Recent Trends in Medication Treatment for Attention-Deficit Hyperactivity Disorder.

Objective: Attention-deficit hyperactivity disorder (ADHD) diagnosis rates and stimulant use have increased recently, particularly among adults, in the context of increased telehealth use and shortages in stimulant medications. To better understand changes in ADHD medication use and inform policy governing the prescribing of these medications, this study aimed to compare stimulant and nonstimulant fills for 2019 versus 2023.

Methods: This study used national all-payer prescription claims data for 2019 (before onset of the COVID-19 pandemic) and 2023 to calculate stimulant and nonstimulant ADHD medication fill rates overall and by patient age and prescriber specialty.

Experiences With Online Mutual Support Groups for Problematic Drinking.

Objective: This study sought to evaluate how the recent increase in use of online meetings has influenced participant experiences with peer-based mutual support groups for problematic drinking.

Methods: The authors conducted semistructured interviews in June and July 2024 with 20 adults who participated in online mutual support meetings for problematic drinking. Participants were recruited from a nationwide online research panel.

Opioid and alcohol use disorder medication availability in outpatient care: national estimates & potential policy levers.

Medications for opioid and alcohol use disorder (MOUD/MAUD) are efficacious, important components of relapse prevention care, and markedly underused. Yet, not all programs treating substance use disorders (SUD) offer them. Using the Substance Abuse and Mental Health Services Administration's 2022 National Substance Use and Mental Health Services Survey (N-SUMHSS), for outpatient programs (excluding opioid treatment programs) that provided "primarily SUD services" (SUD) or "primarily mental health but also SUD services" (MH/SUD; = 9921 programs), we identified program characteristics associated with providing MOUD or MAUD, focusing on potential policy levers (state licensure/certification, national organization accreditation) that could increase MOUD/MAUD access.

The role and reach of alcohol reduction apps.

Although apps are widely available and have several advantages as a tool to support alcohol reduction and recovery, little is known about how individuals are using them. In 2024, we conducted an exploratory sequential mixed-methods study that coupled in-depth interviews with 22 app users and a nationally representative survey of 2002 adults. We explored experiences with and perceptions of alcohol reduction apps.

Clinician Prescribing Practices Involving Medications for Alcohol Use Disorder.

Introduction: Despite the heavy toll of alcohol use disorder (AUD) in the U.S., efficacious medications for AUD (MAUD) are rarely used.

Opioid Use Disorder Treatment in Sexually and Gender Diverse Patients: A Retrospective Cohort Study.

This study assesses differences in opioid use disorder (OUD) treatment among sexually and gender diverse (SGD) vs non-SGD people. Using electronic health record data from a federally qualified health center, this retrospective cohort study explores OUD treatment for adults with an OUD diagnosis, as well as any clinic visit from January 2013 until June 2021 (N = 1,133), through review of medication prescriptions for OUD and OUD-related visits. Patients identifying as lesbian/gay had the lowest prevalence of OUD, with 1% (n = 231) of lesbian/gay patients having an OUD diagnosis, as compared to 1.

Patient Experiences With Group Teletherapy for the Treatment of Mental Illness: A Qualitative Study.

Objective: The authors sought to understand patient experiences with group teletherapy to inform improvements in service delivery.

Methods: From December 2022 to October 2023, semistructured interviews were conducted with 20 adults with depression or bipolar disorder who had received outpatient group teletherapy in the past 2 years. A rapid thematic analysis was conducted by using a matrix to identify patterns and synthesize data.

Medications for Alcohol Use Disorder: Rates and Predictors of Prescription Order and Fill in Outpatient Settings.

Background: Alcohol use disorders (AUD) are prevalent and responsible for substantial morbidity and mortality; yet efficacious treatments are underused. Previous studies have identified demographic and clinical predictors of medication fills, yet these studies typically do not include patients who were prescribed a medication but did not fill it.

Objectives: To examine rates of and factors associated with prescription order and prescription fill for medications for AUD (MAUD) among individuals diagnosed with AUD in outpatient settings.

Perceptions of stimulant and buprenorphine diversion and strategies to address it.

There is ongoing policy debate on the prescribing of controlled substances such as buprenorphine and stimulants via telemedicine. The goal of federal and state policymakers is to ensure access to care while limiting diversion risk. However, there is little evidence on how clinicians view and address diversion and on telemedicine's role in diversion.

High-density lipoprotein (HDL) as an indicator for alcohol use in a psychiatrically ill population.

Aims: To examine the cross sectional and longitudinal associations between the Alcohol Use Disorders Identification Test-Concise (AUDIT-C) and differences in high-density lipoprotein (HDL) in a psychiatrically ill population.

Methods: Retrospective observational study using electronic health record data from a large healthcare system, of patients hospitalized for a mental health/substance use disorder (MH/SUD) from 1 July 2016 to 31 May 2023, who had a proximal AUDIT-C and HDL (N = 15 915) and the subset who had a repeat AUDIT-C and HDL 1 year later (N = 2915). Linear regression models examined the association between cross-sectional and longitudinal AUDIT-C scores and HDL, adjusting for demographic and clinical characteristics that affect HDL.

Racial and Ethnic Differences in Telemedicine Use.

Importance: Individuals of racial and ethnic minority groups may be less likely to use telemedicine in part due to lack of access to technology (ie, digital divide). To date, some studies have found less telemedicine use by individuals of racial and ethnic minority groups compared with White individuals, and others have found the opposite. What explains these different findings is unclear.

Changes in Healthcare Spending Attributable to High Deductible Health Plan Offer Among Enrollees with Comorbid Substance Use Disorder and Cardiovascular Disease.

Background: The rise in prevalence of high deductible health plans (HDHPs) in the United States may raise concerns for high-need, high-utilization populations such as those with comorbid chronic conditions. In this study, we examine changes in total and out-of-pocket (OOP) spending attributable to HDHPs for enrollees with comorbid substance use disorder (SUD) and cardiovascular disease (CVD).

Methods: We used de-identified administrative claims data from 2007 to 2017.

Trends in Use of Telemedicine for Stimulant Initiation Among Children and Adults.

Objective: The authors sought to examine trends in stimulant initiation and follow-up care for attention-deficit hyperactivity disorder (ADHD) via telemedicine.

Methods: This retrospective longitudinal study used national, deidentified commercial health insurance outpatient claims among children (ages 2-17 years; N=535,629) and adults (ages 18-64 years; N=2,116,160) from January 2019 through April 2022. Regression analyses were used to examine risk for stimulant initiation, whether initiation occurred via telemedicine or in-person care, and receipt of a follow-up visit.

Use of Telemedicine and Quality of Care Among Medicare Enrollees With Serious Mental Illness.

Importance: During the COVID-19 pandemic, a large fraction of mental health care was provided via telemedicine. The implications of this shift in care for use of mental health service and quality of care have not been characterized.

Objective: To compare changes in care patterns and quality during the first year of the pandemic among Medicare beneficiaries with serious mental illness (schizophrenia or bipolar I disorder) cared for at practices with higher vs lower telemedicine use.

Choosing Or Losing In Behavioral Health: A Study Of Patients' Experiences Selecting Telehealth Versus In-Person Care.

It is not known how the growth of telehealth has affected patients' choice of visit modalities (telehealth versus in person). In 2023 we conducted a mixed-methods study that paired a nationally representative survey of 2,071 adults (including 571 who used behavioral health services) and semistructured interviews with twenty-six people with depression or bipolar disorder. We explored patients' experiences with visit modality selection and their agency in the decision.

Choice of high-deductible health plans among enrollees with a substance use disorder.

Introduction: High-deductible health plans (HDHPs) expose enrollees to increased out-of-pocket costs for their medical care, which can exacerbate the undertreatment of substance use disorders (SUDs). However, the factors that influence whether an enrollee with SUD chooses an HDHP are not well understood. In this study, we examine the factors associated with an individual with an SUD's decision to enroll in an HDHP.

Alcohol Use Disorder Treatment in Sexually and Gender Diverse Patients: A Retrospective Cohort Study.

While sexually and gender diverse (SGD) people have higher odds of alcohol use disorder (AUD) compared to heterosexual and cisgender people, AUD treatment access and use disparities are not well characterized. The purpose of this study is to assess differences in AUD treatment among SGD versus non-SGD populations. A retrospective cohort study was performed using data from a federally qualified health center electronic health record system in Boston, Massachusetts.

Prescribing Medications for Alcohol Use Disorder: A Qualitative Study of Primary Care Physician Decision Making.

Purpose: Over 29 million Americans have alcohol use disorder (AUD). Though there are effective medications for AUD (MAUD) that can be prescribed within primary care, they are underutilized. We aimed to explore how primary care physicians familiar with MAUD make prescribing decisions and to identify reasons for underuse of MAUD within primary care.