Although overdose deaths from heroin and prescription opioids have declined, deaths involving synthetic opioids are on the rise. Much of the current wave of overdoses is linked to one synthetic opioid: fentanyl.
About half of all U.S. states now have policies that criminalize substance use during pregnancy, consider it grounds for civil commitment, or consider it child abuse or neglect. But research suggests that punitive policies aren't beneficial for infants or their mothers.
This issue features research on preventing child abuse and neglect and improving outcomes for children in the U.S. child-welfare system; a look back on RAND's 70 years of innovation; and an exploration of the human side of artificial intelligence.
Reflecting a comprehensive VA effort to improve pain management, in 2007 fewer veterans received high doses of opioids and more veterans received non-opioid pain therapies, naloxone, and treatment for substance use disorders.
Abundant supply of opioids was one of the major causes of the opioid crisis. Broader supply-side policies that consider the full market, if coupled with effective treatment, are likely to be effective and resistant to substitution effects.
Outpatient guidelines can help hospitalists evaluate inpatients on long-term opioid therapy, but more work is needed to help providers make decisions for inpatients that balance effective pain treatment and opioid risk reduction.
RAND adjunct physician policy researcher Stephen W. Patrick gives testimony at a Senate Health, Education, Labor and Pensions Committee hearing on the impact of the opioid epidemic on children and families.
The association between medical marijuana and lower levels of opioid overdose deaths—identified previously in several studies—is more complex than previously described. It appears to be changing as both medical marijuana laws and the opioid crisis evolve.
Among Medicaid recipients, high-risk prescribing of opioids occurred in 39.4% of episodes. Four characteristics -- older age, rural county of residence, white race, and major depression diagnosis -- were associated with higher rates of all types of high-risk prescribing.
Patients of community health clinics who screen positive for alcohol or opioid misuse have a high probability of an alcohol- or substance-use disorder and a slightly higher prevalence of mental illness than the overall clinic population.
Most buprenorphine prescribers treat many fewer patients than allowed by the current patient limit. Increasing the limit above 100 would likely improve access only for patients of a few high prescribers.
Following three possible recommendations for medical care for people with an opioid addiction may cut deaths among such patients by as much as one-third. Deaths were much lower among patients who were not prescribed opioids or common types of anxiety medications, those who received psychosocial counseling, and those who had quarterly visits with a physician.