"Bounded Equity: The Limits of Economic Models of Social Justice in Cannabis Legislation".

Social equity provisions in cannabis legislation are premised on the hope that the profit generated around adult-use cannabis can be leveraged to ameliorate the damage done by racially biased enforcement of prohibition in black and brown communities. As such, they encapsulate an attempt to reconcile the history of racism in the enforcement of cannabis law through its new future as a profit generating commodity. These programs are gaining traction, but with minimal empirical examination. The development and implementation of these programs raises a number of questions in need of study that we outline in this paper. We argue that Creary's concept of bounded justice-which critiques the inherent limitations of social justice projects that ignore structural forms of social exclusion-can provide a framework for critical understanding of the limitations of such programs, ethnographically grounded empirical research, and a framework for evaluating the justice impacts of legislation. Specifically, we argue that in order to interrogate the possibilities for social justice projects around cannabis, we must address equity at a deeper level by working with communities to investigate hyper-localized and historical factors that have influenced systems and structures.

The Association of State Opioid Misuse Prevention Policies With Patient- and Provider-Related Outcomes: A Scoping Review.

Policy Points This scoping review reveals a growing literature on the effects of certain state opioid misuse prevention policies, but persistent gaps in evidence on other prevalent state policies remain. Policymakers interested in reducing the volume and dosage of opioids prescribed and dispensed can consider adopting robust prescription drug monitoring programs with mandatory access provisions and drug supply management policies, such as prior authorization policies for high-risk prescription opioids. Further research should concentrate on potential unintended consequences of opioid misuse prevention policies, differential policy effects across populations, interventions that have not received sufficient evaluation (eg, Good Samaritan laws, naloxone access laws), and patient-related outcomes. CONTEXT: In the midst of an opioid crisis in the United States, an influx of state opioid misuse prevention policies has provided new opportunities to generate evidence of policy effectiveness that can inform policy decisions. We conducted a scoping review to synthesize the available evidence on the effectiveness of US state interventions to improve patient and provider outcomes related to opioid misuse and addiction. METHODS: We searched six online databases to identify evaluations of state opioid policies. Eligible studies examined legislative and administrative policy interventions that evaluated (a) prescribing and dispensing, (b) patient behavior, or (c) patient health. FINDINGS: Seventy-one articles met our inclusion criteria, including 41 studies published between 2016 and 2018. These articles evaluated nine types of state policies targeting opioid misuse. While prescription drug monitoring programs (PDMPs) have received considerable attention in the literature, far fewer studies addressed other types of state policy. Overall, evidence quality is very low for the majority of policies due to a small number of evaluations. Of interventions that have been the subject of considerable research, promising means of reducing the volume and dosages of opioids prescribed and dispensed include drug supply management policies and robust PDMPs. Due to low study number and quality, evidence is insufficient to draw conclusions regarding interventions targeting patient behavior and health outcomes, including naloxone access laws and Good Samaritan laws. CONCLUSIONS: Recent research has improved the evidence base on several state interventions targeting opioid misuse. Specifically, moderate evidence suggests that drug supply management policies and robust PDMPs reduce opioid prescribing. Despite the increase in rigorous evaluations, evidence remains limited for the majority of policies, particularly those targeting patient health-related outcomes.

Firearm Storage Practices and Risk Perceptions.

INTRODUCTION: During the past 2 decades, gun owners have become more likely to store household firearms loaded and unlocked, and believe that guns make homes safer rather than more dangerous. METHODS: Self-reported household firearm storage practices were described among 2,001 gun owners in relation to whether they report that firearms make homes (1) safer, (2) more dangerous, or (3) it depends. Data were from a probability-based online survey administered in 2015 (completion rate, 55%) and analyzed in 2018. RESULTS: Nearly 60% of gun owners said that guns make homes safer (57.6%, 95% CI=55.1%, 60.1%), 39.9% (95% CI=37.4%, 42.5%) said that it depends (on other factors), and 2.5% (95% CI=1.8%, 3.4%) said that guns make homes more dangerous. A higher proportion of gun owners who reported that they believe guns increase household safety said that they store household firearms loaded and unlocked (39.2%, 95% CI=35.9%, 42.6%), compared with those who thought guns make the home either more dangerous (3.7%, 95% CI=1.3%, 10.1%) or those who thought the effect of guns on household safety depends on additional factors (17.5%, 95% CI=14.7%, 20.7%). CONCLUSIONS: Gun owners who are most likely to assert categorically that firearms in the home make homes safer are, as a group, far more likely to store guns in their home loaded and unlocked.