid programs still did not cover the full continuum of clinically recommended care.

Objective: To determine whether state Medicaid fee-for-service (FFS) programs have expanded coverage and loosened restrictions on access to substance use disorder treatment in recent years.

State Funding For Substance Use Disorder Treatment Declined In The Wake Of Medicaid Expansion.

The US continues to grapple with an escalating epidemic of opioid-related overdose and mortality. State funds, which are the second-largest source of public funding for substance use disorder (SUD) treatment and prevention, play a critically important role in responding to this crisis. Despite their importance, little is known about how these funds are allocated and how they have changed over time, particularly within the context of Medicaid expansion.

Changes In County-Level Access To Medications For Opioid Use Disorder After Medicare Coverage Of Methadone Treatment Began.

In 2020 Medicare began reimbursing for opioid treatment program (OTP) services, including methadone maintenance treatment for opioid use disorder (OUD), for the first time. Methadone is highly effective for OUD, yet its availability is restricted to OTPs. We used 2021 data from the National Directory of Drug and Alcohol Abuse Treatment Facilities to examine county-level factors associated with OTPs accepting Medicare.

Allocation of federal funding to address the opioid overdose crisis in the criminal legal system.

Introduction: The opioid overdose crisis remains a chief public health concern in the United States, and people involved in the criminal legal system are among the most vulnerable to opioid related harms. This study aimed to identify all discretionary federal funding allocated to states, cities, and counties targeting the overdose crisis for criminal legal system-involved populations in fiscal year (FY) 2019. We then aimed to assess the extent to which federal funding was allocated to states with the highest need.

Comparison of Postpartum Opioid Prescriptions Before vs During the COVID-19 Pandemic.

Importance: The COVID-19 pandemic substantially disrupted routine health care and exacerbated existing barriers to health care access. Although postpartum women frequently experience pain that interferes with activities of daily living, which is often successfully treated with prescription opioid analgesics, they are also at high risk for opioid misuse.

Objective: To compare postpartum opioid prescription fills after the onset of the COVID-19 pandemic in March 2020 with fills before the pandemic.

Coverage and Prior Authorization Policies for Medications for Opioid Use Disorder in Medicaid Managed Care.

Importance: Medicaid is a key policy lever to improve opioid use disorder treatment, covering approximately 40% of Americans with opioid use disorder. Although approximately 70% of Medicaid beneficiaries are enrolled in comprehensive managed care organization (MCO) plans, little is known about coverage and prior authorization (PA) policies for medications for opioid use disorder (MOUD) in these plans.

Objective: To compare coverage and PA policies for buprenorphine, methadone, and injectable naltrexone across Medicaid MCO plans and fee-for-service (FFS) programs and across states.

Availability of Medications for Alcohol Use Disorder Treatment in Medicare Part D, 2014-2018.

Objective: Despite increases in alcohol-related mortality, excessive drinking, and alcohol use disorder (AUD) among older adults, the availability of medications for alcohol use disorder (MAUD) for Medicare Part D beneficiaries has not yet been examined.

Method: Prescription data from the Medicare Part D Public Use File were aggregated to the county-year level for the years 2014 to 2018. Descriptive statistics and paired tests were used to examine changes in the availability of MAUD from 2014 to 2018.

Engineering a Bioactive Hybrid Coating for Corrosion Control of Magnesium and Its Alloy.

Magnesium (Mg) and its alloys are promising biodegradable metallic implant materials. However, their clinical applications are limited by their fast corrosion rate in the biological environment. In this work, with an outlook to improve the corrosion resistance of Mg and WE43 Mg alloy, a layer-by-layer interfacially engineered anticorrosive and bioactive coating consisting of a natural oxide lower layer, hydroxyapatite (HA) middle layer, and silk fibroin (SF) top layer was fabricated and investigated.

Racial disparities for COVID19 mortality in Georgia: Spatial analysis by age based on excess deaths.

Introduction: This study uses multiple measures of excess deaths to analyze racial disparities in COVID-19 mortality across Georgia.

Methods: The Georgia Department of Public Health provided monthly mortality data for 2010-2020 stratified by race/ethnicity, age, county, and recorded cause of death. We first calculate crude mortality rates by health district during the time period for all groups for March through June for our historical period to identify significant time-series outliers in 2020 distinguishable from general trend variations.

Availability of Medications for the Treatment of Alcohol Use Disorder in U.S. Counties, 2016-2019.

Objective: Although numerous studies have examined the geographic availability of medications for opioid use disorder, none have measured the availability of medications for alcohol use disorder (MAUD) in the United States. We examined county-level trends in MAUD offerings in the specialty substance use disorder treatment system and compared MAUD availability with local geographic characteristics and alcohol use disorder treatment need.

Method: We constructed annual county-level measures of MAUD availability for 2016-2019 using the National Directory of Drug and Alcohol Abuse Treatment Facilities, determining the number of outpatient facilities offering MAUD in each county ( = 12,568).

Spillover of Medicaid Expansion to Prescribing of Opioid Use Disorder Medications in Medicare Part D.

Objective: The authors examined whether there were positive spillovers in opioid use disorder medication prescribing to Medicare Part D beneficiaries in Medicaid expansion states. Although prior studies have shown several positive benefits of Medicaid expansion for Americans with opioid use disorder, research has not examined potential spillovers to Medicare beneficiaries who have been hit hard by the opioid crisis.

Methods: Prescribing data were taken from the Medicare Part D Prescription Public Use File (2010-2017).

Impact of drug utilization management policy on prescription opioid use in Georgia Medicaid.

Objective: To examine the effectiveness of changes in opioid prescription policies on opioid prescribing and health services utilization rates in Georgia Medicaid.

Methods: This study used data from the Georgia Medicaid patient enrollment, medical and pharmacy claims database from 2009 to 2014.We performed an interrupted time series analysis to examine the effect of the policy changes.

Silk Fibroin Coated Magnesium Oxide Nanospheres: A Biocompatible and Biodegradable Tool for Noninvasive Bioimaging Applications.

Fluorescent nanoparticles (NPs) have been increasingly studied as contrast agents for better understanding of biological processes at the cellular and molecular level. However, their use as bioimaging tools is strongly dependent on their optical emission as well as their biocompatibility. This work reports the fabrication and characterization of silk fibroin (SF) coated magnesium oxide (MgO) nanospheres, containing oxygen, Cr and V related optical defects, as a nontoxic and biodegradable hybrid platform for bioimaging applications.