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Pronounced state-level disparities in prescription of cannabinoids to medicaid patients
Get PDFIntroduction: Dronabinol is approved in the USA for chemotherapy-induced nausea as well as vomiting and HIV-induced anorexia, while cannabidiol is primarily ap- proved for childhood epileptic disorders Lennox-Gastaut and Dravet syndrome. The use pattern for these prescription cannabinoids in the USA is unknown. This study examined Medicaid claims for two FDA-approved prescription cannabinoids, dronabinol and cannabidiol, approved in 1985 and 2018, respectively, from 2016–2020 to better understand the pharmacoepidemiologic trends and distribution of these drugs in US Medicaid amidst the increasing use of non-pharmaceutical formulations of cannabis. Methods: The longitudinal study analyzed Medicaid prescription claims that were calculated by extracting the prescriptions on a state level from 2016 to 2020 for two cannabinoids, dronabinol and cannabidiol, where outcomes over each year were calculated. Outcomes were (1) the number of prescriptions for each state corrected for the number of Medicaid enrollees and (2) dronabinol and cannabidiol spending. Spending refers to the amount reimbursed by the state Medicaid program. Results: Dronabinol prescriptions per state decreased by 25.3% from 2016 to 2020, while cannabidiol prescriptions increased by 16,272.99% from 2018 to 2020. The spending on these drugs parallels that of their prescription trend with a 66.3% decrease in reimbursement for dronabinol (233.3 million in 2020). Dronabinol prescriptions, when corrected for the number of enrollees, in Connecticut were 136.4 times larger than in New Mexico, and seventeen states had zero prescriptions. Idaho’s prescriptions of cannabidiol (27.8/10,000 enrollees) were significantly elevated relative to the national average and were 15.4-fold higher than Washington, DC (1.8/10K enrollees). Conclusions: The prescriptions of pharmaceutical-grade tetrahydrocannabinol decreased while those of cannabidiol increased. This study also identified pronounced state-level variation in cannabinoid prescribing to Medicaid patients. State formularies and prescription drug list variation may contribute to the drug reimbursements in Medicaid, though further research is needed to identify the health policy or pharmacoeconomic origins of these disparities
Fantasies of Ice-Fishing
Get PDFJ. T. Townley has published in Harvard Review, Kenyon Review, The Threepenny Review, and many other magazines and journals. His stories have been nominated for the Pushcart Prize (four times) and the Best of the Net Award. He holds an MFA in Creative Writing from the University of British Columbia and an MPhil in English from Oxford University, and he directs the Master of Arts in Interdisciplinary Studies at Oregon State University. To learn more, visit jttownley.com
Three Flash Essays
Get PDFPeter E. Murphy is the author of eleven books and chapbooks of poetry and prose. His work has appeared in The Common, Guernica, Hippocampus, The New Welsh Reader, Rattle, The Sun, and elsewhere. “Up and Down,” “Funny Tea,” and “The Gun” are adapted from his memoir, Once Upon a Time You Lived in a Castle, which is seeking an agent. Peter is the founder of Murphy Writing of Stockton University in Atlantic City. You can find out more at www.peteremurphy.com
Divers
Get PDFSamuel Amadon is the author of Listener and Often, Common, Some, And Free. He directs the MFA program at the University of South Carolina and edits, with Liz Countryman, the poetry journal Oversound
Trick
Get PDFLeigh Lucas is a writer in San Francisco. She holds an MFA from Warren Wilson and a BA from Stanford. She has been awarded residencies at Tin House, Sewanee, and Kenyon and her poems have appeared in Poem-a-Day, North American Review, and Frontier Poetry
#SBMArch: Museum Archaeology in the 2010
Get PDFThe Strawbery Banke Museum archaeology department moved in with the collections department after the construction of a new Collections Center building in 2007. The department has made new use of tools, such as an online artifact database; electromagnetometry, which helped locate a turn of the 20th-century mikveh excavated in 2014; and GIS, which offers a new approach to site-wide analysis of the many excavations across the campus. Recent archaeological efforts have concentrated on work related to the museum’s Heritage House Program, intended to rehabilitate buildings for interpretive and rental spaces. Ongoing work at historical house sites has meant that the boundaries of excavation have been determined primarily by construction impacts rather than research questions. However, archaeology department research and excavations have continued to uncover significant new information supported by close collaboration with the curatorial and restoration carpentry staff. The museum’s ongoing commitment to public archaeology has offered field-school students, interns, and visitors alike a valuable opportunity to observe the importance of archaeological research in this context, both onsite and on social media platforms