Publications by authors named "Riley D Shearer"

Article Synopsis
  • Moral injury is being studied as a significant factor affecting the mental health and job satisfaction of healthcare workers (HCWs) due to stressful experiences they encounter.
  • A longitudinal study with 473 HCWs showed that witnessing or participating in potentially morally injurious events (PMIEs) increased burnout and turnover intentions, particularly among those who witnessed these events.
  • The findings suggest that organizations should address moral injury in HCWs by implementing strategies that consider the types of morally injurious experiences they face in their work.
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Introduction: Despite effective medications for opioid use disorder (MOUD), treatment engagement remains low. As the overdose crisis is increasingly characterized by opioids co-used with other substances, it is important to understand whether existing models effectively support treatment for patients who use multiple substances. Hospital-based addiction consultation services (ACS) have shown promise at increasing MOUD initiation and treatment engagement, but the effectiveness for patients with specific co-use patterns remains unknown.

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Introduction: To guide improvements in treatment for pregnant persons with substance use disorders within the criminal legal system, treatment programs must first determine the primary substances of concern for this population. The objective of this study is to compare trends in specific substance use upon admission to treatment in pregnancy, based upon whether referrals originated from the criminal legal system or from another referral source.

Methods: This research accessed data on perinatal substance use (1995-2021) and referral sources from the Treatment Episode Data Set-Admissions (TEDS-A).

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Introduction: The US overdose crisis is increasingly characterized by opioid and methamphetamine co-use. Hospitalization is an important opportunity to engage patients in substance use treatment. Understanding characteristics of co-use-related hospital stays can inform the development of services to better support this growing patient population.

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Background: The overdose crisis is increasingly characterized by opioid and stimulant co-use. Despite effective pharmacologic treatment for both opioid use disorder (OUD) and contingency management for stimulant use disorders, most individuals with these co-occurring conditions are not engaged in treatment. Hospitalization is an important opportunity to engage patients and initiate treatment, however existing hospital addiction care is not tailored for patients with co-use and may not meet the needs of this population.

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Background: As overdose deaths continue to rise, public health officials need comprehensive surveillance data to design effective prevention, harm reduction, and treatment strategies. Disparities across race and ethnicity groups, as well as trends in substance use, treatment, or overdose deaths, have been examined individually, but reports rarely compare findings across multiple substances or data sources.

Objective: To provide a broad assessment of the overdose crisis, we describe trends in substance use, treatment, and overdose mortality across racial and ethnic groups for multiple substances.

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Background: As overdose rates increase for multiple substances, policymakers need to identify geographic patterns of substance-specific deaths. In this study, we describe county-level opioid and psychostimulant overdose patterns and how they correlate with county-level social vulnerability measures.

Methods: A cross-sectional observational study, we used nationwide 2016-2018 restricted access Centers for Disease Prevention and Control county-level mortality files for 1,024 counties.

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The drug overdose epidemic in the US necessitates detailed and timely data to inform public health responses. In this article we describe how an electronic health record (EHR) data-sharing collaboration across health systems in Minnesota that was developed in response to the COVID-19 pandemic was adapted to monitor trends in substance use-related hospital and emergency department (ED) visits. We found large increases in methamphetamine- and opioid-involved hospital and ED visits.

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Article Synopsis
  • Hospital admissions for substance use disorders are rising, prompting the need for effective engagement in treatment through addiction medicine consultation services, which improve access to medications and patient outcomes.
  • A study analyzed data from a large Midwest hospital from 2016 to 2021, revealing that Black hospitalized patients with substance use disorders were significantly less likely to receive consultations and medications for opioid use disorder compared to White patients.
  • The findings highlight the need to address racial and ethnic disparities in addiction treatment within hospital settings to ensure equitable care for all patients.
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Background: Individuals with criminal legal involvement (CLI), housing instability, or Medicaid insurance may experience barriers accessing substance use treatment in certain settings. Previous research has found individuals in these groups are less likely to receive medications for opioid use disorder (MOUD), but the role treatment setting may play in low rates of MOUD is unclear.

Methods: We conducted a cross-sectional study using nationally representative survey data from 2015 to 2021.

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Background: Individuals involved in the criminal legal system face unique challenges to accessing substance use disorder (SUD) treatment, yet state-level variation in referrals for treatment remains largely unknown. To address disparities in the overdose crisis among individuals with criminal legal involvement, it is important to understand variation in SUD treatment across states.

Methods: We conducted a retrospective comparison of substance use treatment referrals from the criminal legal system and other sources across participating states.

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Introduction: Overdose deaths involving opioids and stimulants continue to reach unprecedented levels in the United States. Although significant attention has been paid to the relationship between prescription and illicit opioid use, little work has focused on the association between prescription and illicit stimulant use. Thus, this study explores characteristics of those who use or misuse prescription stimulants and/or opioids and associations with use of cocaine, methamphetamine, and heroin.

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We used data from a statewide public health-health system collaboration to describe trends in COVID-19 vaccination rates by racial and ethnic groups among people experiencing homelessness or incarceration in Minnesota. Vaccination completion rates among the general population and people incarcerated in state prisons were substantially higher than those among people experiencing homelessness or jail incarceration.

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Background: Individuals experiencing homelessness or criminal justice involvement (CJI) have higher rates of substance use than the general public. Despite documented barriers to accessing treatment, few studies have compared substance use treatment patterns between these groups.

Methods: This paper uses data from the Treatment Episode Dataset-Admissions between 2006 to 2018 to describe characteristics and trends in substance use treatment admissions indicating homelessness (n=2,524,413), CJI (4,764,750), both (509,902), or neither (8,950,797) in the United States.

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Background: Non-emergent clinical services were limited or suspended during the early stages of the coronavirus disease 2019 (COVID-19) pandemic in the United States (U.S.).

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Objectives: Safety-net hospitals disproportionately care for people with substance use disorders (SUDs), yet little is known about trends in hospital admissions related to specific substances. This study uses electronic health record data to describe trends in substance-specific admissions at a Midwest urban safety-net hospital.

Methods: We included all admissions from 2008 through 2020 and defined them as non-SUD (N = 154,477) or SUD-related (N = 63,667).

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Background And Aims: The recent surge in methamphetamine use highlights the need for timely data on its health effects and healthcare service use impact. However, there is no ICD code for methamphetamine use. This study quantifies the positive predictive value of ICD-9-CM and ICD-10-CM psychostimulant codes for methamphetamine use.

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This cross-sectional study examines patterns in entry location for SARS-CoV-2 testing in a safety-net health system by patient demographic characteristics.

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Objective: To examine trends in polysubstance use among adults in treatment for opioid use disorder (OUD) and estimate associations between polysubstance use patterns and receipt of medications for OUD (MOUD).

Methods: We conducted a cross-sectional longitudinal analysis of treatment admissions for opioid use from 1992 to 2017 using the Treatment Episodes Data Set-Admissions (N = 9,440,157). We used multiple logistic regression to examine co-use patterns and estimate associations between receipt of MOUD and polysubstance use categories (opioid only, any methamphetamine, any cocaine, any alcohol, any benzodiazepine).

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Background: Methamphetamine use, with and without opioids, has increased substantially, but little is known about the sociodemographic characteristics, substance use patterns, or health profiles of individuals who use methamphetamine. To design effective public health interventions, health care professionals and policymakers need data describing individuals who are using methamphetamine in the midst of the opioid crisis.

Methods: We used 2015-2018 data from the National Survey on Drug Use and Health and included non-elderly adults aged 18-64 years.

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