Offersencooley3656

Background Although Medicaid expansion under the Affordable Care Act reduces uninsurance, little evidence exists on its impact on mental health and substance use (MHSU) related healthcare utilization. Therefore, the objectives of this study are to examine the impact of Medicaid expansion on emergency department visits related to mental health and substance use disorders and to examine its effect on the variation in payer mix. Methods The study utilizes state-level quarterly emergency department (ED) visit data from Healthcare Cost and Utilization Project's Fast Stats Database, along with state socio-demographic and health policy data for the analysis. A difference-in-differences regression analysis approach was utilized in comparing MHSU-related ED visit data between expansion and non-expansion states from 2006 to 2019 for all visits and by payer mix. Results Medicaid expansion was associated with additional 0.35 non-Medicare adult MHSU-related ED visits per 1,000 population (p  less then  0.05) in expansion states compared with non-expansion states. In addition, Medicaid expansion was associated with about 20.4% increase (p  less then  0.01) in Medicaid-share of MHSU-related ED visits, about 17.4% reduction (p  less then  0.01) in uninsured-share of MHSU-related ED visits, and about 3% reduction (p  less then  0.05) in privately-insured share of MHSU-related ED visits in expansion states compared with non-expansion states. Conclusions The findings indicate that Medicaid expansion was associated with increased MHSU-related ED visits among the Medicaid population and the overall non-Medicare adult population, while it was associated with reductions in MHSU-related ED visits among the uninsured and privately-insured populations in expansion states compared with non-expansion states.Spirituality is a construct that is reflected in a diversity of strongly felt personal commitments in different cultural and national groups. For persons with substance use disorders (SUDs), it can serve as a component of the recovery capital available to them. This position statement reviews empirical research that can shed light on psychological, social, and biological aspects of this construct. On this basis, the Spirituality Interest Group of the International Society of Addiction Medicine (ISAM) makes recommendations for how this construct can be incorporated into research and clinical care.Introduction As rates of overdose and substance use disorders (SUDs) increase, medical schools are starting to incorporate more content on SUDs and harm reduction in undergraduate medical education (UME). Initial data suggest these additions may improve medical student knowledge and attitudes toward patients with SUDs; however, there is no standard curriculum. Methods This project uses a six-step approach to UME curricular development to identify needs and goals regarding SUDs and opioid overdose at a large single-campus medical school in the United States. We first developed and delivered a pilot curriculum to a small group of medical students. Pilot results and a larger survey led to implementing a one-hour Opioid Overdose Prevention and Response (OOPR) Training for first-year students. Effects of training were tracked using baseline and post-training surveys examining knowledge and attitudes toward opioid overdose and patients with SUDs. Results Needs assessment indicated desire and need for training. The r curricula in SUDs and harm reduction.Background Accurate prevalence estimates are critical to epidemiological research but discordant responses on self-report surveys can lead to over- or underestimation of drug use. this website We sought to examine the extent and nature of underreported cannabis use (among those later reporting blunt use) from a national drug survey in the US. Methods We used data from the 2015-2019 National Survey on Drug Use and Health (N = 281,650), a nationally representative probability sample of non-institutionalized populations in the US. We compared self-reported prevalence of past-year cannabis use and blunt use and delineated correlates of underreporting cannabis use, defined as reporting blunt use but not overall cannabis use. Results An estimated 4.8% (95% CI 4.4-5.2) of people reported blunt use but not cannabis use. Although corrected prevalence, cannabis use recoded as use only increased from 15.2% (95% CI 15.0-15.4) to 15.5% (95% CI 15.3-15.7), individuals who are aged ≥50 (aOR = 1.81, 95% CI 1.06-3.08), female (aOR = 1.35, 95% CI 1.12-1.62), Non-Hispanic Black (aOR = 1.43, 95% CI 1.16-1.76), or report lower English proficiency (aOR = 3.32, 95% CI 1.40-7.83) are at increased odds for providing such a discordant response. Individuals with a college degree (aOR = 0.57, 95% CI 0.39-0.84) and those reporting past-year use of tobacco (aOR = 0.75, 95% CI 0.62-0.91), alcohol (aOR = 0.42, 95% CI 0.33-0.54), cocaine (aOR = 0.50, 95% CI 0.34-0.73), or LSD (aOR = 0.52, 95% CI 0.31-0.87) were at lower odds of providing a discordant response. Conclusion Although changes in prevalence are small when correcting for discordant responses, results provide insight into subgroups that may be more likely to underreport use on surveys.Objective To assess whether cannabis use disorder (abuse or dependence) hospitalizations are increasing over time and examine the variables associated with the outcomes of cannabis use disorder hospitalizations. Methods This study examined the rates of hospitalizations with cannabis use disorder and associated healthcare utilization using the U.S. National Inpatient Sample data from 1998 to 2014. Adjusted logistic regression analyses assessed the association of demographic, comorbidity and hospital characteristics with healthcare utilization (total hospital charges, length of hospital stays, discharge to a non-home setting) during the index hospitalization for cannabis use disorder. Odds ratio (OR) and 95% confidence intervals (CI) were calculated. Results There were an estimated 5,601,382 hospitalizations with cannabis use disorder (primary or secondary diagnosis). The rates of hospitalization (/100,000 admissions) for cannabis use disorder increased 3.7-fold from 439/100,000 admissions in 1998-2000 to 1,631/100,000 admissions in 2013-2014.