Perspectives of opioid use disorder treatment providers during COVID-19: Adapting to flexibilities and sustaining reforms

Peter C. Treitler, Cadence F. Bowden, James Lloyd, Michael Enich, Amesika N. Nyaku, Stephen Crystal 01/01/2022

Objective: The COVID-19 pandemic led to unprecedented temporary federal and state regulatory flexibilities that rapidly transformed medication for opioid use disorder (MOUD) treatment delivery. This study aimed to understand changes in treatment providers’ care during COVID-19, provider experiences with the adaptations, and perceptions of which changes should be sustained long-term. Methods: We conducted in-depth, semi-structured interviews with 20 New Jersey MOUD providers, purposively sampled to reflect diversity in provider setting, specialty, and other characteristics. Using a rapid analysis approach, we summarized content within interview domains and analyzed domains across participants for recurring concepts and themes…

Increased risk for binge drinking among college students with disability who report sexual violence

Carla D. Chugani, Kelley A. Jones, Robert W.S. Coulter, Jocelyn C. Anderson, Janine Talis, Tina R. Goldstein, Tammy Chung, Elizabeth Miller 01/01/2022

Objective This study investigated binge drinking in college students with and without disabilities and sexual violence (SV). Participants: This analysis includes 2,113 college students recruited from campus health or counseling centers between 2015 and 2017, aged 18-24. Method: Multinomial logistic regression procedures were used to estimate adjusted odds ratios (AOR) for past month binge drinking days (BDD). Results: Among students with disabilities, 68% endorsed SV, compared with 53% of those without disability. Disability was not significantly associated with BDD; SV was significantly associated with BDD (p <.0001). Students with SV, regardless of disability status, had 1.7- to 2.1-fold greater odds of having 4+ past month BDD. Conclusions: While disability alone is not a risk factor for binge drinking, novel findings include that students with disabilities binge drink at similarly high rates to their nondisabled peers, and are at elevated risk for SV, which is closely associated with binge drinking...

Regulator-Requested Non-Interventional Postauthorization Safety and Effectiveness Studies for Oncology Drugs: A Systematic Review

Xiao Zhang, Lei Chen, Oswaldo L. Bracco, Soko Setoguchi, Wei Zhou, Mehmet Burcu 01/01/2022

Abstract: There has been a growing number of oncology drug approvals. Non-interventional postauthorization safety/effectives studies (PASSs/PAESs) aim to provide real-world evidence on the safety/effectiveness of oncology drugs postapproval. To understand the current landscape, a comprehensive search as of March 1, 2021, was conducted in major register/databases…

Medically treated opioid overdoses among New Jersey Medicaid beneficiaries: Rapid growth and complex comorbidity amid growing fentanyl penetration

Stephen Crystal, Molly Nowels, Mark Olfson, Hillary Samples, Arthur Robinson Williams, Peter Treitler 12/01/2021

Objective: Medically treated opioid overdoses identify a population at high risk of subsequent mortality and need for treatment. This study reports on medically treated opioid overdose trends in a state with rapid fentanyl spread. Methods: We conducted stratified trend analysis of medically treated overdose due to heroin, synthetic opioids, methadone, or other natural opioids among New Jersey Medicaid beneficiaries aged 12–64 years (2014–2019); evaluated associations with demographics and co-occurring conditions; and examined trends in fentanyl penetration in suspected heroin seizures from New Jersey State Police data. Results: Overdose risk more than tripled from 2014 to 2019, from 120.5 to 426.8 per 100,000 person-years, respectively…

Brief original report: Does smoking status provide information relevant to screening for other substance use among US adults?

Maria R. Khan, Kaoon Ban, Ellen C. Caniglia, Jennifer E. Edelman, Julie Gaither, Stephen Crystal, Natalie E. Chichetto, Kailyn E. Young, Janet Tate, Amy C. Justice, R. Scott Braithwaite 12/01/2021

Abstract: We assessed whether tobacco screening provides clinically meaningful information about other substance use, including alcohol and other drug use, potentially facilitating targeting of screening for substance use. Using data from the Veterans Aging Cohort Study survey sample (VACS; N = 7510), we calculated test performance characteristics of tobacco use screening results for identification of other substance use including sensitivity, specificity, positive-likelihood-ratio (+LR = [sensitivity/(1-specificity)]: increase in odds of substance use informed by a positive tobacco screen), and negative-likelihood-ratio (-LR: [(1-sensitivity)/specificity]: reduction in odds of substance use informed by a negative tobacco screen). The sample was 95% male, 75% minority, and 43% were current and 33% were former smokers. Never smoking, versus any history, indicated an approximate four-fold decrease in the odds of injection drug use (-LR = 0.26), an approximate 2.5-fold decrease in crack/cocaine (-LR = 0.35) and unhealthy alcohol use (-LR = 0.40), an approximate two-fold decrease in marijuana (-LR = 0.51) and illicit opioid use (-LR = 0.48), and an approximate 30% decrease in non-crack/cocaine stimulant use (-LR = 0.75)…

Considerations when assessing the effect of nightshifts on hypertension prevalence

Maxwell Everett, Soko Setoguchi, Aayush Visaria 12/01/2021

Considerations when assessing the effect of nightshifts on hypertension prevalence …

Highly versatile antibody binding assay for the detection of SARS-CoV-2 infection and vaccination

Pratik Datta, Rahul Ukey, Natalie Bruiners, William Honnen, Mary O. Carayannopoulos, Charles Reichman, Alok Choudhary, Alberta Onyuka, Deborah Handler, Valentina Guerrini, Pankaj K. Mishra, Hannah K. Dewald, Alfred Lardizabal, Leeba Lederer, Aliza L. Leiser, Sabiha Hussain, Sugeet K. Jagpal, Jared Radbel, Tanaya Bhowmick, Daniel B. Horton, Emily S. Barrett, Yingda L. Xie, Patricia Fitzgerald-Bocarsly, Stanley H. Weiss, Melissa Woortman, Heta Parmar, Jason Roy, Maria Gloria Dominguez-Bello, Martin J. Blaser, Jeffrey Carson, Reynold A. Panettieri, Steven Libutti, Henry F. Raymond, Abraham Pinter, Maria Laura Gennaro 12/01/2021

Monitoring the burden and spread of infection with the new coronavirus SARS-CoV-2, whether within small communities or in large geographical settings, is of paramount importance for public health purposes. Serology, which detects the host antibody response to the infection, is the most appropriate tool for this task, since virus-derived markers are most reliably detected during the acute phase of infection…

Cerebrospinal fluid biomarkers in Parkinson’s disease with freezing of gait: an exploratory analysis

J. M. Hatcher-Martin, J. L. McKay, A. F. Pybus, B. Sommerfeld, J. C. Howell, F. C. Goldstein, L. Wood, W. T. Hu, S. A. Factor 11/29/2021

Abstract: We explore the association between three Alzheimer’s disease-related and ten inflammation-related CSF markers and freezing of gait (FOG) in patients with Parkinson’s disease (PD). The study population includes PD patients with FOG (PD-FOG, N = 12), without FOG (PD-NoFOG, N = 19), and healthy controls (HC, N = 12). Age and PD duration are not significantly different between groups…

The Impact of Increasing Community-Directed State Mental Health Agency Expenditures on Violent Crime

John S. Palatucci & Alan C. Monheit 11/20/2021

Abstract: Violent crime remains a prevalent threat to population health within the United States. States offer varying policy approaches to prevent violent crime and support behavioral health, such as community-based programs that include substance use disorder prevention and treatment. Using state mental health agency data, we construct a panel of U.S. states over nine years and apply an instrumental variables empirical model with state and time fixed effects to adjust for policy endogeneity, omitted variable bias, and time trends. We find that a 10% increase in community-directed state mental health agency expenditures yielded nearly a 4% reduction in violent crime rates. Larger magnitude reductions in violent crime rates were associated with the presence of gun control regulations and increases in the proportion of the population completing secondary education. Policymakers should consider the added benefit of violent crime reduction when considering budgetary allocations of community-directed state mental health agency expenditures…

Validation of a claims-based algorithm to identify cases of ulcerative colitis in Japan

Haruei Ogino, Hiromu Morikubo, Keita Fukaura, Tasuku Okui, Sean Gardiner, Naonobu Sugiyama, Noritoshi Yoshii, Tsutomu Kawaguchi, Haoqian Chen, Edward Nonnenmacher, Soko Setoguchi, Naoki Nakashima, Taku Kobayashi 11/05/2021

Background and Aim: The prevalence of ulcerative colitis (UC) is increasing in Japan. Validated claims-based definitions are required to investigate the epidemiology of UC and its treatment and disease course in clinical practice. This study aimed to develop a claims-based algorithm for UC in Japan…

Where to begin? Thirty must-read papers for newcomers to pharmacoepidemiology

Anton Pottegård, Lucas Morin, Jesper Hallas, Tobias Gerhard, Almut G. Winterstein, Susanna Perez-Gutthann, Mina Tadrous 11/04/2021

Pharmacoepidemiology, the study of use and effects of medications, devices, diagnostics, and other medical interventions in large populations, is a science under constant development. New study designs are added to the armamentarium, new data sources are being leveraged, and new approaches are developed. All are changing the conduct of pharmacoepidemiological studies…

Prescription Opioid Laws and Opioid Dispensing in US Counties: Identifying Salient Law Provisions with Machine Learning

Silvia S. Martins, Emilie Bruzelius, Jeanette A. Stingone, Katherine Wheeler-Martin, Hanane Akbarnejad, Christine M. Mauro, Megan E. Marziali, Hillary Samples, Stephen Crystal, Corey S. Davis, Kara E. Rudolph, Katherine M. Keyes, Deborah S. Hasin, Magdalena Cerdá 11/01/2021

Background: Hundreds of laws aimed at reducing inappropriate prescription opioid dispensing have been implemented in the United States, yet heterogeneity in provisions and their simultaneous implementation have complicated evaluation of impacts. We apply a hypothesis-generating, multistage, machine-learning approach to identify salient law provisions and combinations associated with dispensing rates to test in future research…

Mobile phone sensor-based detection of subjective cannabis intoxication in young adults: A feasibility study in real-world settings

Sang Won Bae, Tammy Chung, Rahul Islam, Brian Suffoletto, Jiameng Du, Serim Jang, Yuuki Nishiyama, Raghu Mulukutla, Anind Dey 11/01/2021

Background: Given possible impairment in psychomotor functioning related to acute cannabis intoxication, we explored whether smartphone-based sensors (e.g., accelerometer) can detect self-reported episodes of acute cannabis intoxication (subjective “high” state) in the natural environment. Methods: Young adults (ages 18–25) in Pittsburgh, PA, who reported cannabis use at least twice per week, completed up to 30 days of daily data collection: phone surveys (3 times/day), self-initiated reports of cannabis use (start/stop time, subjective cannabis intoxication rating: 0–10, 10 = very high), and continuous phone sensor data. We tested multiple models with Light Gradient Boosting Machine (LGBM) in distinguishing “not intoxicated” (rating = 0) vs subjective cannabis “low-intoxication” (rating = 1–3) vs “moderate-intensive intoxication” (rating = 4–10). We tested the importance of time features (i.e., day of the week, time of day) relative to smartphone sensor data only on model performance, since time features alone might predict “routines” in cannabis intoxication…

The impact of electronic health record functions on patterns of depression treatment in primary care

Elizabeth B. Matthews, Ayse Akincigil 10/21/2021

Background: Many individuals with depression are not being linked to treatment by their primary care providers. Electronic health records (EHRs) are common in medicine, but their impact on depression treatment is mixed. Because EHRs are diverse, differences may be attributable to differences in functionality. This study examines the relationship between EHR functions, and patterns of depression treatment in primary care.

Determinants and Dynamics of SARS-CoV-2 Infection in a Diverse Population: 6-Month Evaluation of a Prospective Cohort Study

Daniel B. Horton, Emily S. Barrett, Jason Roy, Maria Laura Gennaro, Tracy Andrews, Patricia Greenberg, Natalie Bruiners, Pratik Datta, Rahul Ukey, Senthil K. Velusamy, Daniel Fine, William J. Honnen, Yue Sandra Yin, Abraham Pinter, Andrew Brooks, Jay Tischfield, Sabiha Hussain, Sugeet Jagpal, Shobha Swaminathan, Veenat Parmar, Nancy Reilly, Sunanda Gaur, Reynold A. Panettieri, Jeffrey Carson, Martin J. Blaser 10/15/2021

Background: We studied risk factors, antibodies, and symptoms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a diverse, ambulatory population. Methods: A prospective cohort (n = 831) previously undiagnosed with SARS-CoV-2 infection underwent serial testing (SARS-CoV-2 polymerase chain reaction, immunoglobulin G [IgG]) for 6 months…

The Ethics of Human Challenge Trials Using Emerging Severe Acute Respiratory Syndrome 2 Variants

Abie Rohrig, Nir Eyal 10/08/2021

Abstract: The world’s first coronavirus disease 2019 human challenge trial using the D614G strain of severe acute respiratory syndrome 2 (SARS-CoV-2) is underway in the United Kingdom. The Wellcome Trust is funding challenge stock preparation of the Beta and Delta variant for a follow-up human challenge trial, and researchers at hVIVO are considering conducting these trials. However, little has been written thus far about the ethical justifiability of human challenge trials with SARS-CoV-2 variants of concern. We explore 2 specific characteristics of some variants that may initially be thought to make such trials unethical and conclude that SARS-CoV-2 variant challenge trials can remain ethical…

Risk of clinically relevant hyperglycemia with metoprolol compared to carvedilol in older adults with heart failure and diabetes

Chintan V. Dave, Brian L. Strom, Fred A. Kobylarz, Daniel B. Horton, Tobias Gerhard, Chin Lin Tseng, Ilja Dejanovic, Abner Nyandege, Soko Setoguchi 10/01/2021

Background: Although prior literature suggests that metoprolol may worsen glucose control compared to carvedilol, whether this has clinical relevance among older adults with diabetes and heart failure (HF) remains an open question…

Sex hormone-binding globulin (Shbg) in cerebrospinal fluid does not discriminate between the main ftld pathological subtypes but correlates with cognitive decline in ftld tauopathies

Marta Del Campo, Yolande A.L. Pijnenburg, Alice Chen-Plotkin, David J. Irwin, Murray Grossman, Harry A.M. Twaalfhoven, William T. Hu, Lieke H. Meeter, John van Swieten, Lisa Vermunt, Frans Martens, Annemieke C. Heijboer, Charlotte E. Teunissen 10/01/2021

Abstract: Biomarkers to discriminate the main pathologies underlying frontotemporal lobar degeneration (FTLD-Tau, FTLD-TDP) are lacking. Our previous FTLD cerebrospinal fluid (CSF) proteome study revealed that sex hormone-binding globulin (SHBG) was specifically increased in FTLD-Tau patients. Here we investigated the potential of CSF SHBG as a novel biomarker discriminating the main FTLD pathological subtypes…

Perspectives article: income inequality, health, and household welfare

Alan C. Monheit 09/30/2021

Abstract: The growth in US income inequality since the late 1970s has directed much public policy attention to the macroeconomic and political factors contributing to such growth. In this review, I focus on the microeconomic implications of income inequality for household wellbeing, specifically, on whether income inequality per se has an impact on the health of household members. In doing so I review work that has posited the social and biological pathways through which inequality may affect health, and the empirical approaches and challenges to identifying such causality. I find that despite both theoretical and conceptual arguments that income inequality may affect the health of family members through the family’s relative position in the income distribution, the weight of the empirical evidence does not support such a causal relationship. I conclude with a discussion differentiating the importance of income support for those in the lower percentiles of the income distribution, and efforts to improve the relative economic status of others.

The influence of negative mood on solitary drinking preference: An experiment with young adult solitary drinkers

Carillon J. Skrzynski, Kasey G. Creswell, Timothy Verstynen, Rachel L. Bachrach, Tammy Chung 09/25/2021

Solitary drinking is a risk marker for alcohol use disorder; thus, it is important to identify why individuals drink alone and for whom this association is particularly relevant.