Elizabeth Stone

Rutgers Institute for Health, Health Care Policy and Aging Research

Introduction Most Americans live in a state that has legalized cannabis as a medical treatment for pain, but it is unclear how chronic pain intensity relates to cannabis use. Our objective was to examine the association between patient-reported pain measures and cannabis among adults with chronic pain. Methods This cross-sectional study of a repre...

Background Policy evaluation studies that assess how state-level policies affect health-related outcomes are foundational to health and social policy research. The relative ability of newer analytic methods to address confounding, a key source of bias in observational studies, has not been closely examined. Methods We conducted a simulation study...

Background: Policy evaluation studies that assess how state-level policies affect health-related outcomes are foundational to health and social policy research. The relative ability of newer analytic methods to address confounding, a key source of bias in observational studies, has not been closely examined. Methods: We conducted a simulation study...

This cross-sectional study uses a survey to estimate use of cannabis and other pain treatments among adults with chronic pain in areas with medical cannabis programs in 36 US states and Washington, DC.

Background: Pervasive social and structural barriers-including national policies-inhibit HIV testing uptake among priority populations, including adolescents. We assessed the relationship between age-of-consent policies for HIV testing and adolescent HIV testing coverage in 51 low- and middle-income countries. Methods: We pooled data from househ...

Objective: This study examined trends in receipt of smoking cessation medications among smokers with and without mental illness, including serious mental illness, from 2005 to 2019 and characterized physician attitudes and practices related to tobacco screening and cessation treatment. Methods: Medical Expenditure Panel Survey (MEPS) data (2005-...

Gun-related deaths and gun purchases were at record highs in 2020. In light of the COVID-19 pandemic, public protests against police violence, and a tense political environment, which may influence policy preferences, we aimed to understand the current state of support for gun policies in the U.S. We fielded a national public opinion survey in Janu...

Gun-related deaths and gun purchases were at record highs in 2020. In light of the COVID-19 pandemic, public protests against police violence, and a tense political environment, which may influence policy preferences, we aimed to understand the current state of support for gun policies in the U.S. We fielded a national public opinion survey in Janu...

Introduction In response to the role of opioid prescribing in the U.S. opioid crisis, states have enacted laws intended to curb high risk opioid prescribing practices. This study assessed the effects of state prescribing cap laws that limit the dose and/or duration of dispensed opioid prescriptions on opioid prescribing patterns and opioid overdose...

Background: Many states have adopted laws that limit the amount or duration of opioid prescriptions. These limits often focus on prescriptions for acute pain, but there may be unintended consequences for those diagnosed with chronic pain, including reduced opioid prescribing without substitution of appropriate non-opioid treatments. Objective: T...

Importance: High-dose and long-duration opioid prescriptions remain relatively common among children and adolescents, but there is insufficient research on the association of state laws limiting the dose and/or duration of opioid prescriptions (referred to as opioid prescribing cap laws) with opioid prescribing for this group. Objective: To exam...

Inequitable experiences of community gun violence and victimization by police use of force led to nationwide calls to “reimagine public safety” in 2020. In January 2021, we examined public support among U.S. adults for 7 policy approaches to reforming policing and investing in community gun violence prevention. Using a nationally representative sam...

Objective: To evaluate the effects of state opioid prescribing cap laws on opioid prescribing after surgery. Data sources: OptumLabs Data Warehouse administrative claims data covering all 50 states from July 2012 through June 2019. Study design: We included individuals from 20 states that had implemented prescribing cap laws without exemptions...

Objectives. To characterize the experience and impact of pandemic-related workplace violence in the form of harassment and threats against public health officials. Methods. We used a mixed methods approach, combining media content and a national survey of local health departments (LHDs) in the United States, to identify harassment against public he...

Introduction Assessing the impact of COVID-19 policy is critical for informing future policies. However, there are concerns about the overall strength of COVID-19 impact evaluation studies given the circumstances for evaluation and concerns about the publication environment. Methods We included studies that were primarily designed to estimate the...

Background Cancer is the second leading cause of death for people with serious mental illness (SMI), such as schizophrenia and bipolar disorder. People with SMI receive cancer screenings at lower rates than the general population. Aims We sought to identify factors associated with cancer screening in a publicly insured population with SMI and stra...

Objectives To characterize primary care physicians’ (PCPs) attitudes and beliefs about people with opioid use disorder (OUD) and to understand the association between PCPs’ stigmatizing attitudes and their OUD treatment practices, beliefs about treatment effectiveness, and support for policies designed to improve access to OUD medications. Methods...

Introduction: The impact of policies on COVID-19 outcomes is one of the most important questions of our time. Unfortunately, there are substantial concerns about the strength and quality of the literature examining policy impacts. This study systematically assessed the currently published COVID-19 policy impact literature for a checklist of study d...

Background: Persons with serious mental illness (SMI) die 10-20 years earlier than the general population; cancer is the second leading cause of death. Differences in cancer screening between SMI and the general population are not well understood. Objectives: To describe receipt of cancer screening among individuals with versus without SMI and t...

Introduction This study examines whether differences exist by sex in support for specific gun policies aimed at reducing gun violence. Methods Investigators combined 2 waves of the National Survey of Gun Policy administered in January 2017 and January 2019. Data were analyzed in 2020. Opinions on 21 gun policies were examined. Respondents rated th...

Objective To evaluate the impact of Maryland's behavioral health homes (BHHs) on receipt of follow‐up care and readmissions following hospitalization among Medicaid enrollees with serious mental illness (SMI). Data Sources Maryland Medicaid administrative claims for 12 232 individuals. Study Design Weighted marginal structural models were estimat...

Background Most people with opioid use disorder (OUD) are not treated with FDA-approved medications methadone, buprenorphine, or naltrexone. Expanding capacity for evidence-based OUD medication in primary care is a national priority. No studies have examined primary care trainee physicians’ attitudes about these medications. This study surveyed a n...

Direct-to-physician opioid marketing by pharmaceutical companies is widespread and may contribute to opioid overprescribing, an important driver of the US opioid crisis. Using a difference-in-differences approach and Medicare Part D prescriber data, we examined the effects of academic medical centers' conflict-of-interest policies that restrict dir...

Background In response to the role overprescribing has played in the U.S. opioid crisis, in the past decade states have enacted four main types of laws to curb opioid prescribing: mandatory prescription drug monitoring program (PDMP) enrollment laws requiring clinicians to register with a PDMP; mandatory PDMP query laws requiring clinicians to chec...

After the school shooting at Marjory Stoneman Douglas High School in Parkland, Florida in 2018, there was an increase in gun violence prevention-related advocacy. While much of this recent political activity and engagement was led by young adults, little is known about support for specific gun policies within this age group. This study uses data fr...

Background Nineteen US states and D.C. have used the Affordable Care Act Medicaid health home waiver to create behavioral health home (BHH) programs for Medicaid beneficiaries with serious mental illness (SMI). BHH programs integrate physical healthcare management and coordination into specialty mental health programs. No studies have evaluated the...

Objective: This study evaluated the association of the Maryland Medicaid behavioral health home (BHH) integrated care program with cancer screening. Methods: Using administrative claims data from October 2012 to September 2016, the authors measured cancer screening among 12,176 adults in Maryland's psychiatric rehabilitation program who were eli...

Behavioral health homes, shown to improve receipt of evidence-based medical services among people with serious mental illness in randomized clinical trials, have had limited results in real-world settings; nonetheless, these programs are spreading rapidly. To date, no studies have considered what set of policies is needed to support effective imple...

Gun policy is a prominent topic of debate in the 2020 US election cycle. Tracking evolving public attitudes about gun policy is critical in this context. Using data from the National Survey of Gun Policy fielded in 2013, 2015, 2017, and 2019 by the Johns Hopkins Center for Gun Policy and Research, we examined trends in support for more than two doz...

Objective To assess whether there are differences in support for handgun purchaser licensing. Methods We used data from four waves of online, national polling on gun policy. To estimate differences in support for licensing across groups, we categorised respondents by whether they personally owned a gun, lived in a state with handgun purchaser lice...

Public stigma toward people who use illicit drugs impedes advancement of public health solutions to the opioid epidemic and reduces willingness to seek addiction treatment. Experimental studies show that use of certain terms, such as “addict” and “substance abuser,” exacerbate stigma while alternative terms, such as “person with a substance use dis...

News media coverage of the U.S. opioid epidemic influences Americans' knowledge of and preferences for solutions to address the crisis. From 1998 to 2012, news media coverage of the opioid epidemic focused on criminal justice-oriented solutions. We examine whether and how news coverage of solutions has shifted in the recent years of the crisis. We...

Pill mill laws impose strict regulations on pain management clinics to prevent them from issuing opioid prescriptions without medical indication. To date, little is known about the implementation or effects of these laws on opioid overdose deaths. A previously untested concern is that by restricting access to prescription opioids, pill mill laws co...

Medications such as methadone and buprenorphine are effective treatments for opioid use disorder (OUD), but levels of use remain low. Given the importance of the news media as a source of health information for the public and its role in shaping knowledge about these medications, we examined reporting on OUD medication treatment amid the opioid cri...

Individuals with serious mental illness (SMI) experience significant premature mortality due to somatic conditions but often receive sub-optimal somatic care, but little research has been done to understand how general medical clinicians’ attitudes may affect care provision or health outcomes. This review describes general medical clinicians’ attit...

People with serious mental illness (SMI) have mortality rates 2–3-times higher than the general population, mostly driven by physical health conditions. Behavioural health homes (BHHs) integrate primary care into specialty mental healthcare settings with the goal of improving management of physical health conditions among people with SMI. Implement...

Background: Safe consumption sites are spaces where people can legally use pre-obtained drugs under medical supervision and are currently in operation in Canada, Australia and Western Europe. These sites are effective in reducing opioid overdose mortality and other harms associated with opioid use, such as HIV infection, and increasing drug treatm...

Objectives: Behavioral health home (BHH) models have been developed to integrate physical and mental health care and address medical comorbidities for individuals with serious mental illnesses. Previous studies identified population health management capacity and coordination with primary care providers as key barriers to BHH implementation. This...

Objectives: To compare public support for 24 different gun policies between gun owners and non-gun owners in 2017. Methods: We fielded a national public opinion survey in January 2017 using an online panel to measure US adults' support for 24 gun policies. We compared support among gun owners and non-gun owners. Results: For 23 of the 24 polic...

Objective: This study measured Americans' willingness to pay an additional $50 in taxes to improve health care and social services for individuals with serious mental illness. Methods: A nationally representative online survey was conducted with 1,010 respondents. Analysis examined how respondents' demographic characteristics and attitudes towar...

We examine Americans' support for two evidence-based harm reduction strategies - safe consumption sites and syringe exchange programs - and their attitudes about individuals who use opioids. We conducted a web-based survey of a nationally representative sample of U.S. adults in July-August 2017 (N = 1004). We measured respondents' support for legal...

Objective: We conducted a case study examining implementation of Maryland's Medicaid health home program, a unique model for integration of behavioral, somatic, and social services for people with serious mental illness (SMI) in the psychiatric rehabilitation program setting. Method: We conducted interviews and surveys with health home leaders (...