Addiction Medicine: Opioid Use Disorder.

Most overdose deaths in the United States involve opioids. Identification and management of opioid use disorder by primary care physicians is a critical need in health care. Substance use disorders share neurobiological dysregulation of the central motivation and reward pathway (powered by dopamine) that manifests as a cycle of addiction driven by impulse and compulsion.

Addiction Medicine: Tobacco Use Disorder.

The number one cause of preventable disease, disability, and death in the United States is tobacco use. According to data from the National Health Interview Survey, 18.7% of US adults (46 million people) currently use a tobacco product.

Addiction Medicine: Benzodiazepine Use Disorder.

Practice guidelines consistently encourage short-term use of benzodiazepines for the management of common medical conditions. However, these medications are often prescribed long-term for unclear or variable indications. These prescribing patterns may be attributed to perceived low risk and low rate of benzodiazepine use disorders (0.

Addiction Medicine: Alcohol Use Disorder.

Primary care physicians play an integral role in the identification and management of alcohol use disorder, which has implications for the safety and physical and mental health of patients, their families, and the public. Screening to identify risky drinking behavior is recommended by the US Preventive Services Task Force but is not always performed consistently or correctly in primary care. When alcohol use disorder is identified, collaboration with patients is essential to determine an appropriate treatment approach.

Increasing the Representation of Black Men in Medicine by Addressing Systems Factors.

In 2015, data released by the Association of American Medical Colleges (AAMC) showed that there were more Black men applying and matriculating to medical school in 1978 than 2014. The representation of Black men in medicine is a troubling workforce issue that was identified by the National Academies of Sciences, Engineering, and Medicine as a national crisis. While premedical pathway programs have contributed to increased workforce diversity, alone they are insufficient to accelerate change.

Hospital Length of Stay in Patients with and without Serious and Persistent Mental Illness: Evidence of Racial and Ethnic Differences.

Background: Prior studies have documented racial and ethnic differences in mental healthcare utilization, and extensively in outpatient treatment and prescription medication usage for mental health disorders. However, limited studies have investigated racial and ethnic differences in length of inpatient stay (LOS) in patients with and without Serious and Persistent Mental Illness. Understanding racial and ethnic differences in LOS is necessary given that longer stays in hospital are associated with adverse health outcomes, which in turn contribute to health inequities.

COVID-19, Structural Racism, and Mental Health Inequities: Policy Implications for an Emerging Syndemic.

The complex interactions between the 2019 coronavirus disease (COVID-19) pandemic, structural racism, and mental health inequities have led to devastating health, economic, and social consequences. The intersection of these three conditions, which meets criteria for a syndemic (synergistic epidemics), presents numerous policy challenges-and opportunities. Addressing these issues in a unified manner, using a syndemic theory approach, can lead to significant progress and effective solutions for otherwise intransigent problems in society.

Shifting the Policy Paradigm to Achieve Equity.

This article offers a brief history of mental health policies that have shaped current inequities in health care financing and service delivery. Mental health has a unique position within the health care system given the pervasive nature of stigma associated with illness; race and ethnicity often amplify this burden. The acknowledgment of disparities in mental health and the development of policies that address the needs of minority groups are relatively recent phenomena.