The Recent Rise in Homicide: An Analysis of Weekly Mortality Data, United States, 2018-2022.

Background: From 2019 to 2020, homicide showed its largest single-year increase in modern US history. While many have cited the COVID-19 pandemic or the police killing of George Floyd as initiating the rise, there has been limited systematic investigation of how the timing of the increase corresponded with these key events. We investigated trends in firearm and nonfirearm homicide across sociodemographic and geographic groups to clarify the timing and nature of the recent increase.

State Policies Regulating Firearms and Changes in Firearm Mortality.

Importance: Despite high social and public health costs of firearm violence in the United States, the effects of many policies designed to reduce firearm mortality remain uncertain.

Objective: To estimate the individual and joint effect sizes of state firearm policies on firearm-related mortality.

Design, Setting, And Participants: In this comparative effectiveness study, bayesian methods were used to model panel data of annual, state-level mortality rates (1979-2019) for all US firearm decedents, with analyses conducted in October 2023.

Investigating the complexity of naloxone distribution: Which policies matter for pharmacies and potential recipients.

Despite efforts to expand naloxone access, opioid-related overdoses remain a significant contributor to mortality. We study state efforts to expand naloxone distribution through pharmacies by reducing the non-monetary costs to prescribers, dispensers, and/or potential recipients of naloxone. We find that laws that only address liability costs have small and insignificant effects on the volume of naloxone dispensed through pharmacies.

ROMPER: The RAND/USC OPTIC Method for Policy Expert Ratings.

We developed an expert panel approach for identifying expert views on the effectiveness and implementability of population-level policy interventions. ROMPER-the RAND/USC OPTIC Method for Policy Expert Ratings-involves an online, three-round, modified-Delphi process:•Experts rate and comment on policies according to domains of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence-to-Decision framework.•To identify consensus on policy effectiveness and implementability, expert ratings are analyzed using the Inter-Percentile Range Adjusted for Symmetry (IPRAS) technique from the RAND/UCLA Appropriateness Method and visualized using a forest plot.

Geographic and Demographic Differences in the Proportion of Individuals Living in Households With a Firearm, 1990-2018.

Importance: Measures of the proportion of individuals living in households with a firearm (HFR), over time, across states, and by demographic groups are needed to evaluate disparities in firearm violence and the effects of firearm policies.

Objective: To estimate HFR across states, years, and demographic groups in the US.

Design, Setting, And Participants: In this survey study, substate HFR totals from 1990 to 2018 were estimated using bayesian multilevel regression with poststratification to analyze survey data on HFR from the Behavioral Risk Factor Surveillance System and the General Social Survey.

Relationships Between Alcohol and Cannabis Policies in U.S. States, 1999-2019.

Objective: A crucial question regarding the public health impacts of cannabis legalization is its impact on alcohol consumption and alcohol-related harm. However, little is known about whether these changing cannabis policies are occurring in liberal or in restrictive alcohol policy environments, either of which likely affect public health outcomes. We constructed comprehensive state-level alcohol and cannabis policy indices and explored relationships between them.

Racial and ethnic differences in the effects of state firearm laws: a systematic review subgroup analysis.

Background: Despite growing evidence about how state-level firearm regulations affect overall rates of injury and death, little is known about whether potential harms or benefits of firearm laws are evenly distributed across demographic subgroups. In this systematic review, we synthesized available evidence on the extent to which firearm policies produce differential effects by race and ethnicity on injury, recreational or defensive gun use, and gun ownership or purchasing behaviors.

Main Body: We searched 13 databases for English-language studies published between 1995 and February 28, 2023 that estimated a relationship between firearm policy in the USA and one of eight outcomes, included a comparison group, evaluated time series data, and provided estimated policy effects differentiated by race or ethnicity.

Expert Views on State Policies to Improve Engagement and Retention in Treatment for Opioid Use Disorder: A Qualitative Analysis of an Online Modified Delphi Process.

Objectives: The aim of this study was to examine expert views on the effectiveness and implementability of state policies to improve engagement and retention in treatment for opioid use disorder (OUD).

Methods: We conducted a 3-round modified Delphi process using the online ExpertLens platform. Participants included 66 experts on OUD treatment policies.

Methodological considerations for estimating policy effects in the context of co-occurring policies.

Understanding how best to estimate state-level policy effects is important, and several unanswered questions remain, particularly about the ability of statistical models to disentangle the effects of concurrently enacted policies. In practice, many policy evaluation studies do not attempt to control for effects of co-occurring policies, and this issue has not received extensive attention in the methodological literature to date. In this study, we utilized Monte Carlo simulations to assess the impact of co-occurring policies on the performance of commonly-used statistical models in state policy evaluations.

Study design to evaluate a web-intervention to prevent alcohol and cannabis-impaired driving and use among adolescents in driver education.

Background: Alcohol and cannabis are the most commonly used substances among adolescents in the U.S. The consequences related to using both substances together are significantly higher relative to use of either substance alone.

The Cannabis Policy Scale: A New Research and Surveillance Tool for U.S. States.

Objective: Rapid shifts toward cannabis liberalization in the United States have created immense policy variability that is challenging to measure. We developed composite measures to characterize the restrictiveness of U.S.

The kids aren't alright: The effects of medical marijuana market size on adolescents.

We exploit shocks to US federal enforcement policy to assess how legal medical marijuana market size affects youth marijuana use and consequences for youth traffic-related fatalities. Using hand-collected data on state medical marijuana patient rates to develop a novel measure of market size, we find that legal market growth increases youth marijuana use. Likely mechanisms are lower prices and easier access.

Association of polysubstance use disorder with treatment quality among Medicaid beneficiaries with opioid use disorder.

Introduction: The opioid crisis is transitioning to a polydrug crisis, and individuals with co-occurring substance use disorder (SUDs) often have unique clinical characteristics and contextual barriers that influence treatment needs, engagement in treatment, complexity of treatment planning, and treatment retention.

Methods: Using Medicaid data for 2017-2018 from four states participating in a distributed research network, this retrospective cohort study documents the prevalence of specific types of co-occurring SUD among Medicaid enrollees with an opioid use disorder (OUD) diagnosis, and assesses the extent to which different SUD presentations are associated with differential patterns of MOUD and psychosocial treatments.

Results: We find that more than half of enrollees with OUD had a co-occurring SUD, and the most prevalent co-occurring SUD was for "other psychoactive substances", indicated among about one-quarter of enrollees with OUD in each state.

Inpatient Hospitalizations for Firearm Injury: Estimating State-Level Rates from 2000 to 2016.

One particular challenge for gun policy researchers is the lack of a single resource that provides reliable estimates of state-level firearm injuries over time. The data that do exist are sparse across state-years and cost-prohies affect deaths and injuries in the same manner. As part of the Gun Policy in America initiative, RAND researchers developed a publicly available longitudinal database of state-level estimates of inpatient hospitalizations that occur as a result of firearm injury.

Expert Panel Consensus on State-Level Policies to Improve Engagement and Retention in Treatment for Opioid Use Disorder.

Importance: In the US, recent legislation and regulations have been considered, proposed, and implemented to improve the quality of treatment for opioid use disorder (OUD). However, insufficient empirical evidence exists to identify which policies are feasible to implement and successfully improve patient and population-level outcomes.

Objective: To examine expert consensus on the effectiveness and the ability to implement state-level OUD treatment policies.

Better data, less gun violence.

For 25 years, the US government funded little research on firearm violence prevention. Although some dedicated researchers made important discoveries over this period, the scale of the research effort was not commensurate with the problem. Recently, however, there has been an unprecedented surge in research funding: the National Collaborative on Gun Violence Research, a private philanthropy, has awarded more than $21 million since 2018; the federal government has committed $25 million per year since 2019; and some states and other philanthropies have recently invested in such research programs.