Browsing by Author "Greene, Marion S."
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Item Adverse Childhood Experiences (ACEs) and Their Impact on Substance Misuse & Overall Health(The Center for Health Policy, 2018-03-01) Balio, Casey; Greene, Marion S.Adverse childhood experiences (ACEs) encompass a wide variety of distressing events, including emotional, physical, or sexual abuse; witnessing maternal domestic violence; or living with a household member who has a substance use disorder, is mentally ill or suicidal, or is currently or was ever incarcerated during the first 18 years of a child’s life. According to most recent estimates, nearly half of Indiana’s youth have experienced at least one ACE in their life. ACEs are linked to many risk behaviors, including substance use, which can adversely affect health outcomes.Item Adverse Childhood Experiences (ACEs) and their Impact on Substance Misuse & Overall Health(The Center for Health Policy, 2018-03-01) Balio, Casey; Greene, Marion S.Adverse childhood experiences (ACEs) encompass a wide variety of distressing events, including emotional, physical, or sexual abuse; witnessing maternal domestic violence; or living with a household member who has a substance use disorder, is mentally ill or suicidal, or is currently or was ever incarcerated during the first 18 years of a child’s life. According to most recent estimates, nearly half of Indiana’s youth have experienced at least one ACE in their life. ACEs are linked to many risk behaviors, including substance use, which can adversely affect health outcomes.Item Assessment of Risk Behaviors in Patients With Opioid Prescriptions: A Study of Indiana’s Inspect Data(Wiley, 2017-12) Greene, Marion S.; Chambers, Robert Andrew; Yiannoutsos, Constantin T.; Wright, Eric R.; Steele, Gregory K.; Zollinger, Terrell W.; Health Policy and Management, School of Public HealthBackground and Objectives Prescription Drug Monitoring Programs (PDMPs) can serve as screening tools and support the clinical decision‐making process in patients receiving opioids. The objective of the study was to utilize 2014 INSPECT (Indiana's PDMP) data to identify factors that increase patients’ likelihood to engage in opioid‐related risk behaviors. Methods Based on a literature review, four risk behaviors were identified: Receiving >90 morphine milligram equivalents (MME), having >4 opioid prescribers, obtaining opioids from >4 pharmacies, and concurrent use of opioids and benzodiazepines. Two binary logistic regression analyses (engaging in at least one risk behaviors; engaging in all four risk behaviors) and an ordinal regression analysis (engaging in 0–4 risk behaviors) were conducted to identify factors associated with these opioid‐related risk behaviors. Results Of the 1,538,120 unique opioid patients included in the study, 18.4% engaged in one, 5.3% in two, 1.6% in three, and .4% in all four risk behaviors. Depending on the model, prescribing a second monthly opioid increased patients’ odds to engage in risk behaviors by a factor of 10 or more and prescribing two or more benzodiazepines annually increased the odds at least 13‐fold. Conclusions and Scientific Significance About one‐fourth of all patients consuming opioids engaged in one or more risk behaviors; higher number of opioid prescriptions and addition of even a small number of benzodiazepine prescriptions dramatically increased these odds. PDMPs can be helpful in identifying opioid users at high‐risk for misuse. This information could be used to target efforts to reduce the prescription drug epidemic.Item Community Conditions Favorable for Substance Abuse(The Center for Health Policy, 2018-04-01) Jacinto, Corey; Greene, Marion S.The probability of whether an individual engages in substance use is associated with several risk and protective factors. Effective prevention requires understanding these factors. The social-ecological model considers the complex interactions between individual, relationship, community, and societal factors. This can help us understand substance use in a public health context and design strategies to address the problem across multiple levels.Item Community Conditions Favorable for Substance Use(The Center for Health Policy, 2018-04-01) Jacinto, Corey; Greene, Marion S.The probability of whether an individual engages in substance use is associated with several risk and protective factors. Effective prevention requires understanding these factors. The social-ecological model considers the complex interactions between individual, relationship, community, and societal factors. This can help us understand substance use in a public health context and design strategies to address the problem across multiple levels.Item First Do No Harm - The Indiana Providers Guide to the Safe, Effective Management of Chronic Non-Terminal Pain(State of Indiana, 2013) Bell-Sharp, Kim; Gregory, Eigner; Brooks, Tracy L.; Elliott, Alicia; Cragen, Debbie; Ersin, Ozlem H.; Croasdell, Lori; Fernandes, Taya; Duwve, Joan; Fielding, Stephen M.; Gentry, Mark E.; Greene, Marion S.; King, Timothy E.; Kelley, Kristen; Konchalski, Jan; Kuzma, Abigail; LaHood, Amy; MacKie, Palmer J.; McMahan, Deborah; Mowry, James B.; Park, Esther J.; Pontones, Pam; Ring, Barry S.; Robinson, Natalie; Roth, Daniel C.; Rumsey, Todd C.; Schreier, Eric M.; Stone, Cynthia L.; Straub, Tom; Welch, Peggy; Sybesma, J. Michelle; Symmes, Shelly; Whitworth, Michael; Vaught, Cynthia; Weitlauf, Sharon L.; Weaver, Tamara; Zachodni, Carla"First Do No Harm: The Indiana Healthcare Providers Guide to the Safe, Effective Management of Chronic Non-Terminal Pain" was developed by the Indiana Prescription Drug Abuse Prevention Task Force’s Education Committee under the leadership of Dr. Deborah McMahan. This provider toolkit, based on expert opinion and recognized standards of care, was developed over many months with the input of healthcare providers representing multiple specialties and all corners of the state. First Do No Harm provides options for the safe and responsible treatment of chronic pain, including prescriptions for opioids when indicated, with the ultimate goals of patient safety and functional improvement. It was developed as an interactive compendium to the new Medical Licensing Board rule addressing Opioid Prescribing for Chronic, Non-terminal Pain to give healthcare providers tools they can use to comply with the rule.Item The Impact of Parental Incarceration on Children’s Health & Development(The Center for Health Policy, 2018-12-01) Balio, Casey; Greene, Marion S.The incarceration boom in the United States has resulted in high rates of parents serving time. According to recent estimates, one in ten Hoosier children has a parent who is or has been in prison or jail. Though incarceration is often treated as a discrete event, it is important to note that the time period extends both prior to and beyond the incarcerated phase (pre- and post-incarceration). Evidence on the relationship between parental incarceration and various children’s outcomes is inconsistent across the literature and often disappears when controlling for demographic and family characteristics. However, whether the relationship between parental incarceration and children’s health and development is causal or simply correlational, this population is at high risk for adverse outcomes and should be the target of interventions.Item The Impact of the COVID-19 Pandemic on Behavioral Health in Indiana(The Center for Health Policy, 2021-06-01) Kooreman, Harold; Gutta, Jyotsna; Bandali, Elhaam; Greene, Marion S.As of January 2021, the Johns Hopkins Coronavirus Resource Center has confirmed more than 20 million SARS-CoV-2 cases and over 350,000 deaths in the United States alone and 100 million cases and more than 2 million deaths globally. As of December 31, 2020, over half a million Hoosiers had tested positive for COVID-19 and more than 8,000 had died as a result of complications from the disease. This report is a review on the impact the COVID-19 pandemic had (and has) on the mental and behavioral health of Hoosiers. Specifically, we reviewed pandemic-related stress on children, parents, and the elderly; substance use, misuse, and overdose deaths; mental health concerns; suicide; domestic violence; and child abuse and neglect. The current report is a summary of findings. It provides a snapshot in time. Data and conclusions were relevant and timely at the time the report was produced.Item Marijuana Use in Indiana: A Look at Cannabis Laws in and Around Indiana(Center for Health Policy, 2020-04-01) Gutta, Jyotsna; Greene, Marion S.Though under federal law marijuana is still considered an illicit drug, many states have enacted policies decriminalizing and/or legalizing marijuana to some degree. In 14 states (including Indiana), possession, use, cultivation, sale or distribution of marijuana is illegal. Indiana is bordered by states with varying marijuana policies: Kentucky (illegal), Ohio (medical use), and Michigan and Illinois (medical and recreational use). One emerging trend of concern is the use of marijuana products (THC) in e-cigarettes, especially among young people.Item Mental Health, Substance Misuse, and Suicide: Shared Risk and Protective Factors(The Center for Health Policy, 2018-06-01) Hilts, Katy; Greene, Marion S.Mental illness, substance misuse, and suicide are complex conditions with serious public health implications. Evidence suggests that these disorders often co-occur and share many of the same risk and protective factors. Additionally, certain populations are at an increased risk of developing substance use disorders, mental illness, or engaging in suicidal behaviors. Nationally and in Indiana, several factors, including stigma, an undersized mental health workforce, and limited treatment options, inhibit the effective identification and treatment of these conditions.