Funded Projects

The International Classification of Diseases 10th revision codes are insufficient to accurately identify individuals who use opioids and stimulants together. This project will search already collected electronic health record data using a computer program to identify people with polysubstance use and determine what health care they receive. The research will improve understanding of polysubstance use in a region of Los Angeles, California, with very high rates of overdoses involving fentanyl and stimulants. 

Decreasing opioid dosing faster than advised by clinical recommendations often leaves chronic pain unaddressed and may increase the risk of overdose and suicide compared to continuing long-term opioid treatment. The MIRHIQL Resource Center will provide infrastructure support for the network as well as create a risk-benefit decision tool to help providers determine when opioids should be continued as prescribed, tapered, or tapered/discontinued. The center will first develop and validate a clinical definition for individuals who take long-term opioids, then study long-term outcomes in participants who receive treatment in primary care settings. This research will partner with many groups including individuals with lived experience, community health care providers who treat such individuals, research scientists, bioethicists, and professional societies

Decreasing opioid dosing faster than advised by clinical recommendations often leaves chronic pain unaddressed and may increase the risk of overdose and suicide compared to continuing long-term opioid treatment. Continued, long-term use of opioids after surgery by individuals who use opioids increases the risk of postoperative complications, opioid use disorder, and death. Surgery is a critical point-of-care moment for health care providers to interact with patients who use opioids about continued opioid use when harms outweigh benefits. This project will test of the Motivational Interviewing and guided Opioid Tapering support (MI-Opioid Taper) strategy, with or without a medication that reduces anxiety and relieves pain, at four geographically diverse hospitals across the nation.

Effective development of non-addictive therapies for pain requires animal models that reflect the human condition. Unfortunately, currently used models have limitations and have not always done a good job of predicting what will work in human patients. This project will refine a new way of measuring pain-related behaviors in mice that takes advantage of more natural mouse behavior and is less influenced by experimenter biases and artifacts. The research will verify that the promising results hold up in several different types of pain and that different classes of clinically used pain medications are effective. They will also make sure the data can be reproduced by an outside laboratory. If successful, this will support the use of this new read-out for future pain therapy development.

Providing housing and prevention services (often referred to as “housing first”) has great potential to prevent opioid use disorder, continued homelessness, and other problem behaviors among youth experiencing homelessness. However, implementation of these services is challenging because criminal justice system involvement (which is common in this population) often prevents or delays access to housing. This project will explore interactions between criminal justice system involvement and the housing first intervention, toward reducing risks for opioid use and death among justice-involved youth experiencing homelessness

Understanding the mechanisms underlying the transition to chronic pain is key to mitigating the dual epidemics of chronic pain and opioid use in the United States. As part of the National Institutes of Health-funded Acute to Chronic Pain Signatures Program, the Data Integration and Resource Center aims to This project will support a post-doctoral trainee to develop the skills and knowledge needed to pursue a successful career in clinical pain research. The research will involve integrating imaging, physiology, -omics, behavioral, and clinical data to develop biosignatures for the transition from acute to chronic pain, toward understanding how the nervous and immune systems affect post-surgical pain and opioid use.

This project provides protected time for training and research activities that are required for an independent scientific career in the development, testing, and implementation of cutting-edge digital therapies and tools (such as smartphone apps and other web-based resources) that can promote health equity in treatment of opioid use disorder (OUD). The research will adapt and test digital overdose prevention and recovery support interventions for Black Americans with co-occurring OUD and mental illness. 

Opioid use disorder with simultaneous misuse of cannabis and alcohol during pregnancy is associated with increased risk for several infant neurodevelopmental problems. This project will evaluate the effects of opioids and other substances of misuse on the mother’s immune system by studying maternal immune cells and measuring molecules in her blood. The research will also study the role of the nerve communication molecule serotonin produced by the placenta. This research will take advantage of data from the HEALthy Brain and Child Development Study that is focused on child development measures. Together, these studies will provide important new insights into the ways misused substances affect infant brain development and neurodevelopmental outcomes.

Exposure to prescription opioids during pregnancy can alter growth of the fetus and cause persistent neurological problems during childhood. This project will identify biological underpinnings of oxycodone exposure on health of the placenta, brain development of the fetus, and behavioral problems observed in early infancy. This research will also assess whether melatonin supplementation can limit these harmful outcomes. Overall, the research aims to characterize the health effects of oxycodone used during pregnancy, as well as to point to new tools and molecular indicators (biomarkers) for diagnosing, treating, and preventing opioid harm to the fetus and mother.

People who live in rural areas have high rates of chronic pain and poor health outcomes and are less likely to receive evidence-based complementary and integrative treatments for chronic pain. This project will adapt a nurse care management model for use in health systems serving rural patients with chronic pain. The research aims to coordinate care, provide cognitive behavioral therapy, and refer patients to a remotely delivered exercise program.

Technology approaches that deliver electrical current through the skin near a damaged or injured peripheral nerve are used to treat chronic neuropathic pain that does not respond to other treatments. This project will optimize this nerve stimulation approach while also determining how the stimulation works to reduce pain in the body. The research will also look for patient characteristics that predict response by conducting a clinical trial comparing combined peripheral nerve stimulation and conventional medical treatment to medication alone.

Natural products, which are substances found in nature and made by living organisms, have been used in the past as good sources for developing new medications. Natural products isolated from marine bacteria that attach to the pain-signaling protein sigma-2 receptor (also known as transmembrane protein 97 [TMEM97]), may serve as a starting point to create new, non-opioid pain medications. This project will use chemistry and biology approaches to refine such natural products as a treatment for neuropathic pain.

Emergency departments (EDs) are key settings for identifying and treating opioid use disorder (OUD), but EDs are underused for this purpose. This project aims to develop a data system that automates and integrates electronic health record and administrative data from EDs into the Clinical Emergency Department Registry, partnering with the American College of Emergency Physicians. The research will assess the digital readiness of ED systems before developing and deploying the enhanced ED OUD data infrastructure. This research aims to guide near-real time hospital quality improvement initiatives, toward development of a web-based, near-real time dashboard that can be used in EDs across the country.