Research News Roundup: June 19, 2025

Journal: JAMA Health Forum, 2025, doi: 10.1001/jamahealthforum .2025.1288

Authors: Angélica Meinhofer, Lindsey Rose Bullinger, Caroline Hope Kelly, & Maria Fitzpatrick

Abstract:

Importance: Children experiencing parental opioid use disorder are a growing population at heightened risk of physical and mental health issues over the life course. Yet these children are less likely to receive comprehensive, ongoing health care and their parents are more likely to report barriers to access health care for their children. School-based health services have potential to overcome some of these health care access barriers, including parental burden, transportation, time, costs, and health care discontinuity. In 2014, Medicaid revoked its longstanding free care rule, expanding the scope of school-based health services eligible for Medicaid reimbursement. Subsequently, some states began to expand their school Medicaid programs to benefit from the new federal rule.

Objective: To estimate the early effects of state school Medicaid expansions on the receipt of Medicaid-funded school-based health services among children who have experienced parental opioid use disorder.

Design, setting, and participants: This cohort study using nationwide Medicaid claims data included Medicaid-enrolled children aged 5 to 18 years who experienced parental opioid use disorder at any point before age 19 years. A difference-in-differences design that exploits the staggered implementation of school Medicaid expansions between 2014 and 2019 was used. Data were analyzed between January 2023 and January 2025.

Exposures: Children living in states implementing (treatment group) and not implementing (comparison group) school Medicaid expansions, before and after state-specific expansion dates.

Main outcomes and measures: Binary measures indicating receipt of school-based health services, primary care, prevention, rehabilitative, dental, and mental health services, emergency department visits, and inpatient hospital stays.

Results: The sample comprised 6 628 404 person-years from 1 700 304 children. The mean (SD) age was 10.5 (3.9) years and 3 371 918 (51%) were male. School Medicaid expansions increased the receipt of Medicaid-funded school-based health services by 8.9 percentage points (pp; P = .01). Growth was primarily driven by school claims for nursing services (difference, 7.4 pp; P = .02) and for Early and Periodic Screening, Diagnostic and Treatment services (difference, 8.6 pp; P = .04). Reductions in emergency department visits among children aged 5 to 11 years were also documented (difference, -1.8 pp; P = .02).

Conclusions and relevance: This cohort study found that, given the complex health and health care needs of children growing up amid the opioid crisis, integrating health care into schools may offer a promising policy solution.

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Journal: JAACAP Open, 2025, doi10.1016/j.jaacop.2025.06.001

Authors: Sally I-Chun Kuo, Vivia V. McCutcheon, Kathleen K. Bucholz, Danielle M. Dick, Fazil Aliev, Jacquelyn L. Meyers, … Jessica E. Salvatore

Abstract:

Objective: Parental separation and relationship discord are linked to alcohol use behaviors, but their influence on the longitudinal course of alcohol misuse and interactions with genetic predisposition remain unclear. This study examined how the longitudinal course of heavy episodic drinking (HED) from adolescence to young adulthood varies with polygenic risk, parental separation, and relationship discord.

Method: Participants were from the Collaborative Study on the Genetics of Alcoholism (COGA) Prospective Sample, and included individuals from two genetically inferred continental groups: European-like (EA; n = 1761) and African-like (AA; n = 894) who were reassessed biennially (Mage =16.39 at first assessment; Massessment = 4.65). Alcohol misuse was indexed by past-year HED frequency. Predictors included parental separation, parental relationship discord, and problematic alcohol use polygenic scores (PGSPAU). Data were analyzed using linear mixed effects growth models.

Results: HED increased through young adulthood before declining. In EA, parental separation was associated with HED intercepts, but not with linear slope or quadratic curvature. Higher PGSPAU was associated with a faster initial growth and slower decline. In AA, parental relationship discord was not associated with HED intercepts but was associated with a faster initial growth and slower decline. PGSPAU were not associated the intercept or the course of HED. No interaction was found between PGSPAU and parental separation or discord to predict the longitudinal course of HED in either EA or AA samples.

Conclusion: Genetic risk and exposure to parental separation and discord are associated with the course of HED, with some differences across continental groups.

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Journal: Addictive Behaviors, 2025, doi: 10.1016/j.addbeh.2025.108364

Authors: Natalie Sumetsky, Maria Mori Brooks, Jeanine Buchanich, Brooke S G Molina, & Christina Mair

Abstract:

Background: Formal substance use treatment is a key resource for recovery among people with alcohol use disorders. Limited county-level availability of substance use treatment facilities may restrict access to care and ultimately contribute to worsening health outcomes and mortality. However, it is unknown whether the availability of such facilities is associated with county-level alcohol-attributable mortality risk.

Methods: We used Bayesian hierarchical Poisson spatial regression models to assess the relationship between population-weighted county-level treatment facility availability and rates of (1) fully chronic alcohol-attributable mortality, (2) alcohol poisonings, and (3) suicides by exposure to alcohol in 2019-2020. Localized treatment facility availability was calculated using a weighted method incorporating Census block group-level population counts. We adjusted for county-level demographic and socioeconomic factors, hospital density, population density, overall mortality rate, densities of mental health practitioner offices, U.S. Census region, year, and season.

Results: There was county-level heterogeneity in the availability of substance use treatment facilities, with northeastern county treatment facility densities at least twice as high as other regions. Higher county-level densities of treatment facilities were related to increased county-level risk for chronic fully alcohol-attributable deaths and alcohol poisonings but not suicides by exposure to alcohol.

Conclusions: Availability of substance use treatment facilities and the services they offer is heterogeneous across U.S. counties. The positive relationship between population-weighted county-level densities of treatment facilities and chronic fully alcohol-attributable mortality and alcohol poisonings may suggest that treatment facilities are placed in areas of greatest demand; yet, population-level needs may not fully met by these facilities.

To read the full text of the article, please visit the publisher’s website.