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The purpose of this study was to measure changes in the payer mix and incidence of emergency department (ED) opioid-related overdose encounters after an April 2014 expansion of Medicaid to childless adults led to a 43% increase in Medicaid coverage for men and 8% for women statewide.

We explored two competing hypotheses using data visualization and comparative interrupted time-series analysis (CITS) (a) expanded eligibility for Medicaid is associated with a change in payer mix only and (b) sociodemographic groups that gained Medicaid eligibility were more likely to use ED services for opioid overdose. Data included encounters at all Wisconsin nonfederal hospitals over 23 quarters from 2010 to 2015 and American Community Survey estimates of pre- and post-policy Medicaid eligibility by sex and age.

We found an increase in the share of opioid-related ED visits covered by Medicaid for men and women ages 19-29 and for men ages 30-49 following the expansion. The number of visits increased substantially in April 2014 for men ages 30-49, with Medicaid-covered visits driving this result. We found little evidence of an increase in overall visits for other age groups for either men or women.

The relationship between Medicaid expansion and opioid ED use is complex. Changes in case mix and increased access to care likely both play a role in the overall increase in these ED visits. Being uninsured may be an important barrier to seeking emergency care for opioid-related overdoses.

The relationship between Medicaid expansion and opioid ED use is complex. Changes in case mix and increased access to care likely both play a role in the overall increase in these ED visits. Being uninsured may be an important barrier to seeking emergency care for opioid-related overdoses.

The opioid crisis has increased risks for injection drug use (IDU)-associated HIV outbreaks throughout the United States. Polysubstance use and syringe sharing are common among rural people who inject drugs (PWID). However, little is known about how polysubstance IDU affects engagement in HIV prevention efforts among non-urban PWID. Romidepsin price This study assesses the associations between profiles of polysubstance injection, injection-related HIV risk, acquiring syringes from a syringe services program (SSP), HIV testing, and pre-exposure prophylaxis (PrEP) awareness and interest among PWID in rural Appalachia.

We used survey data from 392 respondents in Cabell County, West Virginia who had injected drugs in the past 6 months. We conducted a latent class analysis using seven measures of IDU and tested for associations with injection-related HIV risk, receiving syringes from an SSP, having been tested for HIV, and PrEP awareness and interest.

We identified three classes of polysubstance IDU in our sample polysubstance use, heroin and crystal methamphetamine use, and crystal methamphetamine and buprenorphine/suboxone use. The polysubstance use class had the highest injection-related HIV risk (81.8% at risk), high syringe acquisition at an SSP (67.7%), and highest rate of HIV testing (60.0%). PrEP awareness was low across the sample (30.0%), but most PWID expressed interest in using PrEP (57.7%).

Patterns of polysubstance IDU have unique relationships with key HIV risk factors and protective behaviors. The expansion of harm reduction services in rural settings is warranted to prevent incident HIV infections.

Patterns of polysubstance IDU have unique relationships with key HIV risk factors and protective behaviors. The expansion of harm reduction services in rural settings is warranted to prevent incident HIV infections.

This is a personal history of how I came to view cigarette smoking as an addiction to nicotine. I discuss working with Stanley Schachter and Murray Jarvik. Although I note the importance of Michael Russell (as do many colleagues), I draw attention to the considerable effect on my work of Edward Brecher through his 1972 book, Licit and Illicit Drugs. I give examples of the influence of the makers and sellers of nicotine-containing gum on my career in Canada and the United States as well as on the careers of several important colleagues. Ted Klein, who did public relations for nicotine-replacement products, is noted as an important figure in the tobacco control movement of the time, especially for those doing behavioral and smoking cessation research.

This is a personal history of how I came to view cigarette smoking as an addiction to nicotine. I discuss working with Stanley Schachter and Murray Jarvik. Although I note the importance of Michael Russell (as do many colleagues), I draw attention to the considerable effect on my work of Edward Brecher through his 1972 book, Licit and Illicit Drugs. I give examples of the influence of the makers and sellers of nicotine-containing gum on my career in Canada and the United States as well as on the careers of several important colleagues. Ted Klein, who did public relations for nicotine-replacement products, is noted as an important figure in the tobacco control movement of the time, especially for those doing behavioral and smoking cessation research.

It is well established that college students increase their drinking when they leave home. This study examined changes in drinking as a result of campus closure due to coronavirus disease 2019 (COVID-19), focusing on the influence of living situation.

A sample of 312 college students (mean age = 21.2 years; 62% female; 67% White) responded to an online survey regarding their drinking behavior before and after university closures because of COVID-19. Those participants who lived with peers pre-closure and moved home to live with parents post-closure were compared with those who remained living with peers or remained living with parents in terms of changes in frequency and quantity of drinking.

A comparison of pre- to post-closure drinking indicated significant decreases in the typical number of drinks per week (from 11.5 to 9.9) and maximum drinks per day (from 4.9 to 3.3) and a slight increase in typical drinking days per week (from 3 to 3.2). Patterns of change significantly varied across groups. Those who moved from peers to parents showed significantly greater reductions in drinking days (from 3.