Research News Roundup: May 15, 2025

Journal: JAMA Network Open, 2025, doi: 10.1001/jamanetworkopen. 2025.8469

Authors: Joanne Constantin, Genevieve M. Kenney, Kosali Simon, & Kao-Ping Chua

Abstract:

Importance: After the Medicaid continuous enrollment provision ended on March 3, 2023, millions of Medicaid patients were disenrolled, a process called “Medicaid unwinding.” Whether this process was associated with changes in dispensing of buprenorphine, a medication for opioid use disorder preventing opioid overdose deaths, is unknown.

Objective: To evaluate changes in buprenorphine dispensing during Medicaid unwinding.

Design, setting, and participants: This cross-sectional study used difference-in-differences analysis to assess data from the IQVIA Longitudinal Prescription Database, capturing 92% of US retail prescriptions. Treatment and comparison states were those in the top vs bottom quartile of the percentage change in adult Medicaid enrollment between the month before the state resumed Medicaid eligibility determinations and December 31, 2023. Analyses included Medicaid-insured adults with active buprenorphine prescriptions in quarter 1 from 2017 to 2023.

Exposure: State-level change in adult Medicaid enrollment. The preexposure period was from July 1, 2017, to December 31, 2022, and the postexposure period was from July 1 to December 31, 2023 (quarters 3 and 4).

Main outcomes and measures: Four outcomes assessed buprenorphine dispensing in quarters 3 and 4 from 2017 to 2023: the number of days with active buprenorphine prescriptions, no active prescriptions, 1 or more active prescriptions paid with private insurance, and 1 or more active cash-pay prescriptions. Linear and logistic regression models compared changes in outcomes over time among treatment and comparison states.

Results: Analyses included 754 675 person-years from 569 069 patients (mean [SD] age, 39.2 [9.6] years; 386 719 men [51.2%]). Among adults in treatment states, the number of days with active buprenorphine prescriptions in quarters 3 and 4 decreased by 3.9 days (95% CI, -6.7 to -1.1 days) more compared with adults in comparison states. Adults in treatment states also had an increase of 1.8 percentage points (95% CI, 0.6-3.0 percentage points) in the probability of having no days with active prescriptions, an increase of 1.9 percentage points (95% CI, 0.4-3.4 percentage points) in the probability of having 1 or more active prescriptions paid with private insurance, and an increase of 0.9 percentage points (95% CI, 0.1-1.7 percentage points) in the probability of having 1 or more active cash-pay prescriptions.

Conclusions and relevance: In this cross-sectional study using difference-in-differences analysis, Medicaid patients in states with the highest vs lowest magnitude of Medicaid disenrollment through December 2023 were more likely to decrease or discontinue buprenorphine use and more likely to transition to private insurance or cash to pay for prescriptions. Findings suggest that Medicaid unwinding was associated with disruptions in buprenorphine therapy, raising concerns about the potential for increased opioid-related morbidity and mortality among patients in this population.

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Journal: PLoS One, 2025, doi: 10.1371/journal.pone.0319560

Authors: Luis Miguel Mestre, Roger S. Zoh, Cydne Perry, Julia Fukuyama, & Maria A. Parker

Abstract:

Introduction: While there is evidence demonstrating the association between cigarette smoking and weight status, and mortality and weight status, it has not been examined whether weight status is a mediator between number of cigarettes smoked per day (CPD) and all-cause mortality, limiting our knowledge of this association and potential novel approaches to reduce all-cause mortality due to cigarette smoking. We aimed to evaluate whether weight status mediated the association between CPD and mortality.

Methods: We harnessed the 2003-2018 NHANES and the Linkage Mortality Files, which included adults who smoked ≥ 100 lifetime cigarettes (unweighted n = 5,676). A generalized linear model estimated the association between cigarettes smoked per day (CPD) and weight status (e.g., Body Mass Index (BMI) or Waist Circumference (WC)). An Accelerated Failure Time model with a Weibull distribution estimated the association between CPD and all-cause mortality with weight status as a mediator, adjusting for age, SES, alcohol consumption, race/ethnicity, sex/gender, blood pressure, total cholesterol, and physical activity.

Results: Between 2003-2018, the sample’s mean BMI was 27.97 kg/m2, sample’s mean WC was 97.58 cm and mean CPD was 13.21. The total effect in the mediation analysis of WC adjusted by BMI levels in the association between CPD and all-cause mortality was -0.44 (95% CI = -2.00, -0.20; p = 0.016), the average direct effect was -0.35 (95% CI = -1.86, -0.10; p = 0.036), and the average indirect effect was -0.10 (95% CI = -0.23, -0.05; p < 0.001).

Conclusion: WC, as a surrogate measure of weight status, when adjusted by BMI levels, was a partial mediator between CPD and all-cause mortality. Public health interventions aimed to reduce mortality due to cigarette smoking at the population level should consider weight management programs as a harm reduction strategy to reduce mortality.

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Journal: Drug and Alcohol Dependence Reports, 2025, doi: 10.1016/ j.dadr.2025.10033

Authors: Chanda Phelan, Abby P. M. Katz, Jennifer E. Merrill, Kristina M. Jackson, & Tyler B. Wray

Abstract:

Objective: This study examined the use of social media for recovery support among individuals with substance use disorder (SUD) with past-year treatment attendance and tested whether demographic and SUD history factors were associated with use of social media for recovery support.

Method: Participants (N = 255; 45 % female, 85 % white, mean age = 41.4 [9.6]) recently treated for SUD completed an online survey. The survey gathered demographics, SUD histories, and social media use data. We report descriptive statistics and logistic regression models testing relationships between social media for recovery support and individual factors.

Results: Forty percent of participants used social media for recovery support, and most believed it beneficial. Being female increased use likelihood (OR = 2.56, 95 % CI [1.49, 4.46]), while older age (50 +) was associated with lower use likelihood than young adults (18-35) (OR = 0.35, 95 % CI [0.14, 0.84]). Social media was used primarily to build support systems and follow recovery-related content. Most found support forums on their own and engaged with the groups for meaningful amounts of time (>weekly, >15 minutes).

Conclusions: Results highlight how common it is to use social media for recovery support. Given the sparse evidence on its efficacy, more research is urgently needed to establish whether recovery support forums on social media convey actual benefits, and how to shape one’s digital environment to maximize those benefits.

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Journal: Academic Pediatrics, 2025, doi: 10.1016/j.acap.2025.102800

Authors: Laura M. Prichett, Nancy S. Weinfield, Michael J. Miller, Brian R. E. Schultz, Barry S. Solomon, Eileen M. McDonald, & Leticia M. Ryan

Abstract:

Objective: To quantify the annual direct health care cost of intentional overdose and other types of self-harm resulting in emergency department and/or inpatient encounters among youth in the United States.

Methods: Using the 2021 Nationwide Emergency Department Sample and National Inpatient Sample datasets, produced by the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project, we determined nationally representative cross-sectional frequencies and costs for specific types of self-harm encounters among 8- to 21-year-old pediatric and young adult patients.

Results: The total combined 1-year cost of all self-harm encounters was $869 million (95% confidence interval [CI] $841M-$897M). The majority of this cost was due to intentional overdose-related encounters, which totaled $530 million (95% CI $512M-$547M). Of this total, $232 million (95% CI $223M-$241M) was paid by public insurers and $296 million (95% CI $281M-$312M) was paid by private insurers. Encounters by females accounted for 79% of the intentional overdose costs ($420 million, 95% CI $404M-$435M).

Conclusions: Based on 2021 data, preventing youth intentional overdose could save the US health system up to $530 million, annually. As we collectively work to prevent suicide deaths among young people, it is important to recognize the needs of the larger group of youth who are engaging in serious self-harm and nonfatal suicidal acts, the majority of whom are young females. Prevention of intentional overdose in this population should be a priority, both in terms of upstream public health efforts and promotion of evidence-based methods of safer storage.

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