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Substance Use Harm Reduction

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Commentary
Everyone Over 21 Has a 'License to Drink.' When Should It Get Suspended?
Excessive drinking creates massive economic costs because of its effects on workplace productivity, health care expenditures, and crime. This raises the question: Should some people be required to stop drinking?
Mar 11, 2023
Essay
America's Opioid Crisis: Adopting an Ecosystem Approach
The opioid crisis is metastasizing throughout society, reaching across public health and public safety, but also education, employment, and the child welfare system. Without profound change and new approaches to the crisis, hundreds of thousands of people could die in the coming years.
Jun 30, 2023

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Commentary
The Solution to Telemedicine Prescribing of Buprenorphine Seems Clear to Everyone but DEA
For more than a decade, Congress, clinicians, and policymakers have been requesting implementation of a special registration pathway that would allow registered clinicians to prescribe buprenorphine without an in-person visit requirement. It's clear to us that the time to implement the pathway is now.
Sep 5, 2023
Journal Article
Association of Selected State Policies and Requirements for Buprenorphine Treatment With Per Capita Months of Treatment
State-mandated educational requirements beyond the initial training required to prescribe buprenorphine were associated with increased buprenorphine use over time.
Jun 8, 2023
Blog
Violence in Sudan, Alcohol Use, North Korea: RAND Weekly Recap
This weekly recap focuses on the violence in Sudan, preventing alcohol-related deaths, the North Korean nuclear threat, and more.
Apr 28, 2023
Blog
Violence in Schools, Neurodiversity and National Security, Drug Cartels: RAND Weekly Recap
This weekly recap focuses on preventing school violence, dealing with drug cartels, the benefits of a neurodivergent national security workforce, and more.
Mar 31, 2023
Article
Illegal Opioids Are Hurting Too Many of Us. We Need a New Approach
Fatal overdoses are on the rise in the United States, with the proliferation of potent, synthetic opioids like illicit fentanyl. But deaths are just the tip of America's iceberg-sized opioid crisis. To save and improve lives, policymakers will need to take a holistic approach. People who use opioids and their families should be at the heart of this new response.
Mar 16, 2023
News Release
U.S. Opioid Crisis Best Viewed as Connected Ecosystem; Changing Policymakers' Approach Can Aid Solutions
The nation's opioid crisis, which kills thousands of Americans annually, is best viewed as an ecosystem where all parts of the vexing problem are interconnected, underscoring the need for holistic solutions that address the broad needs of those with substance use disorders, their families, and the communities where they live.
Mar 16, 2023
Report
America's Opioid Ecosystem
Patterns and consequences of opioid use are changing dramatically. Researchers provide a nuanced assessment of America's opioid ecosystem, highlighting how leveraging system interactions can reduce addiction, overdose, suffering, and other harms.
Mar 16, 2023
Visualization
The Ecosystem Approach to Opioid Policy
RAND researchers created a tool to help federal, state, and local policymakers better understand issues surrounding opioids as an ecosystem—and explore innovative policy ideas.
Mar 16, 2023
Journal Article
Association of an Alcohol Abstinence Program With Mortality in Individuals Arrested for Driving While Alcohol Impaired
Individual-level analysis finds that among those arrested for driving under the influence, participation in 24/7 Sobriety reduces risk of death during study period—on the order of 50 percent.
Mar 2, 2023
Report
A Multi-Site Evaluation of Law Enforcement Deflection in the United States
The authors describe how law enforcement deflection programs have been implemented at six U.S. sites and identify key program facilitators and barriers. The authors also conducted outcome analyses at two of the sites.
Jan 10, 2023
Journal Article
Trends in Out-of-Pocket Costs for Naloxone by Drug Brand and Payer in the US, 2010–2018
The findings suggest that the out-of-pocket cost of naloxone has been an increasingly substantial barrier to naloxone access for uninsured patients, a population that constitutes nearly one-fifth of adults with opioid use disorder.
Oct 27, 2022
Journal Article
A National Retrospective Study of Antidepressants' Effects on Overdose and Self-Harm Among Adults Treated With Opioid Analgesics
Individuals with a history of depression who received opioid analgesics had a significantly lower risk for overdose and self-harm after they had been taking antidepressants for at least 6 weeks.
Oct 19, 2022
Journal Article
Changes in Buprenorphine and Methadone Supplies in the US During the COVID-19 Pandemic
This cross-sectional study found that the per capita supply of methadone declined significantly in the second quarter of 2020 and had not returned to 2019 levels as of June 2021. The per capita supply of buprenorphine increased during the same period.
Sep 30, 2022
Blog
Diversity in the Military, Telemedicine Abortion, China and Taiwan: RAND Weekly Recap
This weekly recap focuses on the benefits of increasing and maintaining diversity in the armed forces, the challenges of telemedicine abortion, whether Indo-Pacific countries are backing China or Taiwan, and more.
Aug 26, 2022
News Release
Out-of-Pocket Cost of Naloxone May Keep Many Uninsured from Using Lifesaving Treatment
The cost of buying the opioid antidote naloxone is out of reach for many uninsured Americans, a hurdle that may keep the treatment from saving more people who overdose on opioids.
Aug 19, 2022
Multimedia
What Policy Changes Could Help Save Lives from Illicit Synthetic Opioids Overdose?
In this recording of a July 2022 virtual event, experts discuss findings from the final report by the Commission on Combating Synthetic Opioid Trafficking, and recommendations to reduce the number of lives lost to illicit synthetic opioids.
Aug 18, 2022
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.
Aug 2, 2022
Blog
How Data Can Help Refugees, Homelessness in L.A., Harm Reduction: RAND Weekly Recap
This weekly recap focuses on tapping into Facebook data to help refugees, addressing homelessness in Los Angeles, understanding burnout among health care providers, and more.
May 6, 2022

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Research conducted by

Researcher Spotlight

Chloe Gomez

Ph.D. Candidate, Pardee RAND Graduate School, and Assistant Policy Researcher, RAND

Chloe Gomez (she/her) is a Ph.D. student in the Community-Partnered Policy and Action stream at Pardee RAND Graduate School and an assistant policy analyst at RAND. She has an M.S.W. in clinical mental health and a B.A. in sociology, both from Boston College. Her research interests include…
Allison J. Ober

Senior Health Policy Researcher

Allison J. Ober is a senior health policy and behavioral science researcher at the RAND Corporation. She has extensive expertise in implementation science and intervention research, and over twenty years of experience conducting substance use disorder and HIV prevention research with underserved…

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