Featured Publications
Racial disparities in discontinuation of long-term opioid therapy following illicit drug use among black and white patients
Gaither JR, Gordon K, Crystal S, Edelman EJ, Kerns RD, Justice AC, Fiellin DA, Becker WC. Racial disparities in discontinuation of long-term opioid therapy following illicit drug use among black and white patients. Drug And Alcohol Dependence 2018, 192: 371-376. PMID: 30122319, PMCID: PMC7106601, DOI: 10.1016/j.drugalcdep.2018.05.033.Peer-Reviewed Original ResearchConceptsLong-term opioid therapyIllicit drug useUrine drug testsDrug useOpioid therapyWhite racePositive urine drug testDrug testsMonths of treatmentElectronic medical recordsWhite patientsChronic painPatient raceMedical recordsPatientsLogistic regressionOpioidsRacial disparitiesDrug testingCocaineCannabisTherapyCliniciansDiscontinuationPain
2020
Trajectories of Self-Reported Opioid Use Among Patients With HIV Engaged in Care: Results From a National Cohort Study.
Edelman EJ, Li Y, Barry D, Brennan Braden J, Crystal S, Kerns RD, Gaither JR, Gordon KS, Manhapra A, Merlin JS, Moore BA, Oldfield BJ, Park LS, Rentsch CT, Skanderson M, Williams EC, Justice AC, Tate JP, Becker WC, Marshall BDL. Trajectories of Self-Reported Opioid Use Among Patients With HIV Engaged in Care: Results From a National Cohort Study. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2020, 84: 26-36. PMID: 32267658, PMCID: PMC7147724, DOI: 10.1097/qai.0000000000002310.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCohort StudiesFemaleHIV InfectionsHumansMaleMiddle AgedOpioid-Related DisordersUnited StatesConceptsOpioid useOpioid use trajectoriesCohort studyPain interferenceSelf-reported opioid useVeterans Aging Cohort StudyVeterans Health Administration sitesInfrequent useOpioid use frequencyMarijuana useAging Cohort StudyNational cohort studyEvidence-based treatmentsGroup-based trajectory modelsProspective cohortBaseline factorsIllness severityMultivariable analysisBenzodiazepine medicationVA carePsychoactive medicationsPrescription painkillersPsychiatric symptomsHeroin useMultinomial logistic regressionAssociation of Alcohol Screening Scores With Adverse Mental Health Conditions and Substance Use Among US Adults
Khan MR, Young KE, Caniglia EC, Fiellin DA, Maisto SA, Marshall BDL, Edelman EJ, Gaither JR, Chichetto NE, Tate J, Bryant KJ, Severe M, Stevens ER, Justice A, Braithwaite SR. Association of Alcohol Screening Scores With Adverse Mental Health Conditions and Substance Use Among US Adults. JAMA Network Open 2020, 3: e200895. PMID: 32163167, PMCID: PMC7068229, DOI: 10.1001/jamanetworkopen.2020.0895.Peer-Reviewed Original ResearchConceptsAlcohol Use Disorders Identification TestAlcohol Use Disorders Identification Test-ConsumptionAUDIT-C scoresUse of tobaccoAlcohol screeningCohort studyInjection drugsCocaine useVeterans Aging Cohort StudyVeterans Health Administration facilitiesStimulant useAlcohol useAUDIT scoresAging Cohort StudyLongitudinal cohort studyVeterans Health AdministrationAdverse mental health conditionsSite of careFull Alcohol Use Disorders Identification TestMental health conditionsAlcohol Screening ScoresSelf-reported symptomsSymptoms of depressionDisorders Identification TestUse screening toolsInsights Provided by Depression Screening Regarding Pain, Anxiety, and Substance use in a Veteran Population
Stevens ER, Mazumdar M, Caniglia EC, Khan MR, Young KE, Edelman EJ, Gordon AJ, Fiellin DA, Maisto SA, Chichetto NE, Crystal S, Gaither JR, Justice AC, Braithwaite RS. Insights Provided by Depression Screening Regarding Pain, Anxiety, and Substance use in a Veteran Population. Journal Of Primary Care & Community Health 2020, 11: 2150132720949123. PMID: 32772883, PMCID: PMC7418233, DOI: 10.1177/2150132720949123.Peer-Reviewed Original ResearchConceptsPositive predictive valueSubstance useOdds ratioVeterans Aging Cohort Study (VACS) dataPHQ-9 scoresPrimary care settingCohort study dataTest performance characteristicsSymptoms of anxietyMedian ageDepression screeningLikelihood ratio valuesDepression screenPHQ-9Care settingsVeteran populationPredictive valueSignificant associationSymptomsDiagnostic assessmentAnxietyStudy dataAdditional informationAssociationPain
2019
Predictors of initiation of and retention on medications for alcohol use disorder among people living with and without HIV
Oldfield BJ, McGinnis KA, Edelman EJ, Williams EC, Gordon AJ, Akgün K, Crystal S, Fiellin LE, Gaither JR, Goulet JL, Korthuis PT, Marshall BDL, Justice AC, Bryant K, Fiellin DA, Kraemer KL. Predictors of initiation of and retention on medications for alcohol use disorder among people living with and without HIV. Journal Of Substance Use And Addiction Treatment 2019, 109: 14-22. PMID: 31856946, PMCID: PMC6982467, DOI: 10.1016/j.jsat.2019.11.002.Peer-Reviewed Original ResearchConceptsAlcohol use disorderUse disordersHIV statusUninfected individualsVeterans Aging Cohort Study (VACS) dataEvidence-based medicationsNew alcohol use disorderPrevalence of initiationMultivariable logistic regressionPredictors of initiationFacility-level predictorsCohort study dataMedication initiationPrescription fillsMultivariable analysisBlack raceTreatment gapDecreased oddsNew diagnosisPLWHOlder ageLogistic regressionMedicationsHIVSpecific subpopulationsHigh-dose prescribed opioids are associated with increased risk of heroin use among United States military veterans.
Banerjee G, Edelman EJ, Barry DT, Crystal S, Gordon KS, Gordon AJ, Gaither JR, Green TC, Kerns RD, Manhapra A, Moore BA, Fiellin DA, Marshall BDL. High-dose prescribed opioids are associated with increased risk of heroin use among United States military veterans. Pain 2019, 160: 2126-2135. PMID: 31145217, PMCID: PMC6699915, DOI: 10.1097/j.pain.0000000000001606.Peer-Reviewed Original ResearchConceptsHigh-dose opioid prescriptionsOpioid prescriptionsHeroin useCohort studyPrior receiptHepatitis C virus (HCV) infection statusLong-term opioid prescriptionsPast-year heroin useVeterans Aging Cohort StudyHigh-dose opioidsOpioid-prescribing patternsProspective cohort studyAging Cohort StudyOpioid use disorderCurrent national guidelinesUnhealthy alcohol useUnited States veteransUnited States military veteransVirus infection statusPosttraumatic stress disorderOpioid receiptPrescribed opioidsPain interferenceCox regressionStates veteransPatterns and Correlates of Prescription Opioid Receipt Among US Veterans: A National, 18-Year Observational Cohort Study
Rentsch CT, Edelman EJ, Justice AC, Marshall BDL, Xu K, Smith AH, Crystal S, Gaither JR, Gordon AJ, Smith RV, Kember RL, Polimanti R, Gelernter J, Fiellin DA, Tate JP, Kranzler HR, Becker WC. Patterns and Correlates of Prescription Opioid Receipt Among US Veterans: A National, 18-Year Observational Cohort Study. AIDS And Behavior 2019, 23: 3340-3349. PMID: 31317364, PMCID: PMC7344341, DOI: 10.1007/s10461-019-02608-3.Peer-Reviewed Original ResearchConceptsOpioid use disorderOpioid receiptCohort studyLong-term opioid therapyVeterans Aging Cohort StudyLatent growth mixture modellingPrescription opioid receiptObservational cohort studyAging Cohort StudyOpioid therapyCause mortalityHepatitis COpioid prescriptionsFuture prevention researchOUD diagnosisGrowth mixture modellingUS veteransHigh prevalenceLow doseHigh incidenceUse disordersPrevention researchGenetic discoveriesReceiptHIVPredictors of timely opioid agonist treatment initiation among veterans with and without HIV
Wyse JJ, Robbins JL, McGinnis KA, Edelman EJ, Gordon AJ, Manhapra A, Fiellin DA, Moore BA, Korthuis PT, Gaither JR, Gordon K, Skanderson M, Barry DT, Crystal S, Justice A, Kraemer KL. Predictors of timely opioid agonist treatment initiation among veterans with and without HIV. Drug And Alcohol Dependence 2019, 198: 70-75. PMID: 30878769, PMCID: PMC6836871, DOI: 10.1016/j.drugalcdep.2019.01.038.Peer-Reviewed Original ResearchConceptsOpioid agonist therapyOpioid use disorderVeterans Aging Cohort StudyOAT initiationUninfected patientsClinical encountersNational observational cohortAging Cohort StudyAfrican American patientsImproved health outcomesAgonist therapyCohort studyObservational cohortTreatment initiationPredictive factorsEffective treatmentAdjusted modelUninfected controlsUse disordersPsychiatric diagnosisPWHClinical practicePatientsHealth outcomesRural residenceAssociation of Prescribed Opioids With Increased Risk of Community-Acquired Pneumonia Among Patients With and Without HIV
Edelman EJ, Gordon KS, Crothers K, Akgün K, Bryant KJ, Becker WC, Gaither JR, Gibert CL, Gordon AJ, Marshall BDL, Rodriguez-Barradas MC, Samet JH, Justice AC, Tate JP, Fiellin DA. Association of Prescribed Opioids With Increased Risk of Community-Acquired Pneumonia Among Patients With and Without HIV. JAMA Internal Medicine 2019, 179: 297-304. PMID: 30615036, PMCID: PMC6439696, DOI: 10.1001/jamainternmed.2018.6101.Peer-Reviewed Original ResearchConceptsVeterans Aging Cohort StudyCommunity-acquired pneumoniaImmunosuppressive propertiesPrescribed opioidsCaP riskHIV statusMedian morphine equivalent daily doseVeterans Health Administration medical centersMorphine equivalent daily doseEquivalent daily doseAging Cohort StudyCase-control studyImmune-related outcomesRace/ethnicityIndex dateOpioid exposureCohort studyDaily doseOpioid propertiesStratified analysisMedical CenterMAIN OUTCOMEOpioidsMedicaid dataHIV
2018
Duration of opioid prescriptions predicts incident nonmedical use of prescription opioids among U.S. veterans receiving medical care
Barry DT, Marshall BDL, Becker WC, Gordon AJ, Crystal S, Kerns RD, Gaither JR, Gordon KS, Justice AC, Fiellin DA, Edelman EJ. Duration of opioid prescriptions predicts incident nonmedical use of prescription opioids among U.S. veterans receiving medical care. Drug And Alcohol Dependence 2018, 191: 348-354. PMID: 30176548, PMCID: PMC6596307, DOI: 10.1016/j.drugalcdep.2018.07.008.Peer-Reviewed Original ResearchConceptsPrescription opioid receiptPrescription opioidsMedical careOpioid receiptVeterans Health Administration primary careNonmedical useMultivariable Cox modelInfectious disease clinicProspective cohort studyProportional hazards regressionPrescription opioid medicationsPublic health problemSubstance use disordersMedication-related characteristicsOpioid therapyOpioid medicationsOpioid prescriptionsCohort studyDisease clinicMedian ageHazards regressionEligible participantsPrimary careRisk factorsIncidence rateAlcohol and Mortality
Eyawo O, McGinnis KA, Justice AC, Fiellin DA, Hahn JA, Williams EC, Gordon AJ, Marshall BDL, Kraemer KL, Crystal S, Gaither JR, Edelman EJ, Bryant KJ, Tate JP. Alcohol and Mortality. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2018, 77: 135-143. PMID: 29112041, PMCID: PMC5762259, DOI: 10.1097/qai.0000000000001588.Peer-Reviewed Original ResearchConceptsHepatitis C virusAlcohol exposureAlcohol useDirect biomarkerVeterans Aging Cohort Study Biomarker CohortBlood collection dateRecent alcohol exposureHIV viral suppressionUnhealthy alcohol useRelationship of alcoholAUDIT-C scoresViral suppressionC virusHigh riskRisk of harmHIVClinical settingMortalityPEthExposureBiomarkersRiskImproved detectionAuditIndividualsRacial/ethnic differences in the association between alcohol use and mortality among men living with HIV
Bensley KM, McGinnis KA, Fiellin DA, Gordon AJ, Kraemer KL, Bryant KJ, Edelman EJ, Crystal S, Gaither JR, Korthuis PT, Marshall BDL, Ornelas IJ, Chan KCG, Dombrowski JC, Fortney JC, Justice AC, Williams EC. Racial/ethnic differences in the association between alcohol use and mortality among men living with HIV. Addiction Science & Clinical Practice 2018, 13: 2. PMID: 29353555, PMCID: PMC6389249, DOI: 10.1186/s13722-017-0103-z.Peer-Reviewed Original ResearchConceptsLow-risk alcohol useMortality riskAlcohol useRace/ethnicityWhite PLWHMortality rateAlcohol Use Disorders Identification Test-Consumption (AUDIT-C) questionnaireVeterans Aging Cohort StudyCox proportional hazards modelHigh-risk alcohol useAUDIT-C screeningAging Cohort StudyElectronic health record dataRisk of mortalityHigh-risk relativesUnhealthy alcohol useHigher mortality riskProportional hazards modelHealth record dataHigh mortality rateEthnic groupsMale PLWHCohort studyWhite patientsGeneral outpatients
2017
Association of Cannabis, Stimulant, and Alcohol use with Mortality Prognosis Among HIV-Infected Men
Adams JW, Bryant KJ, Edelman J, Fiellin DA, Gaither JR, Gordon AJ, Gordon KS, Kraemer KL, Mimiaga MJ, Operario D, Tate JP, van den Berg JJ, Justice AC, Marshall BDL. Association of Cannabis, Stimulant, and Alcohol use with Mortality Prognosis Among HIV-Infected Men. AIDS And Behavior 2017, 22: 1341-1351. PMID: 28887669, PMCID: PMC5881942, DOI: 10.1007/s10461-017-1905-4.Peer-Reviewed Original ResearchConceptsVeterans Aging Cohort StudyLow-risk alcohol useRisk alcohol useMortality riskAlcohol useStimulant useAdjusted longitudinal analysesAging Cohort StudyUnhealthy alcohol useAssociation of cannabisVACS IndexCause mortalityCohort studyPatient populationPrognostic indicatorMortality prognosisHIVStudy periodSubstance useCannabisRiskLongitudinal analysisMenMortalityStimulantsLong-term alcohol use patterns and HIV disease severity
Marshall BDL, Tate JP, McGinnis KA, Bryant KJ, Cook RL, Edelman EJ, Gaither JR, Kahler CW, Operario D, Fiellin DA, Justice AC. Long-term alcohol use patterns and HIV disease severity. AIDS 2017, 31: 1313-1321. PMID: 28492393, PMCID: PMC5596310, DOI: 10.1097/qad.0000000000001473.Peer-Reviewed Original ResearchConceptsHIV disease severityVeterans Aging Cohort StudyHigh-risk drinkersDisease severityAlcohol useRisk drinkersLower riskAlcohol use trajectoriesIndex groupModerate riskIndex trajectoriesVeterans Health Administration sitesAging Cohort StudyHigh-risk groupMeasures of morbidityAlcohol Use Disorders IdentificationLow index groupAlcohol consumption trajectoriesUse trajectoriesSubset of participantsAlcohol use patternsVACS IndexCause mortalityCohort studyProspective cohort
2016
The Effect of Substance Use Disorders on the Association Between Guideline-concordant Long-term Opioid Therapy and All-cause Mortality
Gaither JR, Goulet JL, Becker WC, Crystal S, Edelman EJ, Gordon K, Kerns RD, Rimland D, Skanderson M, Justice AC, Fiellin DA. The Effect of Substance Use Disorders on the Association Between Guideline-concordant Long-term Opioid Therapy and All-cause Mortality. Journal Of Addiction Medicine 2016, 10: 418-428. PMID: 27610580, PMCID: PMC5083184, DOI: 10.1097/adm.0000000000000255.Peer-Reviewed Original ResearchConceptsSubstance use disordersLong-term opioid therapyCause mortalityOpioid therapySUD treatmentUse disordersLower mortalityTime-updated Cox regressionUntreated substance use disordersVeterans Aging Cohort StudyOpioid-prescribing guidelinesGuideline-concordant careSUD statusAging Cohort StudyClinical practice guidelinesSUD treatment servicesOverall sampleHIV patientsCohort studyCox regressionPractice guidelinesPatientsTreatment servicesHigh mortalityMortalityThe impact of prescribed opioids on CD4 cell count recovery among HIV‐infected patients newly initiating antiretroviral therapy
Edelman E, Gordon K, Tate J, Becker W, Bryant K, Crothers K, Gaither, Gibert C, Gordon A, Marshall B, Rodriguez‐Barradas M, Samet J, Skanderson M, Justice A, Fiellin D. The impact of prescribed opioids on CD4 cell count recovery among HIV‐infected patients newly initiating antiretroviral therapy. HIV Medicine 2016, 17: 728-739. PMID: 27186715, PMCID: PMC5053822, DOI: 10.1111/hiv.12377.Peer-Reviewed Original ResearchConceptsCD4 cell countBaseline CD4 cell countCell countPrescribed opioidsImmunosuppressive propertiesVeterans Aging Cohort Study (VACS) dataCD4 cell count recoveryAntiretroviral therapy responseCell count recoveryShort-term opioidsViral load suppressionCohort study dataOverall disease severityYear of initiationPrimary independent variableOpioid durationAntiretroviral therapyCount recoveryComorbid conditionsPharmacy dataOpioid propertiesTherapy responseOpioidsPatientsHIVNon‐medical use of prescription opioids is associated with heroin initiation among US veterans: a prospective cohort study
Banerjee G, Edelman EJ, Barry DT, Becker WC, Cerdá M, Crystal S, Gaither JR, Gordon AJ, Gordon KS, Kerns RD, Martins SS, Fiellin DA, Marshall BD. Non‐medical use of prescription opioids is associated with heroin initiation among US veterans: a prospective cohort study. Addiction 2016, 111: 2021-2031. PMID: 27552496, PMCID: PMC5056813, DOI: 10.1111/add.13491.Peer-Reviewed Original ResearchConceptsMultivariable Cox regression modelsNon-medical useCox regression modelHeroin initiationPrescription opioidsHeroin useCohort studyUS veteransOpioid use disorder diagnosisVeterans Aging Cohort StudyProspective cohort studyAging Cohort StudyIllicit opioid usePrimary care clinicsPrimary outcome measureStrong risk factorPost-traumatic stress disorderUninfected veteransUninfected patientsOpioid useRegression modelsCare clinicsPain interferencePrior diagnosisPrimary exposureHepatic Safety of Buprenorphine in HIV-Infected and Uninfected Patients With Opioid Use Disorder: The Role of HCV-Infection
Tetrault JM, Tate JP, Edelman EJ, Gordon AJ, Re V, Lim JK, Rimland D, Goulet J, Crystal S, Gaither JR, Gibert CL, Rodriguez-Barradas MC, Fiellin LE, Bryant K, Justice AC, Fiellin DA. Hepatic Safety of Buprenorphine in HIV-Infected and Uninfected Patients With Opioid Use Disorder: The Role of HCV-Infection. Journal Of Substance Use And Addiction Treatment 2016, 68: 62-67. PMID: 27431048, PMCID: PMC4976086, DOI: 10.1016/j.jsat.2016.06.002.Peer-Reviewed Original ResearchConceptsLiver enzyme elevationAlcohol use disorderUninfected patientsHepatotoxic medicationsHCV infectionUse disordersComposite endpointLiver injuryHIV/HCV co-infected patientsHCV co-infected patientsHIV/HCV statusPre-existing liver injuryCo-infected patientsCohort of HIVHepatitis C infectionHIV/HCVOpioid use disorderRisk of hepatotoxicityHCV statusHepatic safetyMedian ALTC infectionChart reviewEnzyme elevationHIV infectionThe Association Between Receipt of Guideline-Concordant Long-Term Opioid Therapy and All-Cause Mortality
Gaither JR, Goulet JL, Becker WC, Crystal S, Edelman EJ, Gordon K, Kerns RD, Rimland D, Skanderson M, Justice AC, Fiellin DA. The Association Between Receipt of Guideline-Concordant Long-Term Opioid Therapy and All-Cause Mortality. Journal Of General Internal Medicine 2016, 31: 492-501. PMID: 26847447, PMCID: PMC4835362, DOI: 10.1007/s11606-015-3571-4.Peer-Reviewed Original ResearchConceptsSubstance use disordersGuideline-concordant careCause mortalityOpioid therapyLong-term opioid therapyUntreated substance use disordersCurrent substance use disorderTerm opioid therapyTime-updated covariatesPrimary care visitsImportant clinical outcomesMulti-modal treatmentUrine drug testingUninfected patientsUntreated patientsCare visitsChronic painClinical outcomesCox regressionDecreased riskHigh comorbidityMortality burdenRehabilitative therapySUD treatmentHigh risk
2012
Receipt of Opioid Analgesics by HIV-Infected and Uninfected Patients
Edelman EJ, Gordon K, Becker WC, Goulet JL, Skanderson M, Gaither JR, Brennan Braden J, Gordon AJ, Kerns RD, Justice AC, Fiellin DA. Receipt of Opioid Analgesics by HIV-Infected and Uninfected Patients. Journal Of General Internal Medicine 2012, 28: 82-90. PMID: 22895747, PMCID: PMC3539026, DOI: 10.1007/s11606-012-2189-z.Peer-Reviewed Original ResearchConceptsLong-term opioidsHigh-dose opioidsUninfected patientsOpioid receiptHIV statusPain diagnosisHIV infectionVeterans Aging Cohort StudyVeterans Health Administration (VHA) careDaily morphine equivalent doseAcute pain diagnosisDays of opioidsMorphine equivalent doseAging Cohort StudyDesignCross-sectional analysisChronic pain diagnosesICD-9 codesVulnerable patient populationAverage daily doseMorphine equivalentsOpioid prescriptionsCohort studyDaily doseOpioid analgesicsPain management