Rosanna Smart

Addressing Gun Violence Requires Better Means of Measuring It

Proposals to reduce firearm violence in the United States are often controversial, sometimes because there are no data demonstrating their effectiveness. The federal government has many of the requisite tools in place to collect the data, and it does it well on a wide range of other problems. Shying away from measuring this problem may also make it more difficult to fix it.

Responding to the Firearm Violence Crisis: Are Some Newly Enacted Laws Making Things Worse?

Persuasive scientific evidence is accumulating for several commonly implemented laws. Where the science is strong, lawmakers would be wise to consider it when making decisions about how to protect public safety while preserving civil liberties, including the right to bear arms.

Better Data, Less Gun Violence

If the United States is serious about fixing the escalating problem of gun violence, the government needs to measure it. Research that is supported by new funding is overdue but will be hampered until federal and state firearm violence data systems improve.

A New Era for Firearm Violence Prevention Research

Despite many remaining obstacles, the United States may soon have research that clarifies many of the unanswered questions about firearm violence and its prevention. Many critical research questions, neglected for decades, may now benefit from recent federal and private research funding that has supported a surge in research.

Facts Still Matter, Even If the Court Signals Otherwise

The Supreme Court's recent decision in New York State Rifle & Pistol Association v. Bruen threatens to render decades of scientific studies legally irrelevant. But there is still room for research to inform court decisions about firearm regulations.

State Gun Regulations Are a Messy Patchwork. The Supreme Court's Bruen Decision Won't Help

The Supreme Court's decision may not actually narrow the policy gap between states sharply divided over their approach to regulating guns. Rather, its result may not look very different than what we have today—a patchwork of laws that often reflect political and policy demands of individual states.

'Stand Your Ground' Laws May Be Causing More Harm Than Good

Americans have debated whether “stand your ground” laws or gun-free zones make us safer or less safe for decades. These are debates about factual matters that are, in principle, knowable. Without research on these and other topics, bad laws will inadvertently be passed or retained.

How Will Cannabis Legalization Affect Alcohol Consumption?

How will legalization of recreational marijuana affect alcohol consumption? Will drinking go down because people substitute cannabis for alcohol? Or will drinking go up because cannabis and alcohol complement each other? These questions have important implications.

Journal Article

Investigating the Complexity of Naloxone Distribution: Which Policies Matter for Pharmacies and Potential Recipients

In this paper, we estimate the effects on naloxone pharmacy distribution of two types of laws: laws authorizing non-patient-specific prescription distribution of naloxone and laws granting pharmacists prescriptive authority for naloxone.

Journal Article

Martin Y. Iguchi (1955-2021)

This article memorializes Martin Y. Iguchi (1955-2021). Dr. Iguchi was a pioneering clinical scientist and lifelong champion of equity and racial justice and he died after a lengthy illness on June 5, 2021.

Journal Article

How Much Can You Trust the Results of This Health Policy Evaluation: A Pragmatic Guide for State Policymakers

This Perspective is intended to help policymakers and other stakeholders assess policy evaluation studies, with a focus on health policy studies at the state level.

Journal Article

Association of Polysubstance Use Disorder with Treatment Quality Among Medicaid Beneficiaries with Opioid Use Disorder

Ongoing progress toward increasing access to and quality of evidence-based treatment for OUD requires further efforts to ensure that individuals with co-occurring SUDs are engaged and retained in effective treatment.

Tool

Visualizing Firearm Mortality and Law Effects: An Interactive Web-Based Tool

This tool provides users with information about the distribution of firearm deaths across states and demographic subgroups. Users can explore how those deaths might be affected by the implementation of a set of commonly enacted state firearm laws.

Report

The Science of Gun Policy: A Critical Synthesis of Research Evidence on the Effects of Gun Policies in the United States, Third Edition

This report, now in its third edition, synthesizes the available scientific evidence for the effects of various firearm policies on firearm deaths, violent crime, the gun industry, defensive gun use, and other outcomes.

Journal Article

The Kids Aren't Alright: The Effects of Medical Marijuana Market Size on Adolescents

We exploit shocks to U.S. federal enforcement policy to assess how legal medical marijuana market size affects youth marijuana use and consequences for youth traffic-related fatalities.

Commentary

State Firearm Laws After Bruen

The Supreme Court's decision in Bruen is a major change to Second Amendment jurisprudence and could lead to significant changes in the U.S. firearm regulations. The authors describe how state regulations will now be evaluated by lower courts.

Journal Article

Comparing Two Federal Financing Strategies on Penetration and Sustainment of the Adolescent Community Reinforcement Approach for Substance Use Disorders: Protocol for a Mixed-Method Study

The project will advance understanding of effective financing strategies to support the implementation and sustainment of evidence-based practices for the treatment of adolescent substance use disorders.

Journal Article

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

This qualitative study used the ExpertLens online platform to conduct a 3-round modified Delphi process to examine expert consensus on the effectiveness and the ability to implement state-level OUD treatment policies.

Journal Article

Expert Views on State-Level Naloxone Access Laws: A Qualitative Analysis of an Online Modified-Delphi Process

This qualitative study conducted a three-round modified-Delphi process using the online ExpertLens platform. Researchers identified and summarized the views of experts on state-level naloxone access laws.

Tool

Concurrent Policies Simulation Tool

This tool allows users to select from a range of simulation parameters to explore how different models perform and compare models by various performance metrics.

Journal Article

Legal Review of State Emergency Medical Services Policies and Protocols for Naloxone Administration

We provide data on the authority of providers at different emergency medical services licensure levels to administer naloxone. We also describe relevant policies regarding which administration routes and dosages are permitted for each licensure level.

Journal Article

Geographic Disparities in Rising Rates of Firearm-Related Homicide

Our study shows that the rise since 2014 in firearms homicides is concentrated in south-central and midwestern states, and in American Indian and Alaskan Natives, and Black communities, thereby exacerbating existing disparities.

Journal Article

Methodological Considerations for Estimating Policy Effects in the Context of Co-Occurring Policies

Researchers conducted simulations to assess how concurrently implemented policies affected the evaluation of hypothetical state-level policies.

Draft

Evaluating Baltimore's Aerial Investigation Research Pilot Program

Using a Bayesian statistical analytic framework, investigates whether the Baltimore Police Department's use of aerial surveillance could help detectives solve serious violent crimes.

Report

Suggestions for Estimating the Effects of State Gun Policies: Commentary on Four Methodological Problems in the Current Literature

In this report, the authors discuss four common methodological problems that they observed in the literature evaluating gun policies and offer suggestions for how future research on gun policies could be improved.

Journal Article

Moving Beyond the Classic Difference-In-Differences Model: A Simulation Study Comparing Statistical Methods for Estimating Effectiveness of State-Level Policies

Researchers conducted an extensive simulation study to compare the statistical performance of commonly used methods for evaluating state-level opioid policies, including popular difference-in-differences methods.

Report

The Magnitude and Sources of Disagreement Among Gun Policy Experts: Second Edition

This report describes combined results from two fieldings of a survey of gun policy experts designed to identify areas of agreement and whether disagreements stem from assumptions about the policies' effects or from differences in policy objectives.

Journal Article

Assessment of State and Federal Health Policies for Opioid Use Disorder Treatment During the COVID-19 Pandemic and Beyond

Researchers summarize the multitude of ways access to and utilization of treatment for individuals with OUD might have been expanded by state and federal policy during COVID-19 pandemic in 4 key areas: telehealth, privacy, licensing, and medication.

Journal Article

Neonatal Opioid Withdrawal Syndrome Is Associated With Infant Foster Care Entry At The County Level

This study used a decade of data from U.S. counties to examine how rates of neonatal opioid withdrawal syndrome (NOWS) and county-level characteristics were associated with entry in the child welfare system.

Report

Evaluating Baltimore's Aerial Investigation Research Pilot Program: Interim Report

This report provides interim findings on the Aerial Investigation Research pilot program, a Baltimore Police Department program in which manned aircraft equipped with cameras gathered evidence to support crime investigations.

Journal Article

Toward a Typology of Office-based Buprenorphine Treatment Laws: Themes from a Review of State Laws

Buprenorphine is a gold standard treatment for opioid use disorder. Some states have passed laws regulating office-based buprenorphine treatment, with requirements beyond those required in federal law. This study identified themes in state laws.

Tool

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

RAND researchers developed a database of state-level estimates of inpatient hospitalizations for firearm injury. This document describes the methods used to construct the estimates and provides technical documentation to facilitate database use.

Journal Article

Acknowledging and Monitoring the Costs of Seriously Regulating Cannabis

Wilkins & Rychert highlight challenges to achieving the Cannabis Legalization and Control Bill's objectives of reducing cannabis use and harms.

Journal Article

Patient, Prescriber, and Community Factors Associated with Filled Naloxone Prescriptions Among Patients Receiving Buprenorphine 2017–18

This retrospective analysis examines filled naloxone prescriptions among patients receiving buprenorphine treatment and assesses how rates of filled naloxone prescriptions varies by patient, prescriber, and community characteristics.

Report

An Empirical Assessment of the U.S. Army's Enlistment Waiver Policies: An Examination in Light of Emerging Societal Trends in Behavioral Health and the Legalization of Marijuana

This report documents an analysis of the performance of U.S. Army recruits who receive waivers, as well as those with a documented history of marijuana, attention-deficit/hyperactivity disorder, depression, or anxiety.

Journal Article

Individual and Community Factors Associated with Naloxone Co-prescribing Among Long-term Opioid Patients: A Retrospective Analysis

This retrospective analysis examines naloxone co-prescribing in the general population and assess how co-prescribing varies by individual and community characteristics.

Journal Article

Current U.S. State Cannabis Sales Limits Allow Large Doses for Use or Diversion

This cross-sectional study examined how transaction sales limits on recreational cannabis translate to tetrahydrocannabinol doses among U.S. states allowing commercial cannabis sales as of January 1, 2020.

Report

Preliminary Findings from the Aerial Investigation Research Pilot Program

This report provides preliminary findings on the Aerial Investigation Research pilot program, a Baltimore Police Department program in which manned aircraft equipped with cameras gathered evidence to support crime investigations.

Journal Article

Effectiveness and Implementability of State-Level Naloxone Access Policies: Expert Consensus from an Online Modified-Delphi Process

This study gathered expert consensus on the effectiveness and implementability of various state-level naloxone strategies.

Journal Article

Integrating Traditional Practices and Social Network Visualization to Prevent Substance Use: Study Protocol for a Randomized Controlled Trial Among Urban Native American Emerging Adults

A community-informed and culturally grounded opioid prevention intervention can be developed for urban AI/AN emerging adults and can help to build resilience and hopefully decrease opioid use among this underserved population.

Journal Article

Reducing Opioid Overdose Deaths by Expanding Naloxone Distribution and Addressing Structural Barriers to Care

Qualitatively synthesizing evidence from six systematic reviews, the authors conclude that OEND programs generally produce beneficial outcomes across all domains considered, although the authors' ratings for the strength of the evidence are often "limited" or "moderate."

Report

Pitfalls and Potholes: Data Issues to Consider When Analyzing State Opioid Policies, September 14, 2020

This webinar focused on data dimensions that researchers should keep in mind when conducting analyses of state opioid policies and when seeking to draw conclusions from other studies.

Journal Article

Systematic Review of the Emerging Literature on the Effectiveness of Naloxone Access Laws in the United States

The existing literature on naloxone access laws in the United States supports beneficial effects for increased naloxone distribution, but provides inconclusive evidence for reduced fatal opioid overdose.

Journal Article

The State of the Science in Opioid Policy Research

The rigor of study design varies notably across policy categories, highlighting the need for broader adoption of rigorous methods in opioid policy research.

Journal Article

Changes in Firearm Mortality Following the Implementation of State Laws Regulating Firearm Access and Use

Laws that regulate children's access to firearms, the carrying of a concealed firearm, and the use of a firearm in self-defense, are associated with an 11% decrease in the firearms-related death rate.

Tool

Understanding and Using Research on Gun Policy in America: An Interdisciplinary Unit Plan Based on RAND's Gun Policy in America Website, Suggested Grades 10–12

As part of the Gun Policy in America initiative, RAND researchers developed a unit plan centered on the evidence-based resources on the project website. The unit, designed for grades 10-12, helps students understand existing gun policy research.

Report

The Science of Gun Policy: A Critical Synthesis of Research Evidence on the Effects of Gun Policies in the United States, Second Edition

This report, the second edition of an earlier work, synthesizes the available scientific evidence for the effects of various firearm policies on firearm deaths, violent crime, the gun industry, defensive gun use, and other outcomes.

Tool

State-Level Estimates of Household Firearm Ownership

As part of the Gun Policy in America initiative, researchers developed annual, state-level estimates of household firearm ownership from 1980 to 2016, which should help further research on the relationship between firearm ownership and key outcomes.

Journal Article

Legal Requirements and Recommendations to Prescribe Naloxone

We conducted a systematic legal review of state laws that mandate or recommend that healthcare providers prescribe naloxone to patients with indicators for opioid overdose risk.

Report

Comparing the Army's Suicide Rate to the General U.S. Population: Identifying Suitable Characteristics, Data Sources, and Analytic Approaches

Researchers investigate how accounting for demographic factors beyond age and gender (race/ethnicity, time, marital status, and educational attainment) affects suicide rate differences between soldiers and the general U.S. population.

Journal Article

We Need a Taxonomy of State-Level Opioid Policies

Developing and using a state-level opioid policy can facilitate the design and implementation of more effective state-level policies-an essential tool in addressing the opioid crisis.

Journal Article

Capsule Commentary for Azcarate Et Al., Medical Reasons for Marijuana Use, Forms of Use, and Patient Perception of Physician Attitudes Among the US Population

Commentary on an article by Azcarate et al., assessing U.S. adults' motivations for and perceived physician attitudes towards medical cannabis use.

Journal Article

How High: Differences in the Developments of Cannabis Markets in Two Legalized States

This paper is the first to examine cannabis market data from Washington alongside that from Oregon, two states that are similar in regard to legalizing retail sales of cannabis but differ in terms of their regulatory frameworks.

Journal Article

Impact on Nonfirearm Deaths of Firearm Laws Affecting Firearm Deaths: A Systematic Review and Meta-Analysis

State gun policies that reduce firearm homicides are likely to reduce overall homicides in the state by approximately the same number. It is currently unknown whether the same holds for state gun policies that significantly reduce firearm suicides.

Journal Article

Prescribers and Naloxone Pharmacy Claims

Commentary on an article by Truong, Patil, and Rich, on the benefits and dangers of naloxone prescriptions.

Journal Article

An Observational Study of Retail Pharmacy Naloxone Prescriptions: Differences Across Provider Specialties and Patient Populations

This article explores variation in pharmacy-dispensed naloxone by prescriber specialty and patient characteristics.

Journal Article

Strengths and Weaknesses of Existing Data Sources to Support Research to Address the Opioids Crisis

We conducted a scoping study to identify data sources and linking strategies commonly used in opioid studies, describe data source strengths and limitations, and highlight opportunities to use data to address public health research questions.

Journal Article

Early Evidence of the Impact of Cannabis Legalization on Cannabis Use, Cannabis Use Disorder, and the Use of Other Substances: Findings from State Policy Evaluations

Understanding effects of cannabis laws requires greater attention to differences in short- versus long-term effects of the laws, nuances of policies and patterns of consumption, and careful consideration of appropriate control groups.

Journal Article

Who Receives Naloxone from Emergency Medical Services? Characteristics of Calls and Recent Trends

Administration of naloxone by emergency medical services personnel is increasing faster than opioid-related deaths.

Report

After the Grand Opening: Assessing Cannabis Supply and Demand in Washington State

This report provides detailed information about state-legal cannabis production and sales in Washington, as well as insights about the total amount of tetrahydrocannabinol (THC) obtained from legal and illegal sources by Washington residents.

Report

Considering Heroin-Assisted Treatment and Supervised Drug Consumption Sites in the United States

In this mixed-methods report, the authors assess evidence on and arguments made about heroin-assisted treatment and supervised consumption sites and examine some of the issues associated with implementing them in the United States.

Draft

Evidence on the Effectiveness of Heroin-Assisted Treatment

This working paper is part of a series of reports assessing the evidence on and arguments made about heroin-assisted treatment and supervised consumption sites and examining some of the issues associated with implementing them in the United States.

Journal Article

Data Sources and Data-Linking Strategies to Support Research to Address the Opioid Crisis: Final Report

This report highlights key research questions and identifies opportunities to use existing data sources and implement data-linking strategies that can support the HHS five point strategy to combat the opioid crisis.

Report

Examining Consumer Responses to Calorie Information on Restaurant Menus in a Discrete Choice Experiment

In light of the 2014 U.S. Food and Drug Administration final rule requiring the calorie content of food items to be clearly displayed on menus, RAND researchers designed an online survey to look at how this information affects consumers.

Report

The Science of Gun Policy: A Critical Synthesis of Research Evidence on the Effects of Gun Policies in the United States

This report synthesizes the available scientific evidence on the effects of various firearm policies on firearm deaths, violent crime, the gun industry, participation in hunting and sport shooting, and other outcomes.

Research Brief

Incentivizing Employers to Hire Ex-Offenders: What Policies Are Most Effective?

To inform efforts aimed at improving employment rates and earnings potential for ex-offenders, RAND researchers examined employer preferences of policy options designed to incentivize employment of individuals with felony criminal records.

Report

Breaking Down Barriers: Experiments into Policies That Might Incentivize Employers to Hire Ex-Offenders

To inform policies and programs aimed at improving employment rates for ex-offenders, we conducted experiments to examine employer preferences regarding policy options targeted to incentivize hiring individuals with one nonviolent felony conviction.

Journal Article

Variation in Cannabis Potency and Prices in a Newly Legal Market: Evidence from 30 Million Cannabis Sales in Washington State

In Washington state, the potency and price of legal cannabis are currently being shaped by the market rather than by policy levers.

Report

Impact of Proposition 47 on Los Angeles County Operations and Budget

This report recommends how to measure the impact of Proposition 47 (and future legislative mandates) on Los Angeles County operations and budgets and what metrics should be tracked.

Journal Article

Medical Marijuana and Marijuana Legalization

State actions to relax marijuana policies vary substantially, making it difficult to compare policies and draw conclusions about user and market reactions.