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Substance Use

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Substance use touches on many facets of public policy, including health and health care, economic issues, criminal justice, and risk behaviors—particularly among youth. Accordingly, RAND conducts drug policy research that addresses a range of concerns, from treatment effectiveness, harm reduction, drug markets and supply, and predictors and consequences to evaluations of programs to prevent youth from using and abusing drugs, alcohol, and tobacco.

News Release

Density of Marijuana Outlets Associated with More and Higher Use Among Young Adults

Jan 13, 2021

As marijuana outlets open after the drug is legalized, the density of those recreational retailers is associated with more use and a greater intensity of use among young adults.
Multimedia

RAND Remote: High Stakes, Fostering Innovation to Stem the Tide of America's Drug Problems

Jan 28, 2021

In this RAND Remote presentation, Beau Kilmer discusses how RAND is identifying and evaluating innovative approaches to tackle some of America's most pressing drug problems and help strengthen and safeguard communities.

Explore Substance Use

Commentary

Treating Supervised Drug Consumption Sites like Cannabis

Some communities hard-hit by the opioid crisis are interested in opening supervised consumption sites—places where people who use drugs can consume them under supervision of trained staff. What could be done to make it easier to pilot and evaluate these sites in the United States?

Oct 22, 2021
Journal Article

Trends in Visits to Substance Use Disorder Treatment Facilities in 2020

This study examined weekly changes in the number of substance use disorder treatment facility visits in 2020 compared to 2019, and explored variation in change in weekly visits by COVID-19 incidence and historical fatal drug overdose rate.

Oct 22, 2021
Journal Article

Population-Based Estimates of Geographic Accessibility of Medication for Opioid Use Disorder by Substance Use Disorder Treatment Facilities from 2014 to 2020

This cross-sectional study of substance use disorder treatment facilities examined the national share of facilities that offer medication treatment for opioid use disorder (MOUD) and population-based measures of geographic accessibility of facilities offering MOUD.

Oct 22, 2021
Journal Article

Use of Buprenorphine for Those with Employer-Sponsored Insurance During the Initial Phase of the COVID-19 Pandemic

This study examined changes in the use of buprenorphine to treat opioid use disorder in 2020 during the onset of the COVID-19 pandemic using pharmaceutical claims.

Oct 22, 2021
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.

Oct 20, 2021
Journal Article

Origins of the Opioid Crisis and Its Enduring Impacts

In this paper, we examine the role of the 1996 introduction and marketing of OxyContin as a potential leading cause of the opioid crisis.

Oct 19, 2021
Journal Article

Buprenorphine Prescriber Monthly Patient Caseloads: An Examination of 6-Year Trajectories

We examine buprenorphine-prescribing clinicians' patient caseloads over time and explore prescriber characteristics associated with different caseload trajectories.

Oct 1, 2021
Report

Final Evaluation of LA DOOR: Proposition 47 Grant Program

In this report, the authors summarize their findings from an evaluation of Cohort 1 of the Los Angeles Diversion, Outreach, and Opportunities for Recovery program.

Sep 30, 2021
Journal Article

Claims-based Measures of Prescription Opioid Utilization: A Practical Guide for Researchers

We reviewed medical literature for recent studies that use claims data to construct opioid utilization measures, then developed a guide for researchers regarding opioid utilization measures and measure definitions, and how these may influence study results.

Sep 30, 2021
Journal Article

Consensus-based Approach to Managing Opioids, Including Opioid Misuse and Opioid Use Disorder, in Patients with Serious Illness: Protocol for a Modified Delphi Process

Using a modified Delphi approach, we created seven patient cases that capture important management challenges in individuals with serious illness prescribed opioid therapy.

Sep 22, 2021
Periodical

RAND Review: September-October 2021

The cover story highlights strategies to mitigate homegrown terrorism and ideologically inspired violence in the U.S. A second feature describes Costa Rica's ambitious decarbonization plan and its implications for nations around the world.

Sep 7, 2021
Journal Article

Pregnant Women with Substance Use Disorders: The Harm Associated with Punitive Approaches

Punishing pregnant women with SUDs has been ineffective; it's time to prioritize approaches that support pregnant women and their families.

Aug 31, 2021
Journal Article

Longitudinal Associations Between Changes in Cigarette Smoking and Alcohol Use, Eating Behavior, Perceived Stress, and Self-Rated Health in a Cohort of Low-Income Black Adults

We found significant longitudinal associations between smoking behavior and eating behavior, perceived stress, and self-rated health. This has implications for the development of behavior change programs and community-level interventions and policies.

Aug 27, 2021
Dissertation

Three Essays on the Broader Effects of the Opioid Crisis

Investigates the unintended consequences of opioid policies, OxyContin reformulation and prescription drug monitoring programs on crime, labor supply, and child welfare.

Aug 24, 2021
Blog

Historic Lynchings and Voter Registration, China in Space, Firefighters' Mental Health: RAND Weekly Recap

This weekly recap focuses on the link between historic lynchings and voter registration, Afghanistan in the era of fentanyl, supporting firefighters’ mental health, and more.

Jul 30, 2021
Report

Afghanistan in the Era of Fentanyl

Fentanyl and other synthetic opioids are displacing heroin in some major drug markets. What might happen to Afghanistan—the world's largest producer of illegal opium poppy—if demand for its opiates dropped off sharply and permanently?

Jul 26, 2021
Journal Article

Informing the Development of a Standardized Clinical Definition of Neonatal Abstinence Syndrome: Protocol for a Modified-Delphi Expert Panel

The goal of this paper is to describe a protocol for a systematic expert panel process to inform the development of a clinical definition of neonatal abstinence syndrome.

Jul 23, 2021
Journal Article

Mental Health Conditions and Substance Use Disorders Among Youth Subsequently Diagnosed With Opioid Use Disorder or Opioid Poisoning

This study examined receipt of services for mental health conditions and non-opioid substance use disorders among privately insured adolescents and young adults (ie, youth) with subsequent clinically diagnosed opioid use disorder or opioid poisoning.

Jul 21, 2021
Journal Article

Can Novel 'Swift-Certain-Fair' Programs Work Outside of Pioneering Jurisdictions? An Analysis of 24/7 Sobriety in Montana, USA

South Dakota USA's 24/7 Sobriety Program appears to work in Montana as well. Certain delivery of immediate but modest sanctions for repeat driving under the influence (DUI) arrestees who violate alcohol abstinence orders appears to be able to reduce future DUI arrests.

Jul 20, 2021
Journal Article

Cannabis Legalization and Social Equity: Some Opportunities, Puzzles, and Trade-Offs

Legalization for nonmedical purposes may create new sources of disproportionate harm even as it alleviates some inequities associated with cannabis prohibition.

Jul 16, 2021

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RAND Topic:
Substance Use

Topic Synonyms:
Drug Use

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