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Keep up with news and updates from the Milbank Memorial Fund. And read the latest blogs from our thought leaders, including Fund President Christopher F. Koller.
The Fund publishes The Milbank Quarterly, as well as reports, issues briefs, and case studies on topics important to health policy leaders.
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Quarterly Topic
Quarterly Article
August 2025 ASHLY E. JORDAN, RABIAH GAYNOR, CAROL MOORES, YOLANDA CANTY, CHINAZO O. CUNNINGHAM,
In the United States, substance use disorder (SUD) is a significant public health and public safety challenge. Up to two-thirds of individuals who are incarcerated meet SUD criteria, compared with 16.7% of the general population. Individuals who have opioid use disorder (OUD) are also overrepresented in criminal legal settings: approximately 15.0% to 30.0% of individuals who are incarcerated have OUD, compared with 3.7% of the general population. Furthermore, individuals who are incarcerated are at high risk for fatal overdose both inside carceral facilities and upon reentry to the community. Overdose is the third leading cause of death in jails, and overdose deaths have increased more than six times over the past two decades in prisons. Among those reentering the community, fatal overdose is the leading cause of death. The risk of fatal overdose within the first two weeks following reentry is more than 100 times higher than in the general US population. More
July 2025 BRANDON D. L. MARSHALL, Kristen Pendergrass, Sara Whaley,
The US overdose crisis is one of the most severe and devastating public health problems of the 21st century. Since 1999, more than one million Americans have lost their lives to accidental drug overdose. More
July 2025 Hannah L.F. Cooper, Anna L. Mullany, Snigdha Peddireddy, Simone Wien, Melvin "Doug" Livingston, Whitney S. Rice, Anne L. Dunlop, Michael R. Kramer, Madison Haiman, Lasha S. Clarke, Natalie D. Hernandez-Green, Angélica Meinhofer,
See all articles in the special issue, Mental Health and Substance Use Challenges Facing the United States: What Can State Policymakers… More
July 2025 Noa Krawczyk, Hillary Samples,
The United States is facing an ongoing mental health and substance use crisis. In 2023, 58.7 million US adults had a past-year mental illness, 46.3 million had a substance use disorder (SUD), and 20.4 million had both. More
Quarterly Opinion
July 2025 Jerel M. Ezell, Sugy Choi,
Despite recent overall decreases in drug overdose deaths, racial disparities are persisting. This, coming against the backdrop of sweeping national opioid settlements, offers a reminder of the enduring potency of systemic racism in the face of what is otherwise a demonstrable public health success. More
June 2025 Magdalena Cerdá, DANIEL B. NEILL, ELLICOTT C. MATTHAY, JOHNATHAN A. JENKINS, BRANDON D. L. MARSHALL, Katherine Keyes,
People in the United States are dying at record numbers from overdose. Overdose deaths increased from fewer than 17,000 deaths in 1999 to an estimated 100,000 deaths approximately 25 years after, with a peak of almost 108,000 deaths in 2022. Racial/ethnic minoritized groups are now particularly affected: in 2023, the highest rates of overdose were among non-Hispanic Black and American Indian/Alaska Native Americans. Although overdoses increasingly involve both opioids and stimulants, opioids contribute to over three-quarters of all overdose deaths, primarily driven by illegally manufactured synthetic opioids like fentanyl. More
April 2025 Harold A. Pollack, Marissa “Mari” Mackiewicz, Soham Sinha,
Given common physiological and social changes associated with aging, older adults face greater risks of substance-related harms than do younger adults who experience the same patterns of substance use. More
April 2025 Brendan Saloner,
This Perspective examines the role of Medicaid in the innovation of substance use disorder (SUD) treatment. In 2023, an estimated 49 million Americans met criteria for an SUD and more than 100,000 people died of a drug overdose. Compared with the general population, people with SUD experience worse self-rated health, a higher burden of other chronic diseases, and more hospital care. More
June 2024 Tasleem J. Padamsee, Courtni Montgomery, Stefan Kienzle, Jeremy B. Straughn, Andrea Elmore, Deborah L. Fulton-Kehoe, Beryl Schulman, Thomas M. Wickizer, Gary M. Franklin,
Context: Unsafe prescribing practices have been among the central causes of improper reception of opioids, unsafe use, and overdose in the United… More
May 2024 Larisa Svirsky, Dana Howard, Martin Fried, Nathan Richards, Nicole Thomas, Patricia J. Zettler,
Context: Opioid treatment agreements (OTAs) are documents that clinicians present to patients when prescribing opioids that describe the risks of… More
