About

I am an applied policy researcher who studies the economics of risky behaviors and substance use, with an emphasis on how public policies shape health outcomes within the United States. My recent work investigates the effects of recent drug policy innovations as well as the intersection between housing policy and risky behaviors.

Research topics

• Political Science
• Psychiatry
• Medicine
• Sociology
• Law
• Psychology
• Environmental health
• Social Science
• Internal medicine
• Pharmacology
• Family medicine

Selected publications

• The devastating dance between opioid and housing crises: Evidence from OxyContin reformulation

  Journal of Health Economics · 2024-09-15 · 13 citations

  article1st author
  PublisherDOI

• High-Dose Opioid Prescribing in Individuals with Acute Pain: Assessing the Effects of US State Opioid Policies

  Journal of General Internal Medicine · 2024-07-19 · 3 citations

  articleOpen access1st authorCorresponding
  PublisherOA PDFDOI

• Cannabis Laws and Utilization of Medications for the Treatment of Mental Health Disorders

  JAMA Network Open · 2024-09-05 · 5 citations

  articleOpen access1st authorCorresponding

  Importance: Mental health disorders are prevalent yet undertreated health conditions in the US. Given perceptions about the potential effect of cannabis on individuals with mental health disorders, there is a need to understand the association of cannabis laws with psychotropic use. Objective: To investigate the association of medical and recreational cannabis laws and dispensary openings with the dispensing of psychotropic medications used to treat mental health disorders in the US. Design, Setting, and Participants: This cross-sectional study of 10 013 948 commercially insured patients used a synthetic control method to examine the association of cannabis policies with prescribing. Data on all patients dispensed prescriptions for each of the 5 classes of psychotropic medications from January 1, 2007, to December 31, 2020, were extracted from Optum's deidentified Clinformatics Data Mart Database. Statistical analysis was performed from September 2022 to November 2023. Exposures: The 4 exposure variables measured were whether medical or recreational cannabis laws were in effect and whether medical or recreational cannabis dispensaries were open in each state and calendar quarter. Main Outcome and Measures: One measure of the extensive margins of dispensing and 2 measures of the intensive margins of dispensing were constructed for 5 medication classes (benzodiazepines, antidepressants, antipsychotics, barbiturates, and sleep medications). Results: The primary sample (the benzodiazepine sample) included 3 848 721 patients (mean [SD] age, 46.1 [11.4] years; 65.4% women; 53.7% aged 35-54 years). Medical cannabis laws were associated with a 12.4% reduction in the benzodiazepine fill rate (average treatment effect on the treated [ATT], -27.4; 95% CI, -14.7 to 12.0; P = .001), recreational cannabis laws were associated with a 15.2% reduction in the fill rate (ATT, -32.5; 95% CI, -24.4 to 20.1; P = .02), and medical cannabis laws were associated with a 1.3% reduction in the mean number of benzodiazepine fills per patient (ATT, -0.02; 95% CI, -0.02 to 0.02; P = .04). Medical dispensaries were associated with a 3.9% reduction in mean days' supply per benzodiazepine fill (ATT, -1.7; 95% CI, -0.8 to 0.6; P = .001), while recreational dispensaries were associated with a 6.2% reduction (ATT, -2.4; 95% CI, -1.0 to 0.9; P < .001). Medical cannabis laws were associated with a 3.8% increase in antidepressant fills (ATT, 27.2; 95% CI, -33.5 to 26.9; P = .048), and medical dispensaries were associated with an 8.8% increase (ATT, 50.7; 95% CI, -32.3 to 28.4; P = .004). The mean number of antipsychotic medication fills per patient increased by 2.5% (ATT, 0.06; 95% CI, -0.04 to 0.05; P = .02) after medical cannabis laws and by 2.5% (ATT, 0.06; 95% CI, -0.04 to 0.04; P = .02) after medical dispensary openings. Findings for the other drug classes showed substantial heterogeneity by state and direction of association. Conclusions and Relevance: This cross-sectional study of commercially insured patients suggests that there may have been meaningful heterogeneous associations between cannabis policy and state and between cannabis policy and drug class (eg, decreases in dispensing of benzodiazepines but increases in dispensing of antidepressants and antipsychotics). This finding suggests additional clinical research is needed to understand the association between cannabis use and mental health. The results have implications for patient substance use and mental health-related outcomes.

  PublisherDOI

• TennCare Disenrollment Led To Increased Eviction Filings And Evictions In Tennessee Relative To Other Southern States

  Health Affairs · 2024-02-01 · 10 citations

  articleOpen access

  Previous research suggests that enrolling in Medicaid reduces evictions by improving health and providing financial protection. However, previous studies have not examined whether the loss of Medicaid affects eviction outcomes. We analyzed eviction filings and completed evictions after a large, mandatory Medicaid disenrollment in Tennessee in 2005. We conducted a difference-in-differences analysis using data from the Eviction Lab at Princeton University and found that relative to other southern states, the TennCare disenrollment led to a 27.6 percent greater increase in the average annual number of eviction filings at the county level during the period 2005-09 and a 24.5 percent greater increase in the average annual number of completed evictions at the county level during that same period. Our findings have implications for the housing stability of Medicaid recipients today, many of whom are being disenrolled because of the unwinding of the Medicaid continuous enrollment provision that is occurring across the country. To protect housing stability for people disenrolled from Medicaid, policy makers may wish to consider new initiatives aimed at preventing an increase in eviction.

  PublisherDOI

• The Devastating Dance between Opioid and Housing Crises: Evidence from OxyContin Reformulation

  SSRN Electronic Journal · 2023-01-01

  articleOpen access1st authorCorresponding
  PublisherDOI

• Trends in Methadone Dispensing for Opioid Use Disorder After Medicare Payment Policy Changes

  JAMA Network Open · 2023-05-19 · 24 citations

  articleOpen access

  Importance: A significant proportion of Medicare beneficiaries have a diagnosed opioid use disorder (OUD). Methadone and buprenorphine are both effective medications for the treatment of OUD (MOUDs); however, Medicare did not cover methadone until 2020. Objective: To examine trends in methadone and buprenorphine dispensing among Medicare Advantage (MA) enrollees after 2 policy changes in 2020 related to methadone access. Design, Setting, and Participants: This cross-sectional analysis of temporal trends in methadone and buprenorphine treatment dispensing assessed MA beneficiary claims from January 1, 2019, through March 31, 2022, captured by Optum's Clinformatics Data Mart. Of 9 870 791 MA enrollees included in the database, 39 252 had at least 1 claim for methadone, buprenorphine, or both during the study period. All available MA enrollees were included. Subanalyses by age and dual eligibility for Medicare and Medicaid status were conducted. Exposures: Study exposures were (1) the Centers for Medicare & Medicaid Services (CMS) Medicare bundled payment reimbursement policy for OUD treatment and (2) the Substance Abuse and Mental Health Administration and CMS Medicare policies designed to facilitate access to treatment for OUD, specifically during the COVID-19 pandemic. Main Outcomes and Measures: Study outcomes were trends in methadone and buprenorphine dispensing by beneficiary characteristics. National methadone and buprenorphine dispensing rates were calculated as claims-based dispensing rates per 1000 MA enrollees. Results: Among the 39 252 MA enrollees with at least 1 MOUD dispensing claim (mean age, 58.6 [95% CI, 58.57-58.62] years; 45.9% female), 195 196 methadone claims and 540 564 buprenorphine pharmacy claims were identified, for a total of 735 760 dispensing claims. The methadone dispensing rate for MA enrollees was 0 in 2019 because the policy did not allow any payment until 2020. Claims rates per 1000 MA enrollees were low initially, increasing from 0.98 in the first quarter of 2020 to 4.71 in the first quarter of 2022. Increases were primarily associated with dually eligible beneficiaries and beneficiaries younger than 65 years. National buprenorphine dispensing rates were 4.64 per 1000 enrollees in quarter 1 of 2019, increasing to 7.45 per 1000 enrollees in quarter 1 of 2022. Conclusions and Relevance: This cross-sectional study found that methadone dispensing increased among Medicare beneficiaries after the policy changes. Rates of buprenorphine dispensing did not provide evidence that beneficiaries substituted buprenorphine for methadone. The 2 new CMS policies represent an important first step in increasing access to MOUD treatment for Medicare beneficiaries.

  PublisherOA PDFDOI

• Evictions and psychiatric treatment

  Journal of Policy Analysis and Management · 2023-08-22 · 11 citations

  articleOpen access1st author

  Stable housing is critical for health, employment, education, and other social outcomes. Evictions reflect a form of housing instability that is experienced by millions of Americans each year. Inadequately treated psychiatric disorders have the potential to influence evictions in several ways. For example, these disorders may impede labor market performance and thus the ability to pay rent, or increase the likelihood of risky and/or nuisance behaviors that can lead to a lease violation. We estimate the effect of local access to psychiatric treatment on eviction rates. We combine data on the number of psychiatric treatment centers that offer outpatient and residential care within a county with eviction rates in a two-way fixed-effects framework. Our findings imply that 10 additional psychiatric treatment centers in a county lead to a reduction of 2.1% in the eviction rate.

  PublisherOA PDFDOI

• The Effect of State Housing Policies on Eviction Filings and Judgments in the United States, 2001–2018

  Housing Policy Debate · 2023-11-07 · 4 citations

  article1st author

  Housing instability is a significant problem in the United States, with a long literature documenting its impact on the social well-being of Americans. A relatively new line of research has illuminated the degree to which eviction is a substantial contributor to health risks, including “deaths of despair” from alcohol or drug-related accidental poisonings. Although eviction is a persistent threat in the United States, there is comparatively less research that is both longitudinal and that evaluates multiple policies simultaneously to guide decision makers about which policies are more or less effective at lowering eviction activity. In this study we test the association between housing policies and eviction processes for a large proportion of U.S. counties from 2001 to 2018 using a panel of state-level landlord–tenant laws and a panel of local housing-specific investments by the U.S. Department of Housing and Urban Development. We find evidence that some state and local policies are effective at reducing the number of eviction filings and the incidence of multiple filings to the same household, although there is less evidence that actual eviction judgments can be mitigated with these policies.

  PublisherDOI

• Nuisance Ordinances and Overdose Mortality

  SSRN Electronic Journal · 2022-01-01 · 3 citations

  articleOpen access1st authorCorresponding
  PublisherDOI

• Evictions and Psychiatric Treatment

  SSRN Electronic Journal · 2022-01-01

  articleOpen access1st authorCorresponding
  PublisherDOI

Frequent coauthors

• Bradley D. Stein

  RAND Corporation

  11 shared

• Kosali Simon

  Indiana University Bloomington

  11 shared

• Thủy Nguyễn

  Chiba University of Commerce

  10 shared

• Andrew W. Dick

  RAND Corporation

  10 shared

• W. David Bradford

  University of Georgia

  9 shared

• Tisamarie B. Sherry

  RAND Corporation

  9 shared

• Coady Wing

  Indiana University

  4 shared

• Alex Hollingsworth

  The Ohio State University

  4 shared

Labs

• Ashley Bradford LabPI

Education

• PhD, School of Public & Environmental Affairs

  Indiana University

  2023

• MPA, Public Administration and Policy

  University of Georgia

  2018

• BA, Sociology

  University of Georgia

  2016