Posts classified under: Substance Use

mHealth to Enhance & Sustain Drug Use Reduction of the QUIT BI in Primary Care

Abstract:The QUIT-Mobile study proposes to use mobile phone self-monitoring and feedback to enhance and sustain over 12-months the impacts of the Quit Using Drugs Intervention Trial (QUIT), an ef- fective screening and brief intervention (SBI) previously successful in reducing risky drug use (i.e., moderate use) in low-income, diverse patients over a 3-month follow up. We propose to conduct the QUIT-Mobile study for primary care patients who receive care in 8 clinics of federally qualified health centers (FQHC) in Southern California over 12-months follow up, comparing to QUIT and Usual Care (UC). The proposed study is an Effec- tiveness-Implementation Hybrid Type 1 design consisting of a single-blind, 3-arm, RCT with adult, mostly La- tino FQHC primary care patients with risky drug use (ASSIST score 4-26), randomized to 3 conditions (n=320/arm, n=960 total): 1) QUIT-Mobile; 2) standard QUIT; 3) Usual Care. Qualitative data on implementa- tion facilitators and barriers will inform future scale-up and sustainability, in addition to cost data and cost-effec- tiveness analysis. The aims are to examine effectiveness in reducing risky drug use and cost-effectiveness comparing the three arms over 3-, 6- and 12-months. Drug use measures include urine drug tests, and timeline follow-back self-reports for past 7-days and past 30-days (risky drug users have sporadic drug use patterns requiring longer self-report recalls for drug use that urine screens may not detect). The 3-arm study enables testing of the independent and synergistic effects of QUIT-Mobile compared to QUIT and both to Usual Care, acknowledging that mHealth components alone may not be effective outside of a clinical/coaching relationship. The 12-month timeline reflects anticipated scale-up scenarios of annual primary care visits when screening and brief intervention would be repeated routinely. QUIT contains 3 components: 1) patient screening with the WHO ASSIST, 2) brief clinician advice (<4 minutes) including opioid overdose prevention education, and 3) 2- and 6-week telephone drug-use health coaching sessions utilizing motivational interviewing and cognitive be- havioral techniques, delivered by paraprofessional health coaches. QUIT-Mobile proposes to test the addition of mobile phone self-monitoring, feedback, and coach monitoring dashboard to enhance and sustain QUIT’s drug use reductions using mobile app, text-messaging (SMS), or interactive voice response (IVR) to allow par- ticipation by with varying technological preferences. This study does not test which technology platform is more effective, but rather, the effectiveness of the intervention functions (i.e., self-monitoring, automated feedback, coach monitoring) that are delivered via patients’ preferred technologies. This study is novel and timely in inte- grating massively scalable mobile phone tools into an effective primary care BI to prevent substance use disor- der (SUD) in FQHC patients delivered by paraprofessionals. QUIT-Mobile is responsive to the National Opioid Crisis, and the US Mental Health Parity Act and National Academy of Medicine recommendations to integrate behavioral health SBIs into primary care settings to prevent higher level SUD requiring specialty treatment.

Project Number: 5R01DA047386-03

https://reporter.nih.gov/search/XqGvUHDw-U2JrS-UaBk2iQ/project-details/10381700

 

Contact PI/ Project Leader

GELBERG, LILLIAN GELBERG, GEORGE F. KNELLER PROFESSOR (lgelberg@mednet.ucla.edu)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: Only recently has a screening and brief intervention in low-income primary care settings been shown to reduce patients’ illicit drug use over 3-months. Good as this finding is, the next challenge is to sustain patients’ drug use reductions over 12-months to coincide with routine annual primary care visits for rescreening. We propose adding mHealth tools to enhance and sustain drug use reductions in an effective SBI to reduce drug use and prevent addiction.

 

 

Project Start Date: 01-June-2020

Project End Date:31-March-2025

Budget Start Date: 01-April-2022

Budget End Date: 31-March-2023

 

NIH Categorical Spending

Funding IC:  NATIONAL INSTITUTE OF DRUG ABUSE / FY Total Cost by IC: $746,806

Biobehavioral Research Approaches to reduce Effects of Trauma on Mental and Physical Health and Cognitive Outcomes in South Africa

Abstract: The UCLA/South African Trauma Training Research (Phodiso) Program seeks five additional years of funding to prepare future investigators to conduct research on trauma exposure and injury prevention in the context of South Africa’s high levels of interpersonal and community violence and intentional injuries. The Phodiso Program is an international collaboration between UCLA and the South African Research Consortium (SARC), which includes the Human Sciences Research Council (HSRC), North-West University (NWU), and University of Cape Town (UCT) and is based on a number of NIH-funded projects: 1) The Eban Project, a randomized clinical trial testing a culturally congruent intervention for HIV serodiscordant African American couples (R01; 2001-2009; El Bassel, et al., 2010); 2) The Implementation of the Eban Project, (NIH RO1; 2012-2017) 3) The Aftermath of Rape among South African Women (The Fulufhelo Project), a study examining the short- and long-term psychosocial sequelae of rape among South African women (R03; 2009-2013); and 4) The HIV/AIDS Substance use and Trauma Training Program for racial and ethnic minority postdoctoral scholars and early career investigators (R25; 2013-2018) (Wyatt and Milburn, co-PIs). Guided by ecological theory, social learning theory, and the Sexual Health Model, the focus of the Phodiso Scholar’s research will be to minimize the negative health and mental health effects of trauma exposure, specifically depression and post-traumatic stress disorder (PTSD), in South Africa. An additional emphasis of the training will focus on the neurobiological and neurobehavioral manifestations of trauma, disease, substance use and intentional injury. In the past 10 years of funding, a total of eleven scholars have graduated from the Phodiso program and will join the core SARC and the TAMT, to assist with mentoring new Scholars. For this renewal, the UCLA and SARC core faculty and TAMT will conduct a countrywide application process to select one early career research candidate per year for a two-year postdoctoral fellowship. Scholars will receive research mentorship including a quarter of study (i.e., a 3-month period) at UCLA, one selection and planning meeting and one short-term trauma workshop each year in South Africa. Scholars will conduct their own research projects in South Africa as a basis for future studies in this field, and work closely with their SARC host university and TAMT mentors. The Phodiso Trauma Training program and the research careers of the scholars will be tracked over time. Specifically, the sustainability of the training program and integration into academic, private, and government-supported agencies and the Scholar’s ability to establish and sustain independent research careers will be evaluated and documented. Future goals will include encouraging the South African government to adopt the Phodiso program as a successful and replicable model of cross-cultural trauma research training.

Project Number: 2D43TW007278-11

https://reporter.nih.gov/search/3mBMfcaKOkGk9o8D_fB3Zw/project-details/9232020

 

Contact PI/ Project Leader

WYATT, GAIL E, PROFESSOR (GWYATT@MEDNET.UCLA.EDU)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: Myanmar has experienced one of the most serious HIV/AIDS epidemics in Southeast Asia. Because the country has been isolated from the rest of the world for 50+ years, there are very few researchers and public health specialists trained in advanced research methodologies who can do research to guide HIV/AIDS policy and staff the Myanmar University of Public Health. This program will address that need by providing degree and postdoctoral training in advanced research methodology.

 

 

Project Start Date: 25-May-2005

Project End Date: 31-August-2021

Budget Start Date: 15-September-2016

Budget End Date: 31-August-2017

 

NIH Categorical Spending

Funding IC:  FOGARTY INTERNATIONAL CENTER + OFFICE OF THE DIRECTOR, NATIONAL INSTITUTES OF HEALTH/ FY Total Cost by IC: $269,997

Collaborative care teams for hospitalized patients with opioid use disorders: Translating evidence into practice

Abstract: The underuse of effective behavioral health treatments during the hospital stay is a translational science problem that has important consequences. Behavioral health comorbidities are common among hospitalized patients, and are associated with longer lengths of stay, higher costs and worse outcomes. Treatment for opioid use disorder (OUD) is an exemplar of this problem. Patients with OUD are frequently hospitalized, and while treatment is effective, it is dramatically underutilized, leaving patients at high-risk of continued misuse, future overdose, and readmission. There are multiple reasons for this translational inefficiency. While inpatient physicians frequently treat acute overdose and withdrawal, they have limited knowledge and training in behavioral health. Given pressures to minimize length of stay, the team usually prioritizes addressing the acute reason for admission. Moreover, few hospitals have the organizational infrastructure needed to treat behavioral health conditions effectively, such as dedicated teams, evidence-based protocols, or the ability to coordinate transitions of care such that patients can be linked to outpatient and community resources. Interdisciplinary, collaborative care teams (CCT) are a new approach to address translational roadblocks in OUD treatment delivery and have the potential to make a significant contribution to narrowing the treatment gap. Our prior work demonstrated the effectiveness of CCT when used with primary care patients with addiction, but CCT have never been tested as a translational approach in the inpatient setting. If effective, CCT could completely change the paradigm for addressing behavioral health disorders in the inpatient setting. We propose a mixed- methods, multi-site, randomized pragmatic trial in three sites to evaluate whether CCT increase translational efficiency, among hospitalized patients with OUD. We will randomize 414 patients total from Cedars Sinai Medical Center in Los Angeles, the University of New Mexico Hospital, and Baystate Health in Massachusetts to receive either CCT or usual care. Our primary outcomes are inpatient MAT initiation and linkage with post- discharge OUD treatment; secondary outcomes include days spent alive and in the community, treatment engagement, and opioid misuse. To inform future dissemination efforts, we also evaluate contextual factors affecting implementation, the sustainability of the CCT post-implementation, and costs. By blending components of clinical effectiveness and implementation research, leveraging the CTSA consortium including the Treatment Innovation Network and Recruitment Innovation Center, this innovative approach to translational research can generate more rapid translational gains, more effective downstream implementation, and will enhance the efficiency and science of translational research. The CCT offers expertise that most hospital-based physicians lack, creates an organized system of care, and addresses barriers to follow-up care. Knowledge from this study could transform the hospital experience into an opportunity to engage patients with OUD in MAT, resulting in reduced suffering, immediate and long-term gains in patient health, and decreased healthcare costs.

Project Number: 1U01TR002756-01A1

https://reporter.nih.gov/search/_lRWQTJNeEWI9778ibwMLw/project-details/9890409

 

Contact PI/ Project Leader

DANOVITCH, ITAI, CHAIRMAN, DEPARTMENT OF PSYCHIATRY (itai.danovitch@cshs.org)

 

Organization

CEDARS-SINAI MEDICAL CENTER

 

PUBLIC HEALTH RELEVANCE: Despite frequent hospitalizations, patients with opioid use disorders (OUD) are rarely started on effective pharmacotherapy and linked with aftercare, leaving them at high-risk of continued misuse, future overdose, and readmission. We will test the effectiveness of an interdisciplinary, collaborative care, addiction consult team, on increasing the initiation of opioid pharmacotherapy in the hospital and linking patients with post-discharge care. Knowledge from this study could transform the inpatient hospital experience into an opportunity to engage patients with OUD in effective care, resulting in immediate and lasting gains in health and functioning.

 

 

Project Start Date: 01-June-2020

Project End Date: 31-May-2024

Budget Start Date: 01-June-2020

Budget End Date:31-May-2021

 

NIH Categorical Spending

Funding IC:  NATIONAL CENTER FOR ADVACNING TRANSLATIONAL SCIENCES/ FY Total Cost by IC: $1,315,300

Facilitating the Decentralization of Methadone Maintenance Therapy Services into Communities in Vietnam

Abstract: Vietnam is currently decentralizing its methadone maintenance therapy (MMT) dispensing network to its local commune health centers (CHC), which provides a window of opportunity to study decentralization of harm reduction and HIV-related healthcare services into community-based healthcare settings. Commune health workers (CHW) in Vietnam have widespread misconceptions about harm reduction and perceived significant challenges associated with treating people who use drugs. Intervention effort is needed to address these issues to ensure a smooth implementation of the decentralized service model. The proposed two-year study plans to design and pilot test an intervention to facilitate the delivery of decentralized MMT/HIV services via three phases in Phu Tho Province, Vietnam. In Phase 1, we will conduct task analysis with MMT clients and cross-functional analysis with service providers to identify the steps/tasks that are associated with most procedural delays, errors, redundancies, and/or unnecessary reworks. We will also evaluate each CHC’s capacity and readiness to deliver the MMT services. In Phase 2, under the framework of intervention mapping, a multidisciplinary working group will go through the six steps to design the intervention and develop its implementation and evaluation plan. The intervention, with a primary focus on process optimization, will be executed through a combination of in-person training and mobile phone application utilization. In Phase 3, we will pilot the intervention in six CHC-based MMT distribution sites. The six CHC will be randomized to either an intervention condition or a control condition. The intervention outcomes on CHW and MMT clients will be evaluated at baseline, 3-, and 6-months. The intervention will be revised and finalized based on acceptability/feasibility evaluation data, process evaluation data, and feedbacks from intervention facilitators and participants.

Project Number: 5R34DA043783-02

https://reporter.nih.gov/search/DzuiYtIG0UOuFPYSlFdgxQ/project-details/9768996

 

Contact PI/ Project Leader

LIN, CHUNQING (lincq@ucla.edu)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE:  Decentralizing specialized health services into community-level healthcare settings has the potential to improve access to care; yet the complex process and how the potential benefits could be realized warrant more empirical research. The study will use structured implementation science methodologies to guide the development of an intervention model focusing on process optimization of the methadone maintenance therapy (MMT) service decentralization in Vietnam. The research methodologies and findings will be a source of important information for the global policymakers, programmers, and research communities to advance the understanding and strategies in decentralization of healthcare services.

 

 

Project Start Date: 01-September-2018

Project End Date: 31-August-2022

Budget Start Date: 01-September-2019

Budget End Date:  31-August-2022

 

NIH Categorical Spending

Funding IC:  NATIONAL INSTITUTE ON DRUG ABUSE/ FY Total Cost by IC:$307,743

Effects of methamphetamine use on risk behavior, systemic and mucosal inflammation, and sexually transmitted infection (STI)/HIV risk among men who have sex with men

Abstract: This K23 Career Development Award will provide early career support for the investigation of behavioral and biological risk factors for HIV/STI transmission caused by methamphetamine (MA) use among men who have sex with men (MSM). This K23 award will provide support for the candidate to develop expertise in the following areas: 1) Biological impacts of MA use and addiction medicine; 2) Clinical trials methods and biobehavioral interventions; 3) Applied immunology; 4) Professional development; and 5) Responsible conduct of research. Dr. Blair will be mentored by a multidisciplinary team with expertise in addiction, infectious diseases, immunology, and statistics. Dr. Steven Shoptaw has an extensive track record in addiction research and training of future independent investigators. Dr. Jesse Clark will provide mentorship in clinical trial methods, operations, and safety procedures; Dr. Grace Aldrovandi will provide mentorship in applied immunology, with an emphasis on mucosal immunology; and Dr. Robert Weiss will provide mentoring in advanced statistical methods. MA use is an important driver of HIV transmission and the burgeoning STI epidemic among MSM. Understanding the interaction of biological and behavioral risk factors for HIV/STI transmission caused by MA use is imperative for effective HIV/STI interventions. Dr. Blair proposes to investigate the joint effects of MA use, HIV, sexual risk behavior, and rectal gonorrhea/chlamydia (GC/CT) on systemic and rectal inflammation. Stored plasma specimens and behavioral data obtained every 6 months over 2 years from 140 MSM will be used to assess the joint effects of HIV and MA use on systemic inflammation and risk behavior using a 2×2 factorial design stratified by HIV serostatus (70 positive; 70 negative) and results of urine MA screening (70 with MA use; 70 without MA use). 40 HIV-negative MA-using MSM (20 with rectal GC/CT; 20 without rectal GC/CT) will be recruited separately from a community-based university research clinic. MA exposure will be manipulated using contingency management (CM) to evaluate the effects of a decline in MA use on biological markers of inflammation (e.g., cytokines). Following initiation of CM, sexual risk behaviors will be assessed weekly for 8 weeks. Inflammatory rectal cytokines will be measured weekly with rectal swabs and linked with biomarkers of MA exposure over 8 weeks. These activities will accomplish the following aims: 1) Measure the joint effects of HIV and MA use on systemic cytokine concentrations and risk behavior; 2) Identify the effects of MA exposure and concomitant rectal GC/CT on rectal cytokine concentrations; and 3) Evaluate the association of MA use frequency with sexual risk behavior in the setting of rectal inflammation. Through this K23 Career Development Award, Dr. Blair will establish herself as an independent clinician-investigator with expertise in intersectional research on the biological and behavioral impacts of MA and other drugs on HIV/STI transmission dynamics.

Project Number: 1K23DA054004-01A1

https://reporter.nih.gov/search/tAgUSBhBMk6GQ6zuICfECA/project-details/10326738

 

Contact PI/ Project Leader

BLAIR, CHERIE SAVINE, INFECTIOUS DISEASES FELLOW (CherieBlair@mednet.ucla.edu)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: Understanding the interaction of biological and behavioral risk factors for HIV/STI transmission caused by methamphetamine use is imperative for effective HIV/STI interventions. This innovative project will evaluate the joint effects of methamphetamine use, HIV, sexual risk behavior, and rectal GC/CT on systemic and rectal inflammation – a key step in designing potent prevention interventions. Findings from this project will be important toward the development of effective interventions that combine methamphetamine reduction with STI screening and HIV prevention.

 

 

Project Start Date: 15-July-2021

Project End Date: 30-June-2026

Budget Start Date: 15-July-2021

Budget End Date:  30-June-2022

 

NIH Categorical Spending

Funding IC:  NATIONAL INSTITUTE ON DRUG ABUSE/ FY Total Cost by IC: $202,392

Trajectories of socially regulated gene expression, methamphetamine use, and viral load among HIV-positive men who have sex with men (MSM) receiving contingency management

Abstract: he K01 Mentored Research Scientist Development Award will provide Dr. Michael Li with invaluable research experience, mentored training from interdisciplinary faculty, and training activities in a combination of behavioral and basic sciences, which will prepare him well in his career as a biobehavioral researcher in addiction medicine and HIV treatment/prevention. This K01 mechanism will support Dr. Li’s research and training efforts to develop expertise in the following areas: (1) neurally regulated “stress” gene expression markers and links to addiction and HIV disease progression; (2) cultural competence and ethical conduct; (3) technical assay and substantive analytic methods in gene expression research; (4) clinical trial methods; and (5) professional development. Dr. Li has assembled an interdisciplinary mentorship team who will support key aspects of his training and research. Dr. Steven Shoptaw is a highly productive and influential researcher in addiction medicine, and he has an extensive track-record mentoring people who later became successful independent researchers. Co-mentor Dr. Steven Cole has pioneered the field of social genomics, and will direct Dr. Li’s training in transcriptomic methods. Dr. Jesse Clark will guide Dr. Li in clinical trial operations and safety procedures, and Dr. Thomas Belin will provide extensive mentoring in advanced statistical methods and inferential frameworks in clinical trials. Dr. Li proposes to investigate whether a neurally regulated “stress” gene expression pattern can serve as a clinically meaningful, non-abstinence-based endpoint for contingency management for methamphetamine (METH) use disorder (MUD) in MSM living with HIV. Abstinence determined by urine testing has been the only standard clinical outcome for MUD treatment, but provides an incomplete picture of patient recovery. The gene expression pattern called the conserved transcription response to adversity (CTRA) may provide insight into changes in both psychosocial health and pathogenesis over the course of MUD treatment. The CTRA is marked by upregulated expression of pro-inflammatory genes and downregulated expression of Type I interferon genes in response to negative psychosocial experiences such as depression, anxiety, and violence, problems also comorbid with METH use. The CTRA also involves some of same gene regulatory pathways that contribute to METH-related pathogenesis, such as those involving inflammation and innate antiviral responses (relevant to PLWH). My proposed research will use a two-arm clinical trial design (N=55) with 35 HIV-positive MSM with MUD receiving contingency management for METH reduction, and 20 HIV-positive MSM who qualify as a non-substance-using control to accomplish the following aims: 1) to investigate whether CTRA gene expression coincides with METH use and viral load; 2) to investigate whether psychosocial indicators of addiction are associated with CTRA; and 3) to conduct an exploratory pilot investigation to determine the degree to which CTRA mediates the association between METH use and viral load. Together, this K01 research project and training plan will play a fundamental role in my early success as an independent substance use and HIV researcher.

Project Number: 1K01DA051329-01A1

https://reporter.nih.gov/search/P51IV4WiG0m3UfJ8wdV_1w/project-details/10161548

 

Contact PI/ Project Leader

LI, MICHAEL JONATHAN, POSTDOCTORAL SCHOLAR (mjli@mednet.ucla.edu)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: Determining whether a patient is both feeling better and improving physiologically when treating people living with HIV (PLWH) for methamphetamine use disorder (MUD) requires identification of a clinically significant measure separate from abstinence. My proposed K01 activities open the exciting opportunity to address this challenge by testing a gene expression pattern identified by the field of social genomics, which may provide insight into both psychosocial health and biological processes that impact chronic disease risk in PLWH receiving MUD treatment. Support from this K01 will facilitate my training in transcriptomics, clinical trial methods, and ethical/culturally competent practices, all of which will help me achieve my long-term career goal—to be a leading researcher of biomarker assessment tools for PLWH receiving addiction treatment.

 

 

Project Start Date: 01-April-2021

Project End Date: 31-March-2026

Budget Start Date: 01-April-2021

Budget End Date:31-March-2022

 

NIH Categorical Spending

Funding IC:  NATIONAL INSTITUTE ON DRUG ABUSE/ FY Total Cost by IC: $189,401

The impact of cannabinoids on inflammation, HIV viral load and symptoms of distress among persons living with HIV

Abstract: This Mentored Research Scientist Development Award (K01) will provide Dr. Chukwuemeka N. Okafor with training and expertise needed to facilitate his transition toward research independence in HIV and drug use prevention research. Dr. Okafor’s proposed training plan is designed to build upon his previous work in HIV and drug use epidemiology to increase his knowledge and expertise in: (1) the design, implementation and analysis of clinical trials and behavioral interventions for drug use prevention in the context of HIV (2) addiction research and research that integrates behavioral science and biological markers in the context of drug use and HIV (3) training in the ethical conduct of research and (4) career skills necessary for academic research. Dr. Okafor will achieve these training goals via didactic coursework, directed readings, workshops, scientific conferences, fieldwork and mentoring from an expert multidisciplinary panel of mentors led by Dr. Steve Shoptaw (primary mentor). The proposed research activities addresses an important public health issue regarding the impact of cannabis on health outcomes among persons living with HIV (PLWH). Majority of the few studies of the consequences of cannabis use in PLWH have produced mixed findings. Potential explanations for lack of clear evidence of the health consequences of cannabis might be due to the different active constituents (cannabinoids) in the cannabis products used. Tetrahydrocannabidiol (THC) and cannabidiol (CBD) are the most frequently studied cannabinoids and growing evidence suggest that they have opposing effects on symptoms of distress (e.g. depression and anxiety) and HIV relevant health outcomes (inflammation and HIV viral load). Specifically, THC is associated with mood altering and negative health effects, while CBD does not alter mood and may have therapeutic properties. Therefore, whether quantifiable biomarkers of THC and CBD in PLWH who use cannabis can provide clarification on the consequences of cannabinoids in PLWH has not being determined. The proposed project will employ two approaches to address this question including a secondary analysis of existing data from a cohort study and a pilot feasibility study involving PLWH who use cannabis. Specifically, the proposed project aims to: 1) determine relationships between measured concentrations of THC and CBD in urine with biomarkers of inflammation and HIV viral load in PLWH, (2) investigate associations between measured concentrations of THC and CBD in urine with symptoms of distress among PLWH and 3) To determine feasibility of and impact of a 28-day cannabis abstinence based contingency management (CM) program on changes in symptoms of distress, inflammation and HIV viral load. Completing the proposed project will provide an excellent pedestal for Dr. Okafor to transition into an independent research career.

Project Number: 1K01DA047912-01A1

https://reporter.nih.gov/search/DNeos6ubMUitt9tNVrm4Lg/project-details/9779460

 

Contact PI/ Project Leader

SHOPTAW, STEVEN J, PROFESSOR (sshoptaw@mednet.ucla.edu)

 

Organization

BAYLOR UNIVERSITY

 

PUBLIC HEALTH RELEVANCE: With the evolving state laws governing cannabis use in the United States, there is a need for sound scientific evidence on the impact of the different active constituents in cannabis on the health outcomes of vulnerable populations particularly persons living with HIV (PLWH). Through this K01 award, I will develop skills and knowledge in clinical trials, behavioral interventions for drug use, addiction research and research integrating biological markers in HIV and drug use research. Findings from this study will provide timely data on the impact of THC and CBD on symptoms of distress, inflammation and HIV viral load in PLWH.

 

 

Project Start Date: 01-August-2019

Project End Date: 31-July-2024

Budget Start Date: 01-August-2019

Budget End Date:31-July-2020

 

NIH Categorical Spending

Funding IC:  NATIONAL INSTITUTE ON DRUG ABUSE/ FY Total Cost by IC:  $156,368

Using data science to measure the impact of opioid agonist therapy in patients admitted with Staphylococcus aureus bloodstream infections

Abstract: This career development award will provide early career support for investigation of the management of infec- tious diseases in the setting of addiction in hospitals. The award will provide support for the candidate to develop expertise in the following areas: 1) addiction science research; 2) natural language processing; 3) machine learn- ing; 4) professional development; and 5) responsible conduct of research. For this, Dr. Goodman-Meza will be mentored by a multidisciplinary, cross-institutional team with expertise in addiction, infectious diseases, and data science. His primary mentor, Dr. Steve Shoptaw, has an extensive track record in addiction-related research and training of future independent investigators. His co-mentors include Dr. Alex Bui and Dr. Matthew B. Goetz. Dr. Bui is an expert in biomedical data science and heads NIH training programs in this field. Dr. Goetz has broad experience of productive infectious diseases clinical research within the Veterans Health Administration (VHA). The current opioid epidemic in the United States has been associated with an increase in infections, in particular hepatitis C and bacterial infections. Bacterial infections are the leading infectious diagnosis leading to hospitali- zation in individuals with an opioid use disorder (OUD), and incur significant healthcare expenditures. Despite the availability of opioid agonist therapy (OAT) in the form of methadone or buprenorphine, less than 20% of people with OUD actually receive OAT. Hospitalization for a bacterial infection may be an ideal time to initiate OAT, but the benefits of this practice are unknown. In this proposal, the candidate will assess the impact of initiating OAT in people who inject opioids admitted to the VHA due to a Staphylococcus aureus blood stream infection (bacteremia) – the most common bacterial pathogen among people who inject opioids. Using data already collected for 36,868 cases of S. aureus bacteremia (SAB) from the VHA electronic data repository, the candidate will address three research questions: 1) is a natural language processing algorithm (NLP) more ac- curate than a standard International Classification of Diseases (ICD) code-based approach at screening records to correctly identify individuals who inject opioids in a cohort of patients admitted with SAB; 2) what are the temporal and geographic trends of SAB in people who inject opioids and those who receive OAT at the facility- level; and 3) using a machine learning framework, what are the estimated impacts of OAT on patient centered outcomes – death, readmissions, leaving against medical advice, and subsequent outpatient engagement in OAT. These formative data will help the candidate to establish a productive early career as a physician-scientist and advise development of an OAT-delivery strategy to mitigate infectious complications of injection opioid use. Through this award, Dr. Goodman-Meza will establish himself as an expert physician-scientist at the intersection of infectious disease and addiction, poised to make significant contributions to this important area of medicine.

Project Number: 1K08DA048163-01

https://reporter.nih.gov/search/l7oGElned0OBY3RvfOgPgQ/project-details/9721752

 

Contact PI/ Project Leader

GOODMAN, DAVID, Doctor (dgoodman@mednet.ucla.edu)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: Serious, life-threatening bacterial infections in people who inject drugs are increasing with the current national opioid epidemic. Hospitalization of people who use opioids for treatment of infectious complications may be an ideal time to initiate opioid agonist therapy (OAT), an evidence-based practice that has been historically underuti- lized. This project will use innovative data science methods to estimate the impact of initiating OAT in the hospital for patients with a history of opioid injection admitted for treatment of blood stream infections caused by Staph- ylococcus aureus in the Veterans Health Administration.

 

 

Project Start Date: 15-June-2019

Project End Date: 31-May-2024

Budget Start Date: 15-June-2019

Budget End Date: 31-May-2020

 

NIH Categorical Spending

Funding IC:  NATIONAL INSTITUTE ON DRUG ABUSE/ FY Total Cost by IC: $203,040

NIDA Clinical Trials Network: Big South/West Node

Abstract: The Big South/West Node of the NIDA Clinical Trials Network (CTN) represents an expansion of the Texas Node that has been a part of the CTN since 2005. With this expansion, the node will now be guided by the shared leadership of Madhukar H. Trivedi, MD of University of Texas Southwestern Medical Center (UTSW) Steven Shoptaw, PhD of UCLA, and Jennifer S. Potter, PhD, MPH, of UT Health Science Center at San Antonio (UTHSCSA). This fourth competing renewal application builds on our successful track record of leading CTN trials, being good network partners by providing excellent sites for multi-site studies, high productivity in publishing, and training the next generation of scientists. During the 2015-2020 funding cycle, our team developed and led: the largest pharmacotherapy trial for the treatment of methamphetamine use disorder to date (extended-release naltrexone plus high-dose bupropion; CTN0068 ADAPT-2), an in-depth study of the causes of death in a cohort of people living with HIV/HCV and substance use disorder (CTN0064A1), and an implementation study to develop and deploy universal screening for opioid use disorder and measurement based care using buprenorphine (CTN0090 MBC4OUD). Finally, a study testing transcranial magnetic stimulation (TMS) as a treatment for stimulant use disorder has been approved for development, in collaboration with the Southern Consortium Node (CTN0108). For this renewal application, we capitalize on the experience of the Multiple PIs, who collectively have expertise in the treatment of stimulants, the treatment of and public health response to the opioid crisis, and the treatment and care of HIV. Additional investigators bring content expertise spanning addiction science and clinical care, translational science, dissemination and implementation science, informatics, and trial implementation. The expanded Big South/West Node is named to denote the importance of including geographic regions in the South that have historically not been represented within the CTN (i.e., Arkansas, Oklahoma, Louisiana). This geographical expansion provides greater access to diverse patient populations (e.g., diverse racial and ethnic groups; underinsured; underserved; native [American Indian] and immigrant groups) within diverse settings (e.g., rural, urban). Our existing partnerships with primary care networks, large health care systems, and use of electronic health records (EHR) to positively impact substance use, has been further broadened to include multiple statewide networks and resources in new partner states. Our research agenda includes a focus on the fourth wave of the opioid epidemic, building upon the expertise of our investigators in treating stimulant and opioid use disorders, and the changing needs of the regions we serve. Our team has experience with innovative study designs that target all areas of the translational science continuum, and equip our Node to successfully and significantly improve the care of persons who misuse substances.

Project Number:2UG1DA020024-16

https://reporter.nih.gov/search/qtTbPx5VBkmjMkHnI3pnDQ/project-details/10057104

 

Contact PI/ Project Leader

SHOPTAW, STEVEN J, PROFESSOR (sshoptaw@mednet.ucla.edu)

 

Organization

UT SOUTHWESTERN MEDICAL CENTER

 

PUBLIC HEALTH RELEVANCE: Substance use, particularly the use of stimulants and opioids in the fourth wave of the opioid epidemic, are a major public health problem. Research is needed to develop new substance use disorder treatments and to determine how to best broadly disseminate the treatments that are currently available and effective. The National Institute on Drug Abuse’s National Drug Abuse Treatment Clinical Trials Network (CTN) and the Big South/West Node will contribute their expertise to solving the substance use problems impacting our Southern region as well as nationally.

 

 

Project Start Date: 01-September-2005

Project End Date: 28-February-2025

Budget Start Date: 01-June-2020

Budget End Date: 28-February-2021

 

NIH Categorical Spending

Funding IC:  NATIONAL INSTITUTE ON DRUG ABUSE/ FY Total Cost by IC: $4,398,040

uTECH: Machine Learning for HIV Prevention Among Substance Using GBMSM

Abstract: Gay, bisexual and other men who have sex with men (GBMSM) are disproportionately impacted by HIV in the U.S. Substance use is an important influence on HIV risk among GBMSM; and partner seeking for both sex and substance use have largely moved online and to geosocial networking platforms designed for GBMSM (e.g., Grindr). Technological advances in the collection and mining of “big data” to inform behavioral health interventions have increased in recent years but have not been applied directly to HIV prevention and substance use harm reduction among GBMSM. At the same time, despite major advances in biomedical HIV prevention (i.e., pre-exposure prophylaxis [PrEP]) and substance use harm-reduction (i.e., medication assisted therapy [MAT]), these strategies are underutilized by GBMSM. My research team and I conducted formative research on social media data mining and machine learning through a NIDA A/START (R03) to identify patterns of technology use that are associated with HIV risk and substance use among GBMSM. We established computational functionality of a culturally tailored social media data mining program among substance using GBMSM. I now take an important scientific risk to use this technology to develop an HIV prevention intervention for GBMSM, tentatively titled uTECH, that leverages insights from machine learning to trigger personalized intervention content in order to increase biomedical HIV prevention and substance use harm reduction. Specifically, I propose to conduct a two-phase study. In Phase 1 I will conduct qualitative interviews with GBMSM to inform the iterative development and refinement of uTECH. In Phase 2, I will test the acceptability, appropriateness and feasibility of uTECH in a comparative implementation science trial. For this phase, I will (a) enroll racially diverse, HIV- negative, substance using GBMSM; (b) randomize them to either the uTECH intervention or a comparison group; and (c) measure acceptability, appropriateness and feasibility through 6 months post-intervention. My primary implementation science outcomes will be acceptability (i.e., Acceptability of Intervention Measure [AIM]), appropriateness (i.e., Intervention Appropriateness Measure [IAM]), and feasibility (i.e., Feasibility of Intervention Measure [FIM]). I believe that the power of “big data” and new technologies can be harnessed for effective HIV prevention with substance using GBMSM. In the era of increasing HIV prevention fatigue among GBMSM, the ability to deliver quick, convenient and highly personalized interventions presents an opportunity to reinvigorate HIV prevention.

Project Number: 3DP2DA049296-01S1

https://reporter.nih.gov/search/nFB_Tkpd50ClD8nWRvjc1Q/project-details/10400487

 

Contact PI/ Project Leader

HOLLOWAY, IAN WALTER, ASSOCIATE PROFESSOR (holloway@luskin.ucla.edu)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: Gay, bisexual and other men who have sex with men (GBMSM) are the largest HIV transmission group in the U.S. and substance use is an important factor driving new HIV infections in this population. The overarching goal of this proposal is to reinvigorate HIV prevention among GBMSM by refining and testing the acceptability, appropriateness and feasibility of an innovative, social media “big data” machine learning intervention, which aims to reduce HIV transmission risk by integrating biomedical and behavioral risk reduction strategies.

 

FOA: PA-20-272/ Study Section: Unavailable

 

Project Start Date: 15-August-2019

Project End Date: 31-May-2024

Budget Start Date: 15-August-2019

Budget End Date: 31-May-2024

 

NIH Categorical Spending

Funding IC:  NATIONAL INSTITUTE ON DRUG ABUSE/ FY Total Cost by IC: $13,728

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