Association of State Cannabis Legalization With Cannabis Use Disorder and Cannabis Poisoning.

Importance: Whether state implementation of medical and recreational cannabis laws is associated with increased cannabis use disorder (CUD) and/or cannabis poisoning among adults is not evident.

Objective: To examine state-level medical and recreational cannabis laws' associations with CUD and cannabis poisoning, overall and by sex and age subgroups.

Design, Setting, And Participants: In this longitudinal cohort study, state-level CUD and cannabis poisoning diagnoses from January 2011 to December 2021 were examined across all 50 US states and the District of Columbia before and after the implementation of medical and recreational cannabis laws (MCLs and RCLs, respectively) using a staggered adoption difference-in-differences approach.

Association between state-level medical marijuana legalization and marijuana use during pregnancy: A population-based study.

Background And Objectives: Despite marijuana's association with adverse pregnancy and birth outcomes, its use during pregnancy increased over the last two decades. During this period, medical marijuana has been legalized in 38 states and the District of Columbia. States with legalized medical marijuana have observed increased marketing of marijuana and related products.

Opioid and benzodiazepine misuse in the United States: The impact of socio-demographic characteristics.

Background And Objectives: In 2021, drug overdose deaths in the United States reached a new record of 107,622. Misuse of opioids and benzodiazepines accounts for a large portion of drug overdose deaths. However, the effects of socio-demographic characteristics on misuse of opioids and benzodiazepines are not evident.

Georgia community pharmacies and clinics: An evaluation of health outcomes and care access.

Background: Care access remains a major social determinant of health. Safety net clinics may not be numerically sufficient to meet the health care demand for vulnerable populations. Community pharmacists remain a trusted health care provider and serve as first-line care access points.

The impact of Medicaid expansion on mental health and substance use related inpatient visits.

Objective: Under the Affordable Care Act, many states expanded their Medicaid eligibility, allowing individuals living at or below 138% of the Federal Poverty Level to receive insurance coverage. As a result, forty states and the District of Columbia have expanded Medicaid to date. Although Medicaid expansion is expected to increase access to care in general, it is not evident if it has helped increase access to mental health and substance use-related healthcare, especially in inpatient settings.

Access to methadone clinics and opioid overdose deaths in Georgia: A geospatial analysis.

Background: As a result of the opioid epidemic, the demand for treatment options for opioid use disorder (OUD) such as methadone has increased. Methadone can only be administered in methadone clinics. Though numerous methadone clinics are located across the state of Georgia, access to methadone treatment may still be a concern for certain areas of the state.

Impact of Medicaid expansion on mental health and substance use related emergency department visits.

Although Medicaid expansion under the Affordable Care Act reduces uninsurance, little evidence exists on its impact on mental health and substance use (MHSU) related healthcare utilization. Therefore, the objectives of this study are to examine the impact of Medicaid expansion on emergency department visits related to mental health and substance use disorders and to examine its effect on the variation in payer mix. The study utilizes state-level quarterly emergency department (ED) visit data from Healthcare Cost and Utilization Project's Fast Stats Database, along with state socio-demographic and health policy data for the analysis.

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.

The associations of medical marijuana policies with opioid-related health care utilization.

Objective: To examine the associations between medical marijuana policies and opioid-related hospitalizations and emergency department visits.

Data Sources: We utilized quarterly rates of hospital discharge data from the Healthcare Cost and Utilization Project's (HCUP) Fast Stats Database from 2005 to 2016 along with state-level sociodemographic data from US Census Bureau and Bureau of Labor Statistics and opioid-related state health policy data from publicly available sources for the analysis.

Study Design: Analyses were carried out using a difference-in-differences regression approach.

The Association Between School Tobacco Control Policies and Youth Smoking Behavior.

Background: While U.S. tobacco control policy has focused mainly on tobacco excise taxes, product advertising bans, and state tobacco control policies such as indoor/outdoor smoking bans, little attention has been paid to school tobacco control policies and their impact on youth smoking behavior.

Deaths among opioid users: impact of potential inappropriate prescribing practices.

Objectives: To examine the association between potential inappropriate prescribing practices of opioids and deaths among opioid users in the Georgia Medicaid population.

Study Design: A retrospective analysis of individual pharmacy claims data from Georgia Medicaid from 2009 through 2014.

Methods: The sample was restricted to patients without cancer aged 18 to 64 years with an opioid prescription and included 3,562,227 observations representing 401,488 individuals.

Opioid Analgesics in Georgia Medicaid: Trends in Potential Inappropriate Prescribing Practices by Demographic Characteristics, 2009-2014.

Background: There has been a dramatic rise in the number of opioid prescriptions and opioid overdose deaths in the United States over the past 15 years. Misuse and abuse of opioids is also a growing public health concern in the United States. Medicaid enrollees are more likely to be prescribed opioids and are at higher risk of prescription drug overdose compared with non-Medicaid populations.

Opioids in Georgia Medicaid: Gender and Insurance Disparities in Utilization and Potential Inappropriate Prescribing Practices.

Objectives: Medicaid populations have been disproportionately affected by the opioid epidemic. In Georgia, opioid deaths have increased at more than twice the rate of the nation at large. It is unknown if certain populations within the Medicaid unduly receive opioid prescriptions or experience inappropriate prescribing of opioids.

Pain as a Risk Factor for Loneliness Among Older Adults.

Objective: The objective of this is to examine whether pain is associated with the onset of loneliness in a sample of community-dwelling older adults.

Methods: We used data from the 2008 and 2012 Health and Retirement Study. We limited the sample to community-dwelling persons aged 60 years and over who were not lonely in 2008 in order to predict the risk of onset of loneliness (incidence) in 2012.

Availability of tobacco cessation services in substance use disorder treatment programs: Impact of state tobacco control policy.

Objective: Given the high prevalence of smoking among substance use disorder (SUD) patients, the specialty SUD treatment system is an important target for adoption and implementation of tobacco cessation (TC) services. While research has addressed the impact of tobacco control on individual tobacco consumption, largely overlooked in the literature is the potential impact of state tobacco control policies on availability of services for tobacco cessation. This paper examines the association between state tobacco control policy and availability of TC services in SUD treatment programs in the United States.

Health Insurance Enrollment and Availability of Medications for Substance Use Disorders.

Objective: Medications for treatment of substance use disorders are underutilized in treatment programs in the United States. Little is known about how insurance enrollment within states affects treatment program decisions about whether to offer medications. The primary objective of the study was to examine the impact of health insurance enrollment on availability of substance use disorder medications among treatment programs.

Diagnostic Imaging Services in Magnet and Non-Magnet Hospitals: Trends in Utilization and Costs.

Purpose: The purpose of this study was to better understand trends in utilization and costs of diagnostic imaging services at Magnet hospitals (MHs) and non-Magnet hospitals (NMHs).

Methods: A data set was created by merging hospital-level data from the American Hospital Association's annual survey and Medicare cost reports, individual-level inpatient data from the Healthcare Cost and Utilization Project, and Magnet recognition status data from the American Nurses Credentialing Center. A descriptive analysis was conducted to evaluate the trends in utilization and costs of CT, MRI, and ultrasound procedures among MHs and NMHs in urban locations between 2000 and 2006 from the following ten states: Arizona, California, Colorado, Florida, Iowa, Maryland, North Carolina, New Jersey, New York, and Washington.

Loneliness as a public health issue: the impact of loneliness on health care utilization among older adults.

Objectives: We aimed to determine whether loneliness is associated with higher health care utilization among older adults in the United States.

Methods: We used panel data from the Health and Retirement Study (2008 and 2012) to examine the long-term impact of loneliness on health care use. The sample was limited to community-dwelling persons in the United States aged 60 years and older.

Master Settlement Agreement (MSA) spending and tobacco control efforts.

We investigate whether the distributions to the states from the Tobacco Master Settlement Agreement (MSA) in 1998 is associated with stronger tobacco control efforts. We use state level data from 50 states and the District of Columbia from four time periods post MSA (1999, 2002, 2004, and 2006) for the analysis. Using fixed effect regression models, we estimate the relationship between MSA disbursements and a new aggregate measure of strength of state tobacco control known as the Strength of Tobacco Control (SoTC) Index.

Is there a business case for magnet hospitals? Estimates of the cost and revenue implications of becoming a magnet.

Background: Although Magnet hospitals (MHs) are known for their better nursing care environments, little is known about whether MHs achieve this at a higher (lower) cost of health care or whether a superior nursing environment yields higher net patient revenue versus non-MHs over an extended period of time.

Objective: To examine how achieving Magnet status is related to subsequent inpatient costs and revenues controlling for other hospital characteristics.

Data And Methods: Data from the American Hospital Association Annual Survey, Hospital Cost Reporting Information System reports collected by Centers for Medicare & Medicaid Services, and Magnet status of hospitals from American Nurses Credentialing Center from 1998 to 2006 were combined and used for the analysis.

Adoption of national quality forum safe practices by Magnet® hospitals.

Background: Magnet® hospitals (MHs) are known for their high retention rates of nurses and positive work environment, yet little is known about whether MHs also have higher levels of safe practice adoption rates compared with non-Magnet hospitals (NMHs).

Methods: In this study, we investigate adoption of National Quality Forum (NQF) Safe Practices in 34 regions during 2004 to 2006 that were part of the Leapfrog Group initiative to improve quality of hospital care. We conducted a secondary data analysis by combining multiple data sets from the American Hospital Association Annual Survey,Healthcare Cost Reports Information System, and Leapfrog Group Annual Hospital Survey.

Money Matters: Cost Effectiveness of Juvenile Drug Court with and without Evidence-Based Treatments.

The 12-month cost effectiveness of juvenile drug court and evidence-based treatments within Court were compared with traditional Family Court for 128 substance abusing/dependent juvenile offenders participating in a four-condition randomized trial. Intervention conditions included Family Court with community services (FC), Drug Court with community services (DC), Drug Court with Multisystemic Therapy (DC/MST), and Drug Court with MST enhanced with a contingency management program (DC/MST/CM). Average cost effectiveness ratios for substance use and criminal behavior outcomes revealed that economic efficiency in achieving outcomes generally improved from FC to DC, with the addition of evidence-based treatments improving efficiency in obtaining substance use outcomes.