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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
Briana S. Last, Jane M. Zhu,
See all articles in the special issue, Mental Health and Substance Use Challenges Facing the United States: What Can State Policymakers Do? Access… More
Jonathan Purtle, Amanda I Mauri, David Frederick,
In this article, we provide an overview of emergent models for funding crisis systems in the United States and the policy and service contexts related to these models. Our review assesses the status of crisis system financing recommendations proposed by Hogan and Goldman proposed in 2020 and complements prior reports about financing crisis services. More
Rachel Donnelly, Mateo P. Farina,
Mental health (e.g., anxiety, depression) continues to be a major public health concern in the United States that impacts millions of individuals, their families, and communities. Approximately 21% of adults 18 years and older, or 55 million adults, reported symptoms of recent depression in 2022, demonstrating the wide reach of mental health challenges. More
Kate McEvoy, Hannah Maniates,
Medicaid has both greatly advanced the scope and integration of mental health and substance use disorder services among payers and remains a work in progress with respect to scaling and funding these services across the country. More
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
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
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
Corey Davis, Amy Lieberman, Czarina Behrends,
The United States continues to experience a nearly unprecedented level of drug-related health harms, with over 105,000 Americans dying of overdose in 2023 alone. Although overall overdose deaths declined slightly from 2022 to 2023, rates for Black people continued to rise. Stimulants such as cocaine and methamphetamine are increasingly involved in overdose deaths, and xylazine and other contaminants continue to be prevalent in the illicit drug supply. More
David H. Jernigan,
Alcohol is a causal factor in more than 200 disease and injury conditions in the human body. The Centers for Disease Control and Prevention (CDC) define excessive drinking as binge drinking (4 or more drinks for women, 5 or more for men on one occasion in the past month), heavy drinking (8 or more drinks for women, 15 or more for men in a week), and any drinking during pregnancy or by persons younger than age 21 years. More
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
Jane M. Zhu, Ruth Rowland, Inga Suneson, Deborah J. Cohen, K. John McConnell, Daniel Polsky,
Behavioral health access gaps are well documented in Medicaid, in which managed care now covers most enrollees, and for which there are typically fewer options for going out-of-network for care. Despite the growing role of managed care organizations (MCOs) in financing and delivering behavioral health services, little is known about MCO levers that can improve access to care. More
Annette M. Dekker, Adrian Yen, Andrea Larco Canizalez, Yesenia Perez, David Salazar, Bita Ghafoori, Dorit Saberi, Breena R. Taira,
The Trauma Recovery Center (TRC) model brings comprehensive care to underserved victims of crime, with improvements in PTSD symptoms and quality of life. Funding concerns were the central limitation in model implementation according to TRC staff. More
Marco Thimm-Kaiser, Katherine Keyes,
The potential adverse effects of social media use for adolescents have received substantial attention. In response, a growing number of state-level social media regulations are emerging in the United States. These policy interventions are being implemented in the context of mixed scientific evidence, forcing policymakers to weigh the need for proactive regulation against the limitations of extant research. We explore policymakers’ publicly stated rationales for social media regulations and contextualize their claims within extant scientific literature. More
David B. Joyce, Jeffrey Swanson,
Extreme Risk Protection Orders (ERPOs) are an effective legal tool for reducing firearm suicide by temporarily removing access to firearms for certain individuals who exhibit dangerous behavior. Unlike most state laws restricting access to firearms based on status, ERPOs are predicated on the assessment of future risk of harm to self or other, as determined by civil court file finding. Emerging research indicates that separating those in crisis from lethal means reduces firearm mortality. We assess Maine’s unique approach and consider whether it is a replicable policy option for other states or should be modified to comport with other states’ more broadly applicable model. More
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