Experiences of the changing illicit drug supply among racial and ethnic minoritized people in three US states: a qualitative study.

Background: Amidst a national surge in overdose deaths among racial and ethnic minoritized people and people who use stimulants (cocaine or methamphetamines), our objective was to understand how these groups are adapting to a rapidly changing illicit drug supply.

Methods: We conducted semi-structured interviews with 64 people who use drugs and who self-identified as Black, Hispanic, Multiracial, or other Non-White race in three states (Michigan, New Jersey, and Wisconsin). Transcribed interviews were coded thematically.

How emergency departments are responding to the opioid crisis: Results from a statewide survey in Kentucky.

Objective: There is a rising effort for hospital emergency departments (EDs) to offer and expand substance use disorder (SUD) services. This state-wide evaluation studies SUD services offered along the continuum of implementation across Kentucky's EDs to inform future state efforts to build ED bridge programs.

Methods: We conducted a mixed-methods study using an online survey of all Kentucky Emergency Department Directors between January and May of 2023.

Personal Experiences With Xylazine and Behavior Change: A Qualitative Content Analysis of Reddit Posts.

Objectives: Xylazine is a rapidly spreading adulterant in the United States' drug supply and is increasingly associated with overdoses and severe wounds, but there is a dearth of information about the clinical presentation or means of treatment for human xylazine exposure. The objective of this study was to explore personal attitudes about xylazine in the drug supply and experiences with xylazine-related use among people who reported using drugs and contributed content to social media site Reddit.

Methods: To conduct a retrospective qualitative content analysis, the study team extracted all posts and comments from Reddit, which mentioned the terms "xylazine" or "tranq.

Harm Reduction and Treatment Among People at High Risk of Overdose.

Importance: Rates of overdose deaths involving synthetic opioids remain high, increasingly involve stimulants combined with opioids, and are increasing rapidly in racially and ethnically minoritized communities, yet little is known about access to harm reduction and treatment services in these groups.

Objective: To characterize access and barriers to harm reduction and treatment in a racially and ethnically diverse population of people who use drugs.

Design, Setting, And Participants: A cross-sectional telephone survey of people recruited from 39 treatment, harm reduction, and social service organizations in Milwaukee County, Wisconsin; Flint and Detroit, Michigan; and statewide in New Jersey was conducted from January 30 to July 28, 2023.

A content analysis of legal policy responses to xylazine in the illicit drug supply in the United States.

Background: Xylazine is a veterinary sedative that is quickly spreading in the U.S. illicit drug supply and is increasingly associated with fatal overdoses and severe wounds.

High prevalence of hepatitis C virus infection among incarcerated persons: Results from the Louisiana Hepatitis C Elimination Plan's opt-out testing program in prisons.

In the United States, modelling studies suggest a high prevalence of hepatitis C virus (HCV) infection in incarcerated populations. However, limited HCV testing has been conducted in prisons. Through the Louisiana Hepatitis C Elimination Plan, persons incarcerated in the eight state prisons were offered HCV testing from 20 September 2019 to 14 July 2022, and facility entry/exit HCV testing was introduced.

Piloting racial bias training for hospital emergency department providers treating patients with opioid use disorder.

Racial disparities in opioid overdose have increased in recent years. Several studies have linked these disparities to health care providers' inequitable delivery of opioid use disorder (OUD) services. In response, health care policymakers and systems have designed new programs to improve equitable OUD care delivery.

Association of buprenorphine retention and subsequent adverse outcomes following non-fatal overdose: An analysis using statewide linked Maryland databases.

Introduction: Patients receiving buprenorphine after a non-fatal overdose have lower risk of future nonfatal or fatal overdose, but less is known about the relationship between buprenorphine retention and the risk of adverse outcomes in the post-overdose year.

Objective: To examine the relationship between the total number of months with an active buprenorphine prescription (retention) and the odds of an adverse outcome within the 12 months following an index non-fatal overdose.

Materials And Methods: We studied a cohort of people with an index non-fatal opioid overdose in Maryland between July 2016 and December 2020 and at least one filled buprenorphine prescription in the 12-month post-overdose observation period.

Reported xylazine exposure highly associated with overdose outcomes in a rapid community assessment among people who inject drugs in Baltimore.

Background: Addressing xylazine harms are now a critical harm reduction priority, but relatively little epidemiological information exists to determine prevalence, magnitude, and correlates of xylazine use or related outcomes.

Methods: We conducted a rapid behavioral survey among people who inject drugs (n = 96) in Baltimore November-December 2022. Using a novel indicator of self-reported presumed xylazine effects, we examined prevalence and sociodemographic correlates of past year presumed xylazine effects and association with overdose and wound-related outcomes.

Medications For Opioid Use Disorder Increased Among Louisiana Medicaid Enrollees During Policy Reforms, 2018-21.

Increasing access to medications for opioid use disorder (MOUD) is a key strategy in addressing the opioid crisis. To increase MOUD access, state governments have pursued a combination of increased funding for MOUD and requirements that providers offer treatment. Louisiana has pursued multiple strategies, including a requirement that residential treatment programs offer MOUD as part of their licensure.

Attitudes and beliefs about Vermont's 2021 buprenorphine decriminalization law among residents who use illicit opioids.

Background: In July 2021, Vermont removed all criminal penalties for possessing 224mg or less of buprenorphine.

Methods: Vermont residents (N=474) who used illicit opioid drugs or received treatment for opioid use disorder in the past 90 days were recruited for a mixed-methods survey on the health and criminal legal effects of decriminalization. Topics assessed included: motivations for using non-prescribed buprenorphine, awareness of and support for decriminalization, and criminal legal system experiences involving buprenorphine.

Examining Pre-Release Interventions on HIV Outcomes 12 Months After Release from Louisiana State Corrections.

Louisiana has the highest proportion of people living with HIV (PLWH) in state prison custody. Linkage to care programs minimize odds of HIV care drop-off after release. Louisiana has two pre-release linkage to HIV care programs, one implemented through Louisiana Medicaid and another through the Office of Public Health.

Increasing overdose deaths among Black Americans: a review of the literature.

In 2020, opioid overdose fatalities among Black Americans surpassed those among White Americans for the first time in US history. This Review analyses the academic literature on disparities in overdose deaths to highlight potential factors that could explain these increases in overdose deaths among Black Americans. Overall, we find that differences in structural and social determinants of health; inequality in the access, use, and continuity of substance use disorder and harm reduction services; variability in fentanyl exposure and risk; and changes in social and economic circumstances since the onset of the COVID-19 pandemic are central to explaining this trend.

Health services use among formerly incarcerated Louisiana Medicaid members within one year of release.

Objectives: To determine the association between enrollment in Medicaid prior to release compared with post-release, and the use of health services and time to the first service use after release among Louisiana Medicaid members within one year of release from Louisiana state corrections custody.

Methods: We conducted a retrospective cohort study linking Louisiana Medicaid and Louisiana state corrections release data. We included individuals ages 19 to 64 years released from state custody between January 1, 2017 and June 30, 2019 and enrolled in Medicaid within 180 days of release.

Characteristics and health service use of Medicaid-insured individuals filling naloxone under a standing order in Louisiana.

Background: Naloxone distribution is a key intervention to reduce opioid overdose deaths. On January 23, 2017, Louisiana implemented a standing order that permits pharmacies to dispense naloxone to patients without a patient-specific prescription.

Objectives: To examine the characteristics and health service use of Louisiana Medicaid members filling naloxone under the standing order.

Reducing Opioid Analgesic Prescribing in Dentistry Through Prescribing Defaults: A Cluster-Randomized Controlled Trial.

Objective: To determine the effect of a uniform, reduced, default dispense quantity for new opioid analgesic prescriptions on the quantity of opioids prescribed in dentistry practices.

Methods: We conducted a cluster-randomized controlled trial within a health system in the Bronx, NY, USA. We randomly assigned three dentistry sites to a 10-tablet default, a 5-tablet default, or no change (control).

Mixed Method Evaluation of Louisiana's Prerelease Medicaid Enrollment Program, 2017-2019.

Background: Over 600,000 people leave US prisons annually. Many are eligible for Medicaid upon release but may need support to enroll. Carceral facilities in nearly half of states have implemented systems to facilitate Medicaid access for those leaving incarceration, but there is limited information on program implementation models or outcomes.

Louisiana Medicaid access for treatment and care for hepatitis C virus (LA-MATCH) project: A cross-sectional study protocol.

Introduction: This article presents the Louisiana Hepatitis C Elimination Program's evaluation protocol underway at the Louisiana State University Health Sciences Center-New Orleans. With the availability of direct-acting antiviral (DAA) agents, the elimination of Hepatitis C (HCV) has become a possibility. The HCV Elimination Program was initiated by the Louisiana Department of Health (LDH) Office of Public Health (OPH), LDH Bureau of Health Services Financing (Medicaid), and the Louisiana Department of Public Safety and Corrections (DPSC) to provide HCV treatment through an innovative pricing arrangement with Asegua Therapeutics, whereby a fixed cost is set for a supply of treatment over five years.

Engaging LGBTQ Communities in Community-Partnered Participatory Research: Lessons from the Resilience Against Depression Disparities Study.

Background: The Resilience Against Depression Disparities (RADD), a community partnered, randomized comparative effectiveness study, aimed to address mental health in Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning (LGBTQ) racial/ethnic populations in New Orleans and Los Angeles.

Objectives: To describe engagement methods, lessons learned, and recommendations in engaging LGBTQ individuals and agencies throughout the RADD study.

Methods: RADD used a community partnered participatory research framework to engage LGBTQ community members and agencies.

A Rapid Assessment of Disaster Preparedness Needs and Resources during the COVID-19 Pandemic.

This year has seen the emergence of two major crises, a significant increase in the frequency and severity of hurricanes and the COVID-19 pandemic. However, little is known as to how each of these two events have impacted the other. A rapid qualitative assessment was conducted to determine the impact of the pandemic on preparedness and response to natural disasters and the impact of past experiences with natural disasters in responding to the pandemic.

Depression at the Intersection of Race/Ethnicity, Sexual Orientation, and Income.

The current study uses an intersectional framework to examine subgroup differences in the prevalence of depression among a community sample of predominantly low-income, racial/ethnic and sexual minority adults. Between May 2017-June 2018, participants (N=1753) were recruited from and screened for depression in community organizations that predominantly serve sexual minority clients based in Los Angeles, California and New Orleans, Louisiana. Twenty-six percent of people screened for study eligibility met criteria for depression (Patient Health Questionnaire-8≥10).