Projects (by center/institute)

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Principal Investigator: Christopher Keith Haddock

The health of military personnel is critical to the mission of the U.S. Military and tobacco use causes more morbidity and mortality in the military than do obesity, alcohol use, and illicit drug use combined. The purpose of this study is to develop information that will advance tobacco control policy in the armed services. Project goals include explicating barriers to tobacco policy implementation, describing the social meaning of tobacco use and cessation within the military culture, and identifying best practices in military tobacco control policy implementation.

For more information: Abstract
Principal Investigator: Nattinee Jitnarin

Awarded to NDRI-USA

Smokeless tobacco (SLT) use rates within the U.S. Fire Service are substantially higher than those among  other civilian occupations. Fire Service’s SLT use has resulted in health disparities, with minority male  firefighters 10 times more likely to use SLT than male minorities in the general population. Given firefighting  alone increases risk for cancers which have been linked to SLT use, it is critical that occupational research  address this preventable cancer risk. Unlike other occupational groups with high SLT use (i.e., the military),  there are no tailored interventions for the fire service. This project will use formative research to examine  firefighters’ occupational norms, attitudes, beliefs/perceptions about cancer and SLT use, examine cultural and  structural barriers to cessation, and ways to motivate firefighters to quit and promote abstinence. This project  will tailor Enough Snuff (a military SLT cessation program), and create one for firefighters (FIRE­SLT). FIRESLT will be beta­tested in order to examine its feasibility prior to implementing the intervention on a larger  scale. 

For more information: Abstract
Principal Investigator: Christopher Keith Haddock

Tobacco use rates within the U.S. military remain higher than those among civilian populations. Although numerous military tobacco control policies have been issued, their effective implementation has been thwarted by influences outside the military, including lack of strong civilian support. By exploring perceptions about military tobacco control among three key civilian groups: veterans' service organizations, public health groups, and tobacco control groups, and developing and piloting an educational intervention, this study will address knowledge gaps about military tobacco control efforts and facilitate civilian support for them.

For more information: Abstract
Principal Investigator: Carlos Poston

Although soldiers must be ready to respond to occupational and war theatre demands at a moment's notice, there is an epidemic of overweight and obesity and a need for improved fitness and health in the military. Using a cluster randomized clinical trial we propose to test the effectiveness of a High-Intensity Functional Training (HIFT) intervention to improve the body composition and fitness of active duty military personnel. The HIFT intervention will be compared to usual Army Physical Readiness Training and outcomes will include changes in body composition and traditional fitness measures, tests of occupational- and combat- preparation, and measures of cardiovascular health risk and systemic inflammation for both groups.

For more information: Abstract
Principal Investigator: Ellen Benoit

Community Wise is a manualized, multilevel intervention to reduce health inequalities related to alcohol and illicit drug use that was developed and pilot-tested in a distressed community with concentrations of African American residents (DCAA) using community-based participatory research (CBPR) methods. We seek to apply the Multiphase Optimization Strategy (MOST) - an innovative and rigorous framework that employs factorial designs - to identify the most efficient, scalable, and sustainable components of Community Wise. Our innovative and rigorous combination of CBPR and MOST will produce an optimized intervention that is more acceptable to communities, reduces participant burden, and can be adapted and tested to reduce other health inequalities.

For more information: Abstract
Principal Investigator: Ellen Benoit

Despite considerable attention to the sexual health of young men who have sex with men (YMSM), new HIV and STD infections are rapidly increasing among this population. A critical aspect of sexual behavior among YMSM is the process by which they receive cultural scenarios from external sources, interpret them and enact them with sexual partners. To understand this phenomenon and inform the development of more effective interventions for YMSM, the proposed study will conduct mixed-methods interviews with an ethnically diverse sample of 160 urban YMSM (33% Black, 33% Latino, 33% White; of whom 50% within each racial/ethnic group will be ages 16-20 and 50% will be ages 21-25).

For more information: Abstract
Principal Investigator: Alexander S. Bennett

This study promises to greatly inform efforts to identify effective programs for preventing opioid misuse and opioid-related overdose among veterans. Identification of the salient contexts for risky opioid use and an understanding of how even routine, adherent pain management behaviors can evolve into risky ones will provide the means to more creative and time-sensitive interventions to prevent or mitigate risky behaviors before they lead to negative health consequences including overdose and even untimely death. Similarly, understanding how veterans themselves conceptualize risk, and draw on social and institutional supports, will allow for greater refinement in future efforts to educate veterans and assist them in establishing meaningful institutional affiliations and social relationships that may serve as protective factors against opioid-related health risks.

For more information: Abstract

Supplement Study: New standing orders in the state of New York related to the distribution of the life-saving opioid antagonist, naloxone (Narcan™) have created an opportunity for the parent grant’s managerial staff to distribute the drug directly to veterans who are at high risk of opioid-related overdose. This supplementary research project (R01DA036754-01S1) will achieve the following aims: 1) Train opioid-using veterans in the administration of naloxone to reverse an opioid-related overdose and assess their retention of knowledge provided in an educational video. 2) Assess the uses of and experiences of having naloxone kits among recently returned veterans over a period of one year. 3) Evaluate the potential for personal possession of naloxone to impact overdose risk behaviors.

Supplement Study #2: This study (3R01DA036754-03S1) will conduct a stakeholder analysis of impacts of naloxone training and provision across various institutional settings and treatment/service modalities. The ongoing study in which this supplement will be situated is currently distributing naloxone to at-risk veterans under the auspices of the Opioid Overdose Prevention Program (OOPP) registered by the NY State Department of Health) at NDRI. This supplement aims to expand scientific understanding of naloxone’s impact by: 1) developing preliminary survey instruments for assessing naloxone-related attitudes, and perceived impacts on participants’ ongoing management of opioid use; 2) conducting a stakeholder analysis of opioid users, treatment providers, first-responders and overdose survivors; and 3) collecting follow-up data over a 12-month period from recent overdose survivors whose overdoses were reversed with naloxone.
Principal Investigator: Ellen Benoit

Childhood sexual abuse (CSA) remains a critical public health issue among Black and Latino sexual minority men, as it is associated with multiple negative outcomes including substance misuse, poor mental health, revictimization, and high-risk sexual behavior. Most CSA research with sexual minority men relies on quantitative assessment that often precludes consideration of cultural variations in how formative sexual experiences are understood, are based on inconsistent or overly restrictive definitions of abuse, and therefore may fail to detect certain abusive experiences (e.g., those involving female perpetrators), which can have harmful health consequences if they remain unrecognized. This mixed-methods study will overcome existing limitations by drawing on perspectives of Black and Latino sexual minority men and relevant service providers to better understand the role of, and need to include, sexual abuse histories in treatment and counseling settings, with the long-term goal of improving assessment and health outcomes.

For more information: Abstract
See SSIC for information on current projects
Principal Investigator: Sara Anne Jahnke

The US fire service serves as the front line of defense against any domestic emergency and volunteer firefighters (VFF) comprise the majority of firefighters. Unfortunately rates of overweight and obesity are at epidemic proportions among VFFs and cardiovascular disease remains the leading cause of line of duty deaths. Moreover few resources tailored to the unique culture and needs of firefighters are available to help occupational medicine physicians who provide their fitness for duty examinations. This project will engage firefighters and occupational medicine clinicians in tailoring an internet/mobile intervention and pilot test the program with a sample of VFFs with the goal to prepare and launch a national randomized clinical trial.

For more information: Abstract
Principal Investigator: Sara Anne Jahnke

Behavioral health interventions implemented to mitigate negative outcomes linked to trauma in the fire service have had limited or iatrogenic effects on firefighters. The National Fallen Firefighters Foundation (NFFF) and the national fire service community have invested considerable resources developing a new behavioral health model to address exposure to traumatic events. The proposed randomized controlled trial will be the first to determine the efficacy of the NFFF’s Consensus Protocol on Firefighter Behavioral Health Stress First Aid Intervention (SFAI), as well as evaluating its implementation and acceptability.

For more information: Abstract
Principal Investigator: Sara Anne Jahnke

The aim of this study is to conduct a cluster randomized clinical trial evaluating the efficacy of The First Twenty health promotion program among volunteer firefighters in the national volunteer fire service. Primary outcomes include changes in body composition and fitness outcomes.

For more information: Abstract
Principal Investigator: Sara Anne Jahnke

The US fire service serves as the front line of defense against any domestic emergency, often with negative consequences for the health of firefighters. While research on occupational risk factors in firefighters has received increased attention over the past decade, female firefighters' unique health concerns have largely been ignored and this dearth of knowledge likely contributes to the remarkably low number of female firefighters. By exploring barriers to health and wellness among female firefighters through accessing the perspectives of both firefighters and key fire service leadership, as well as conducting a national survey of health concerns, this study will be the first to address significant knowledge gaps about women who play a key role as first responders in ensuring public safety.

For more information: Abstract
Project Director: Pedro Mateu-Gelabert

The proposed study will examine the feasibility, acceptability, safety, effectiveness, and cost of an Accessible Care intervention for engaging people who inject illicit drugs in hepatitis C care. Four times as prevalent in the US as HIV infection, hepatitis C is already the leading cause of liver failure and liver transplantation, the disease burden and health care costs will continue to rise in the coming decades, and the 1.5-2.0 million people who inject illicit drugs are the most severely affected. If we are to end the hepatitis C epidemic in or country, data are needed on effective methods to provide successful antiviral therapy to the core population affected by the epidemic.

For more information: Abstract
Principal Investigator: Samuel R. Friedman

This project will estimate changes in injection and non-injection drug use, in HIV, AIDS and AIDS mortality rates among injection drug users, and in drug- and HIV-related interventions among drug users, in 96 large metropolitan areas over a 21-year period (1992 - 2012). We will investigate how these epidemics and interventions affect one another, and how macro-contextual factors like economic and social conditions shape them both. We will identify metropolitan areas in which serious drug use, HIV or AIDS epidemics are emerging, and offer state and local health departments and drug agencies the best information available on policies and programs that might reduce these epidemics. Our findings will also help national public health agencies, including the CDC and SAMHSA, and other researchers, plan a mixture of evidence-based programs and policies to reduce the forces that lead to high-risk drug use and the associated HIV and AIDS epidemics.

For more information: Abstract
Principal Investigator: Enrique Rodriguez Pouget

Despite all research and prevention efforts, 56,000 new HIV infections take place in the United States each year. Many researchers and public health authorities are calling for research to develop "structural interventions" that change social and normative contexts so people can more easily avoid HIV risk. We aim to develop new measurement tools to let us understand why and how such structural interventions do or do not work-which is an essential part of the research needed to develop effective interventions.

For more information: Abstract
Principal Investigator: Brian R. Edlin

The purpose of this study is to determine the risks of acquiring hepatitis C virus (HCV) infection associated with specific injection practices in a cohort of young, high-risk injection drug users (IDUs) on the Lower East Side of Manhattan, and the possible protective effect of pre-existing HCV-specific immune responses. Hepatitis C is the most rapidly rising opportunistic infection in persons with human immunodeficiency virus (HIV) infection and already the leading cause of death in persons with HIV/HCV co-infection. Because it is more prevalent and more readily transmitted among IDUs than HIV, HCV prevention serves as a sensitive model for the prevention of HIV and other bloodborne infections among IDUs. Despite advances in our understanding of HCV and its transmission, HCV continues to spread rapidly among IDUs, who now account for most new HCV infections in the developed world. A better understanding of the risks associated with the sharing of syringes and other injection equipment and many other opportunities for blood contact that arise during the preparation and injection of drugs is needed to guide the development of more effective prevention interventions.

For more information: Abstract
Principal Investigator: Pedro Mateu-Gelabert

Within the past 10 years, the nonmedical use of prescription opioids (POs) has increased 40% in the U.S. with the largest increases occurring among adolescents and young adults (SAMHSA, 2011). These trends are alarming from a public health perspective because opioid use is associated with significant risk for HIV, HCV and STIs, yet very little U.S.-based research to date has explored the risk behaviors of nonmedical PO users. The proposed mixed-methods, respondent-driven sampling (RDS)-based study will assess the drug and sex- related disease risk associated with nonmedical PO use and determine prevalence rates for HIV, HCV and STIs (Chlamydia and Gonorrhea) among young adult (ages 18-29) nonmedical PO users in New York City, an endeavor which will contribute to the development of disease prevention messages tailored to this group's distinct characteristics, needs and drug-use practices.

For more information: Abstract
Principal Investigator: Brian R. Edlin

The purpose of the proposed study is to examine the effectiveness of integrated care program for hepatitis C, addiction, and HIV prevention in active injection drug users (IDUs), in comparison with standard, separate treatment for each of these conditions. Hepatitis C is the leading cause of liver failure and liver transplantation in the US, and the disease burden and health care costs are expected to dramatically increase in the coming decades. Successful methods for engaging active IDUs in treatment for substance abuse and hepatitis C will be critical to mitigating the extraordinary morbidity and mortality these epidemics will cause.

For more information: Abstract
Principal Investigator: Hannah L. Cooper

For over 30 years almost all studies of the determinants of HIV/AIDS infection, and most studies of HIV/AIDS progression and outcomes, have focused on one key population (e.g., injectors, men who have sex with men, or heterosexuals) in isolation from other key populations. Our and others' research, however, suggests that HIV/AIDS epidemics and programs in these different key populations may affect one another, which means that the prevailing siloed approach is likely to have missed (a) fundamental dynamics of HIV/AIDS epidemics, and (b) vital opportunities to prevent new infections by intervening in cross-key- population dynamics. The proposed study will help foster and guide a new research paradigm about how HIV/AIDS epidemics and programs affect one another across key populations that will (a) identify previously unknown but fundamental dynamics of these epidemics, and (b) open up new arenas for the development of programs and policies that prevent HIV transmission across key populations.

For more information: Abstract
Principal Investigator: Honoria M. Guarino

Recent empirical and clinical evidence suggests that the use of illicit drugs - particularly injection heroin use - occurs at alarmingly high rates among young adult immigrants from the former Soviet Union (FSU) living in the U.S., yet virtually no systematic research has been conducted on this problem. The proposed mixed-methods study of contextual factors shaping drug use patterns, HIV/HCV risk behavior, and utilization of drug treatment and disease prevention services among opioid-using FSU youth promises to contribute significantly to public health by providing an evidence base to inform the development of culturally-targeted drug treatment and HIV/HCV prevention approaches for this vulnerable and underserved population. Finding effective and acceptable strategies to prevent or reduce the harmful physical, psychosocial and community consequences of opioid misuse and injection drug use among this high-risk group of young drug users is of the utmost importance from a societal perspective - not only to ameliorate the human cost of these problems, but also to contain the financial burden they pose to the wider society.

For more information: Abstract
Principal Investigator: Samuel R. Friedman

Half or more of HIV transmission events may occur within the period of high infectivity (and often high risk behavior) that can last 11 months or more after a person is initially infected. Unfortunately, neither test-and-treat intervention methods nor Acute HIV Infection projects have found effective ways to intervene against transmission during this risky "recent infection" period. We seek to develop effective intervention techniques against HIV transmission among drug users and their community members during the recent infection period using a combination of drug injection-, sexual- and social-network-based contact tracing methods; community alerts in the networks and venues of recent infectees; and the logic of going "up" and "down" infection chains.

For more information: Abstract
Principal Investigators: Pedro Mateu-Gelabert, Honoria Guarino

The growing population of young people who inject drugs (PWID) is at extremely high risk for HCV infection through the use of contaminated injection equipment, yet, to date, no behavioral intervention has been sufficiently potent to produce significant reductions in HCV incidence among PWID. To address this critical public health need, our team developed Staying Safe (Ssafe), an innovative, strengths-based, socio-behavioral HCV prevention intervention found in preliminary research to be highly acceptable and feasible, with strong indications of efficacy. The proposed randomized, controlled trial will assess the effectiveness of the Ssafe intervention in reducing both injection-related HCV/HIV risk behavior and HCV incidence among young adults (ages 18-29) who inject opioids (heroin and/or prescription opioids).

For more information: Abstract
Principal Investigator: Samuel R. Friedman

The goal of the Transdisciplinary Theoretical Synthesis and Development Core ("Theory Core," for short) is to strengthen the theoretical bases of CDUHR Investigators' research and, more generally, of global research in HIV epidemiology, prevention, and care for substance users (SUs) and those in their communities. In CDUHR-III, the Theory Core focused heavily on training and consultation about the relative merits of appropriate individual/ psychological and social theories for studying individual- and social-level influences and correlates of HIV risk, prevention, adherence, and retention for SUs. However, HIV research and interventions now face serious problems that require a shift beyond reliance on the psychosocial theoretical approaches that have dominated HIV prevention and care for the last three decades. Despite many new promising behavioral and biomedical prevention and treatment interventions, the HIV and substance use epidemic continues to spread at unacceptable rates in the U.S. and internationally.

For more information: Abstract
Principal Investigator: Lloyd Goldstamt

Young male sex workers in Vietnam show high prevalence rates of HIV and other STIs, reflecting their involvement in multiple concurrent sex exchanges with both male and female partners, yet they have limited exposure to, or engagement in, health services, including community outreach, HIV/STI testing and treatment, and vaccination for HBV and HPV. Building on the substantial research capacity and health services infrastructure developed in our prior research collaboration in Vietnam, we propose to address these gaps in community outreach and health services access by using Sexual Health Promotion as a conceptual framework, and a research design based on principles of implementation science to deliver an intervention that combines already proven intervention technologies - community outreach nursing and sexual health promotion interventions - to enhance outreach coverage and to foster engagement and retention in health services among YMSWs in the two strategically selected cities in Vietnam (Hanoi and Ho Chi Minh City). It is anticipated that the intervention will significantly contribute to intervention capacity-building in Vietnam and may als contribute to intervention development in neighboring countries in Southeast Asia that face similar challenges.

For more information: Abstract
Principal Investigator: Eloise Dunlap, Ellen Benoit

The proposed investigation of the illicit bath salts market will clarify the subculture developing around use and sales, including changes in product, pricing and packaging, and levels of market- and use-related violence. The study will also document users' perceptions of health and safety risks; for example, it will identify subculture etiquettes by which regular users may modulate consumption so as to avoid serious consequences. The knowledge emerging from this study will enable the development of more accurate drug education, prevention, treatment and health related programs for bath salts users.

For more information: Abstract
Principal Investigator: Ellen Benoit, Eloise Dunlap

African American females remain disproportionately vulnerable to infection with HIV, primarily transmitted through sex with an infected male. Using script theory, this project will greatly advance scientific understanding of why and how marginalized heterosexual black women engage in various forms of sexual behavior with multiple partners, and whether and how condoms are used and safer sex messages are interpreted. These findings will build on the investigators' previous research on male scripts, leading to improvements in developing culturally sensitive messages for safer sex practices and reducing multiple partnering practices and HIV/STI infections among this high-risk population.

For more information: Abstract
Principal Investigator: Andrew L. Golub

Custodial parents in poor urban African American households often engage in a series of short cohabiting relationships which present unique risk and possibly protective factors for children's mental health problems and negative outcomes. Understanding the nature of the turnover in cohabiting partners, changes in coparenting contributions and the impact on children's well-being will yield insights that should prove invaluable to developing policies to support children's healthy development such as programs that recognize and enhance the coparenting contributions by unmarried social fathers and others that limit the disruption associated with the formation and dissolution of relationships.

For more information: Abstract
Principal Investigator: Andrew L. Golub

A high proportion of returning veterans have been experiencing drug abuse, alcohol abuse, smoking, serious psychological distress, and related civilian reintegration problems (e.g., homelessness, unemployment, family distress). This study seeks to provide new, in-depth insights that will lead to improvements in outreach initiatives and treatment programs for the predominately African American veterans returning to the inner-city, who face particularly high risks and more complex problems than other veterans. Ultimately, the findings will help preserve these veterans' physical and mental health; reduce substance abuse and HIV infection; reduce the cost of care; and reduce the social burden of troubled veterans with unmet mental health and substance abuse concerns.

For more information: Abstract
Principal Investigator: Michelle C. Acosta

Approximately 2.3 million Americans currently abuse heroin or prescription opioids, with the cost of opioid use disorders (OUDs) annually exceeding $30 billion. Unfortunately, most individuals with substance use disorders (SUDs), including OUDs do not receive treatment, and the minority that receive treatment do not typically receive effective psychosocial treatment interventions due to cost and other operational barriers. The proposed Mobile Therapeutic System, a novel, interactive, psychosocial intervention for SUDs delivered via mobile phones, may allow for the provision of effective and cost-effective treatment that may be widely disseminated, thereby significantly improving access and effectiveness of SUD treatment in a variety of populations, including individuals with OUDs, while limiting costs.

For more information: Abstract
Principal Investigator: Ian David Aronson

When hospital emergency departments (EDs) offer routine HIV testing to reach substance users and other high-risk patients, those who could benefit most frequently decline. Thus, an important health priority remains not only offering HIV testing to more patients, but developing strategies to increase test rates by working with patients who are reluctant to learn their HIV status. The proposed research will develop and evaluate the acceptability, feasibility, and preliminary efficacy of a mobile computer-based video intervention designed to increase HIV test rates among vulnerable patients in EDs and other high volume clinical settings nationwide.

For more information: Abstract
Principal Investigator: Ian David Aronson

Because adolescents and young adults face markedly increased HIV risk yet frequently do not test, we propose to develop a Mobile Augmented Screening (MAS) tool designed to increase HIV testing, and to facilitate linkage to care and ongoing prevention education. This tool will help clinicians address undiagnosed youth HIV, and enable young patients to receive much needed treatment and avoid unknowingly transmitting infection. Our product is designed to help existing program staff reach an increased number of clients; and to improve public health by encouraging reluctant young patients to accept important HIV testing and care they may otherwise decline.

For more information: Abstract
Principal Investigator: Ian David Aronson

Because people who inject drugs (PWID) frequently lack adequate information about HIV or HCV testing and prevention, or overdose prevention and response training, we propose to develop a Mobile Intervention Kit to deliver technology-based interventions from a library of theory-guided video content. This flexible tool will help service organizations to prevent overdose deaths and identify undiagnosed HIV and HCV, enabling clients to receive much needed treatment and avoid unknowingly transmitting infection. Our product is designed to help existing program staff reach an increased number of clients; and to improve public health by encouraging reluctant patients to accept important services they may otherwise decline.

For more information: Abstract
Principal Investigator: Andrew Rosenblum

There are more than 300,000 opioid-addicted patients who are receiving methadone maintenance therapy from opioid treatment programs (OTPs) in the United States. Large numbers of these attend OTPs located in areas impacted by Hurricane Sandy. Disruption of methadone dispensing and other services can have severe consequences to patients (and treatment seekers) such as relapse, dropping out of treatment and resumption or increase in HIV/HCV injection risk behaviors. The goal of this study is to develop recommendations for OTPs in their recovery efforts from Hurricane Sandy and their planning for future emergencies by obtaining data from OTPs (directors, staff, de-identified records, and patients), out of treatment persons who subsequently sought addiction treatment, and New Jersey and New York SOTA Directors about Sandy preparedness and response.

For more information: Abstract

Supplement Study: This supplemental project will expand and extend the original aim and protocol of our study by conducting a national survey of at least 50 opioid treatment programs (OTPs). (Our current sample includes 9 OTPs that were affected by Hurricane Sandy.) The supplemental project sample will be stratified by region and urbanicity (rural, suburban, urban); and OTPs would be oversampled in areas that have a history of natural disasters to determine their disaster planning and recovery resources and needs. We also plan to interview state and federal officials to learn more about how key government agencies can help OTPs prepare for and respond to emergencies such as hurricanes, other weather-related events, terrorist attacks, and power and internet outages. Based on the current parent ASPR Sandy project (HITEP140014), we have already identified significant consequences of inadequate OTP preparation including increased injecting behavior, relapse to illicit opioid use, involuntary reductions in methadone dosage and suspension or termination of psychotherapeutic medications. These negative outcomes appear to be associated with incomplete continuity of operation plans (COOPs), particularly in the domains of transportation and communication, and the absence of relationships with alternative treatment programs. By conducting a nationwide survey we would be able to collect a robust, representative array of data to assure that findings are generalizable across the United States. We will disseminate our results to OTPs – as policy recommendations and as a model COOP – through AATOD, State Opioid Treatment Authorities, social media, and peer reviewed publications.
Principal Investigator: Andrew Rosenblum

Despite the high prevalence of opioid addiction among persons under criminal justice supervision there has been very limited penetration of medication assisted treatment (MAT; methadone, buprenorphine, and extended-release naltrexone); an intervention that has a very strong evidence base. To spur implementation of MAT, we propose a Stage I study to develop and assess the feasibility, acceptability, utility and sustainability of an interactive eLearning modality and an eLearning + an organizational approach (Technology Transfer [TT] model) to advance knowledge and facilitate inclusion of MAT in drug and felony courts. We expect this development/pilot project to lead to a protocol that will be tested in a larger-scale efficacy trial to implement evidenced-based therapy for opioid-addicted criminal justice clients.

For more information: Abstract
Principal Investigator: Andrew Rosenblum

Abuse of prescription opioids has reached epidemic proportions, especially among enrollees in opioid treatment programs (OTPs) in certain regions of the United States. Our previous work indicated that chronic pain contributes to opioid abuse, especially among OTP patients. However little is known about current and lifetime prevalence of different types of opioids among methadone enrollees or factors that may contribute to the use of different types of opioid drugs.

For more information: Abstract
Principal Investigator: Harlan Matusow

Data from prescription drug monitoring programs (PDMPs) are increasingly used by opioid treatment programs and office-based opioid treatment providers (OTPs) to ensure that if patients are being prescribed controlled substances, they are medically warranted and taken as directed. In the absence of this information, treatment providers do not have the resources to effectively manage care, and their patients are at increased risk of continued addiction, overdose, and death. Others may be diverting prescription drugs. Accessing the data from PDMP databases can guide therapeutic decision making and assist in better understanding how patients continue to use or abuse prescription opioids as they remain in treatment. This will also assist OTPs in better differentiating what medications to offer the patients during the course of treatment.

Under a subcontract from the American Association for the Treatment of Opioid Dependence, we undertook to survey 13 OTPs to assess their PDMP practices. We compared baseline usage (12/31/14) with quarterly rates of usage over calendar year 2015. Overall, rates of unreported prescriptions among OTP enrollees were not significantly different from those already in treatment when the study commenced. On a quarterly basis, unreported prescriptions were relatively stable, and the composite numbers at the end of the year were not significantly different from those at baseline,

Two questions deserve further scrutiny: 1) Why do some programs consistently fail to check the PDMP, even when 10-15% of those persons checked are found to have unreported prescriptions? 2) What factors lead to discharge of the 20-25% of those patients with unreported prescriptions?

Once these questions are answered, we need to identify ways in which the PDMPs can be used in the service of keeping people in treatment, rather than in discharging 1 in 5.
Principal Investigator: Andrew Rosenblum

It is conservatively estimated that 30-60 million Americans experience non-trivial chronic pain and that this disorder imposes substantial personal burden in terms of disability and suffering and incurs significant economic and social costs, such as employee absenteeism and high health care utilization. To address this public health concern, we propose to develop a novel interactive, web-based program to provide comprehensive, psychosocial treatment to opioid-treated, chronic pain patients with aberrant drug-taking behavior. The proposed research will contribute new empirical information relevant to improving the treatment of chronic pain by enabling the widespread delivery of evidence-based psychosocial treatment to chronic pain patients.

For more information: Abstract
Principal Investigator: Andrew Rosenblum

Although a significant minority of veterans from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) in VA primary care centers present with co-occurring PTSD and substance use problems, most do not receive adequate treatment. To address this public health concern, we propose to modify the content of an efficacious web-based CBT intervention that will target substance use, PTSD and other problems common among OEF/OIF veterans, and will conduct an economic analysis that will compare costs & benefits of our web-based intervention with usual treatment at VA primary care settings. Results of this study have the potential to markedly improve psychosocial treatment for substance use and related disorders among OEF/OIF veterans and enable rapid and widespread diffusion of a science-based intervention to this population.

For more information: Abstract




  • About NDRI
          Since 1967, National Development and Research Institutes, Inc. (NDRI), a private, not-for-profit 501(c)(3) organization, has conducted substance use and other bio-behavioral research nationwide and throughout the world.

          Drawing on the expertise of our interdisciplinary professional staff and our partners such as medical centers, treatment and prevention programs, universities, CBOs, industry and government NDRI has advanced public health across diverse populations including high-risk and underserved persons, uniformed services, youth and veterans.

          In addition to its focus on addiction, NDRI, organized under specialized institutes, has generated scientific discoveries associated with infectious diseases (particularly HIV and Hepatitis C), overdose, chronic pain, prevention of cardiovascular disease and cancer, tobacco control and criminal justice.


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