Funded Projects

People who work in harm reduction settings aiming to keep people with substance use disorders safe from overdose and other negative health outcomes are exposed to high rates of lifetime and occupational stress and trauma. Their work conditions can have adverse effects on patient care and also on their own well-being, such as unmet mental health needs, burnout, and relapse. This project will adapt the Stress First Aid intervention for harm reduction workers. The research will test the impact of this intervention on social support, burnout, secondary traumatic stress, use of mental health care, engagement, and turnover. The long-term goal of this work is to implement a sustainable and effective national occupational stress intervention for harm reduction workers to strengthen their important role in helping individuals get treatment and avoid overdose.

Although medication-based treatment for opioid use disorder (OUD) can effectively reduce overdose risk and improve health outcomes, most people discontinue treatment too soon. Peer support specialists, who are individuals with direct experience with a substance use disorder, can offer social support to help individuals with OUD overcome barriers to treatment and recovery. This project will develop, deliver, and evaluate an innovative peer support specialist intervention to help individuals begin and stay in a treatment program. The research will focus on rural populations and underserved communities, using a dynamic modeling framework to prioritize at-risk communities for treatment offered through mobile health clinics.

People who survive sexual violence are at increased risk for posttraumatic stress disorder (PTSD) and opioid misuse. Emergency departments are often the first, and in some cases only, contact with the medical care system for survivors of sexual violence. This makes them a suitable setting to initiate interventions to address the risk of PTSD and opioid misuse in these individuals. This project will develop and test a brief, low-cost video and text message intervention that can be initiated in the emergency department to prevent onset or escalation of PTSD and opioid misuse among people who survive sexual violence.

The overdose crisis has expanded rapidly among adolescent populations in recent years, largely due to illicit substances containing lethal amounts of the highly potent synthetic opioid fentanyl. However, a provider shortage limits access to effective treatment for adolescents with opioid use disorder and other substance use disorders (SUD). Although primary care is a promising setting for expanding delivery of SUD treatment to adolescents, many primary care providers lack the training, resources, and support systems to deliver these services confidently and effectively. This project will leverage a large-scale rollout of integrated behavioral health care in a statewide health system. The research will test whether embedding behavioral health specialists into primary care visits, introducing case management and electronic clinical decision support tools, and reducing stigma will increase delivery of SUD treatment to adolescents.

Osteoarthritis is a degenerative joint disease marked by progressively worsening chronic joint pain that affects function and quality of life. Non-opioid, alternative medications are needed for people with this condition. Joint inflammation, damage, and pain involve signaling through the interleukin-6/glycoprotein 130 pathway. This project will test blocking this pathway in rodents with a new molecule with improved drug-like properties, toward developing an oral medication for osteoarthritis. 

There are a dearth of integrated treatments that simultaneously address the fundamental causes of chronic pain and opioid misuse/opioid use disorder and that focus on well-being among individuals with chronic pain and opioid misuse/disorder. This research will study how to improve the lives of patients with chronic pain and opioid misuse/disorder via tailored interventions that explicitly target increasing quality of life and engagement in valued activities, the cultural centering of interventions to meet the needs of diverse patient populations and reducing stigma of chronic pain and opioid misuse/disorder. Specific research projects will i) test the effectiveness, mechanisms, and implementation of an integrated psychosocial treatment for chronic pain and opioid use disorder among individuals receiving buprenorphine from outpatient treatment clinics, and ii) will use community-based participatory research methods to develop a culturally centered strategy for screening and brief intervention of chronic pain and opioid use disorder among American Indian/Alaska Native patients in primary care settings. This research will shed light on a difficult problem and improve health and wellbeing with a focus on diverse and underserved populations.

The goal of the Tailored Retention and Engagement for Equitable Treatment of Opioid use disorder (OUD) and Pain (TREETOP) research program is to develop effective, equitable, and sustainable interventions for chronic pain and opioid misuse/disorder that improve engagement in medication for opioid misuse/disorder treatment and retention in office-based addiction treatment. TREETOP will prioritize disproportionately affected rural and Black communities. The Engagement research project will investigate whether pain self-management can improve pain and engage primary care patients to seek medication treatment for opioid misuse/disorder. The Retention project will investigate whether pain self-management and/or flexibly dosed buprenorphine/naloxone can improve pain and retention in treatment among patients who have already begun care in office-based addiction treatment programs. With engagement from stakeholders and representatives with varied perspectives and lived experiences, this research will advance the science of sustainably and equitably managing chronic pain and opioid misuse/disorder, prioritizing disproportionately affected communities.

Medicaid covers the cost of treatment for opioid use disorder (OUD) for most individuals who need it, including minoritized populations and those with risk factors related to low income, education, and employment. The Medicaid Outcomes Distributed Research Network has supported efforts to improve OUD treatment by developing novel measures of treatment quality and examining effects of treatment quality on overdoses. Using this network, this project will leverage university-state partnerships in 12 states to inform quality improvement initiatives and Medicaid policy. The research will develop provider-level quality measures for OUD using Medicaid administrative data and measure patient-reported outcomes. The research will also look for approaches to use claims-based quality measures and practice-level quality improvement strategies to improve treatment outcomes for people with OUD.

The number of drug overdoses in New York continues to rise. In response, the New York State Office of Addiction Services and Supports (OASAS) is promoting approaches that embrace person-centered care, evidence-based practices, equitable treatment, and harm-reduction principles. In this project, researchers will partner with OASAS to build a quality measurement and management research center that provides performance feedback to support and encourage leadership and staff of treatment clinics to improve practice. The center will also publicize quality measures to ensure public accountability.

This study will assess the implementation of an evidence-based treatment in correctional settings by comparing the effectiveness of two medications used to treat opioid use disorder—extended-release buprenorphine (XR-B) vs. extended-release naltrexone (XR-NTX)—among adults currently incarcerated in U.S. jails and prisons at five distinct trial sites. This study will allow providers, correctional and public health authorities, payers, and policymakers’ timely and relevant data to assess the effectiveness of these medications as potentially useful re-entry treatment options. Findings from this study have implications for expanding public safety and limiting the societal costs of heroin, fentanyl, and prescription opioid addictions.

Opioid use disorder (OUD) is a significant public health problem in the United States. Particularly troubling is the rapid evolution of an opioid epidemic within the past decade, characterized by a surge in unintentional overdose deaths involving synthetic opioids, such as fentanyl. The current standard of care for opioid overdose is reversal with opioid antagonist naloxone. Naloxone is effective at reversing overdose from prescription opioids and heroin, but less effective when combating fentanyl, due to fentanyl?s high potency. Therapeutic monoclonal antibodies (mAbs) against fentanyl could overcome this problem by specifically preventing the drug from entering the central nervous system, averting overdose and attenuating opioid-induced respiratory depression. This study will develop and design of laboratory protocols needed to establish a Good Manufacturing Practice (GMP) process, quality assurance protocol, and stability profile for a new human mAb against fentanyl. Subsequent production of current GMP material will enable Good Laboratory Practice (GLP) toxicology studies in rats and dogs and eventually a Phase I/IIa clinical trial. This material will also be used in final opioid-induced respiratory depression studies in mice and non-human primates to confirm therapeutic efficacy of final drug product. If successful, these activities will enable filing for an investigational new drug application for this mAb candidate with the FDA.