Bradley Stein
@bradleydstein.bsky.social
1.2K followers 860 following 110 posts
Child psychiatrist/ health services/policy researcher at RAND, studying improving access, treatment, and outcomes for individuals with mental health and substance use disorders. Often found at youth soccer games and finding recipes to try in my smoker
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bradleydstein.bsky.social
Thanks to the NIMH for funding this work and shout-out to all the school leaders who responded to the @rand.org American School Leader Panel!
bradleydstein.bsky.social
Policymakers and school boards: are you considering neighborhood context when crafting phone policies? Open dialogue with parents, teachers, and students is key to making effective rules
bradleydstein.bsky.social
These differences raise important questions on equity and the impacts for different student populations— teens using phones more freely at school could see impacts on learning and mental health. Middle and high school principals face tough choices balancing safety, independence, and distractions.
bradleydstein.bsky.social
And most elementary schools stick to strict bans: over 81% only allow phones on campus if students keep them put away all day. By high school, policies get much looser—many let students use phones outside class or at teacher discretion.
bradleydstein.bsky.social
Our national analysis found schools in higher-income communities are more likely to allow phones than those in high-poverty neighborhoods.
bradleydstein.bsky.social
New Research Alert: Did you know nearly all U.S. public schools restrict student cell phone use—but the types of bans are very different depending on the school? Our recent paper, led by led by my @rand.org colleague Jon Cantor, just published in @jamahealthforum.com examines this issue
bradleydstein.bsky.social
Such an important topic. Great to see @parcka.bsky.social diving into this with my @rand.org colleague Liz!
parcka.bsky.social
Talking with youth about substance use isn’t easy. Dr. Elizabeth D’Amico shares how Motivational Interviewing #MI can help build trust. 🩷🎧 Listen to the newest episode of Let’s Talk About Drugs in the Intermountain West #LTAD now!
bradleydstein.bsky.social
Want all the numbers? Check out the NIDA and Foundation for Opioid Response Efforts supported study here:

journals.lww.com/journaladdic...
bradleydstein.bsky.social
Bottom line: Medicaid unwinding wasn’t just a paperwork issue- it disrupted effective treatment of opioid use disorder for thousands. Policymakers must find ways to protect coverage and care continuity as insurance rules evolve.
bradleydstein.bsky.social
Did other insurance types like commercial insurance and Medicare, or paying out-of-pocket pocket fill the gap? Turns out, they didn’t: overall, more people ended up going without effective treatment.
bradleydstein.bsky.social
In states with the greatest Medicaid disenrollment, the changes were greatest: ending episodes rose +5.5%, and new starts fell nearly -4% after unwinding.
bradleydstein.bsky.social
Our national study led by @rand.org colleague Rachel Landis in the American Society of Addiction Medicine’s Journal of Addiction Medicine found that after unwinding, more Medicaid buprenorphine treatment episodes ended (+3%), and fewer Medicaid treatment episodes started (-2.6%).
bradleydstein.bsky.social
New research alert: Medicaid covers nearly 40% of treatment for opioid use disorder (OUD), but recent “unwinding” of pandemic-era enrollment protections led many to lose coverage nationwide. How did this affect life-saving buprenorphine treatment?
bradleydstein.bsky.social
High cost (average price nearly $45) may have limited OTC demand.
But the bottom line is that while OTC approval increased naloxone availability, most people still get naloxone from pharmacies (often using insurance) or community programs
bradleydstein.bsky.social
States averaged a total of ~400 OTC units per million residents.
By comparison, pharmacies and community programs each distributed more than 15 times as many units/million over a similar period. OTC sales were higher in some states but still fell far short of pharmacy and community distribution.
bradleydstein.bsky.social
In the first year, sales peaked around 23 units per million people and soon stabilized below 15 units per million.
bradleydstein.bsky.social
New research alert: Naloxone can stop opioid overdoses and save lives. When it went over-the-counter in Sept 2023, did Americans start buying it? We examined this question in a study now out in @jamainternalmed.com
bradleydstein.bsky.social
School-based teams are encouraged to use TRS-IA results and action planning guides to facilitate strategic planning, team collaboration, and continuous quality improvement. Try it out or read more : psycnet.apa.org/fulltext/202...
APA PsycNet
psycnet.apa.org
bradleydstein.bsky.social
School staff across 47 states rated the TRS-IA domains as highly important, but slightly less applicable in practice. This gap between importance and applicability reflects common implementation challenges for new practices.
bradleydstein.bsky.social
User ratings for each domain show which areas schools value most and where support is needed. Confirmatory factor analysis shows solid reliability and meaningful scores for real-world use
bradleydstein.bsky.social
Developed using expert consensus & validated in a 2,700-person study, TRS-IA helps schools spot what they do well and where they need to improve programming and practices.
bradleydstein.bsky.social
The TRS-IA measures 7 domains: campus safety, staff training, classroom strategies, staff self-care, community context, early intervention, & targeted/intensive programming.
bradleydstein.bsky.social
2 out of 3 adults faced at least one adverse childhood event. Trauma impacts learning & health—and schools are critical in helping all kids thrive