How did we get here and where do we go from here?: Supporting undocumented students through a pandemic.

Communities of color have been disproportionately impacted by the coronavirus disease (COVID-19) pandemic, exposing the influence of decades of policies that have under-resourced and marginalized these communities. The history of segregation and inadequate funding in education has been exacerbated by the pandemic, compounding the educational inequities already present in the United States. The intersection of this inequity alongside immigration policies over the past years have led the undocumented student population to be adversely impacted. The lack of access to health care and social safety net programs, fear of deportation, and an over reliance on technology for schooling leaves a large segment of students vulnerable for adverse academic, emotional, and social outcomes. This paper will trace the historical path of educational segregation, immigration policies, and how these led to the disproportionate impact of COVID-19 on undocumented students. It will discuss interventions for undocumented students within an antioppressive ecological framework and the ethical responsibilities that school-based mental health professionals have to support undocumented students to fulfill their highest potential, manage the emotional toll of the pandemic, and advocate for change in immigration and educational policies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Modeling the potential impact of abuse-deterrent opioids on medical resource utilization.

Objectives: To extend a previously published manuscript on a model for estimating potential avoided medical events and cost savings in the US associated with the introduction of extended-release abuse-deterrent opioids and incorporate new methods of evaluating abuse deterrence using human abuse potential studies. Methods: A model was developed to estimate reductions in abuse-related events and annual savings in the US. Model inputs included: opioid abuse prevalence, abuse-deterrent opioid cost and effectiveness at deterring abuse, and opioid abuse-related events and costs. Direct (medical and drug) and indirect (work loss) cost savings (2017 US$) and abuse-related events were estimated assuming the replacement of the entire extended-release opioid market (brand and generic) by brand abuse-deterrent opioids. Results: Replacing the extended-release opioid market with abuse-deterrent opioids is estimated to lower annual abuse-related medical events by ∼13-31% (e.g. 78,000-186,000 emergency department visits) and lower annual medical costs by ∼$640 M-$1,538 M, depending on the abuse-deterrent technology (physical/chemical barrier or agonist/antagonist). Replacement of extended-release oxycodone with extended-release abuse-deterrent oxycodone is associated with the largest amount of cost savings and highest number of avoided medical events, followed by replacing extended-release morphine with an extended-release abuse-deterrent opioid. Replacement of transdermal fentanyl is associated with the smallest amount of cost savings and lowest number of avoided medical events. Conclusion: Agonist/antagonist abuse-deterrent opioid technology is associated with higher annual medical cost savings and more avoided events than physical/chemical barrier technology. Total net savings are dependent upon the abuse-deterrent opioid price relative to non-abuse-deterrent opioids.