2022
Association Between Exposure to Complementary and Integrative Therapies and Opioid Analgesic Daily Dose Among Patients on Long-term Opioid Therapy
Black AC, Zeliadt SB, Kerns RD, Skanderson M, Wang R, Gelman H, Douglas JH, Becker WC. Association Between Exposure to Complementary and Integrative Therapies and Opioid Analgesic Daily Dose Among Patients on Long-term Opioid Therapy. The Clinical Journal Of Pain 2022, 38: 405-409. PMID: 35440528, DOI: 10.1097/ajp.0000000000001039.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidChronic PainCohort StudiesComplementary TherapiesFemaleHumansMaleMorphine DerivativesVeteransConceptsLong-term opioid therapyMorphine equivalent daily doseVeterans Health AdministrationDaily doseCIH exposureOpioid doseOpioid therapyWhole health systemCIH useVHA electronic health recordsIntegrative health modalitiesOpioid analgesic doseMean starting doseMental health diagnosesElectronic health recordsAnalgesic doseCIH therapiesNonopioid treatmentCohort entryOpioid taperingStarting doseAdverse eventsPain intensityChiropractic careVHA facilitiesLongitudinal analysis of the prevalence and correlates of heavy episodic drinking and self‐reported opioid use among a national cohort of patients with HIV
Oldfield BJ, Li Y, Vickers‐Smith R, Barry DT, Crystal S, Gordon KS, Kerns RD, Williams EC, Marshall BDL, Edelman EJ. Longitudinal analysis of the prevalence and correlates of heavy episodic drinking and self‐reported opioid use among a national cohort of patients with HIV. Alcohol Clinical And Experimental Research 2022, 46: 600-613. PMID: 35257397, PMCID: PMC9018502, DOI: 10.1111/acer.14801.Peer-Reviewed Original ResearchConceptsSelf-reported opioid useOpioid useHeavy episodic drinkingNational cohortRisk factorsDepressive symptomsVeterans Aging Cohort StudyVeterans Health Administration sitesOpioid-related risksHIV disease progressionModifiable risk factorsPast-year cigarette smokingAging Cohort StudyGreater illness severityEpisodic drinkingOpioid-related overdoseHigh-risk drinkingCohort studyProspective cohortIllness severityCigarette smokingClinical correlatesDisease progressionLower oddsMultinomial logistic regressionSocial and Behavioral Sciences: Response to the Opioid and Pain Crises in the United States
Kerns RD. Social and Behavioral Sciences: Response to the Opioid and Pain Crises in the United States. American Journal Of Public Health 2022, 112: s6-s8. PMID: 35143280, PMCID: PMC8842200, DOI: 10.2105/ajph.2022.306773.Peer-Reviewed Original Research
2021
Sociodemographic and clinical correlates of gabapentin receipt with and without opioids among a national cohort of patients with HIV
Oldfield BJ, Li Y, Vickers-Smith R, Becker WC, Barry DT, Crystal S, Gordon KS, Kerns RD, Rentsch CT, Marshall BDL, Edelman EJ. Sociodemographic and clinical correlates of gabapentin receipt with and without opioids among a national cohort of patients with HIV. AIDS Care 2021, 34: 1053-1063. PMID: 34114904, PMCID: PMC8664891, DOI: 10.1080/09540121.2021.1939851.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidChronic PainCohort StudiesGabapentinHIV InfectionsHumansOpioid-Related DisordersProspective StudiesConceptsOpioid useHigh dosesSelf-reported opioid useVeterans Aging Cohort StudyHigh-dose opioidsMean daily doseAging Cohort StudyHigh-dose benzodiazepinesNational prospective cohortOpioid doseOpioid receiptCohort studyFoot painProspective cohortDaily doseIndependent predictorsChronic painPain interferenceClinical variablesClinical correlatesNational cohortMultinomial logistic regressionPWHLogistic regressionOpioidsLong-term Patterns of Self-reported Opioid Use, VACS Index, and Mortality Among People with HIV Engaged in Care
Adams JW, Li Y, Barry DT, Gordon KS, Kerns RD, Oldfield BJ, Rentsch CT, Marshall BDL, Edelman EJ. Long-term Patterns of Self-reported Opioid Use, VACS Index, and Mortality Among People with HIV Engaged in Care. AIDS And Behavior 2021, 25: 2951-2962. PMID: 33569682, PMCID: PMC8442670, DOI: 10.1007/s10461-021-03162-7.Peer-Reviewed Original Research
2020
All-cause mortality among males living with and without HIV initiating long-term opioid therapy, and its association with opioid dose, opioid interruption and other factors
Gordon K, Manhapra A, Crystal S, Dziura J, Edelman E, Skanderson M, Kerns R, Justice A, Tate J, Becker W. All-cause mortality among males living with and without HIV initiating long-term opioid therapy, and its association with opioid dose, opioid interruption and other factors. Drug And Alcohol Dependence 2020, 216: 108291. PMID: 33011662, PMCID: PMC7644145, DOI: 10.1016/j.drugalcdep.2020.108291.Peer-Reviewed Original ResearchConceptsMorphine equivalent daily doseCause mortalityLong-term opioid therapyTime-updated Cox regressionStrong dose-response relationshipUnnatural deathsEquivalent daily doseDose-response relationshipOpioid doseOpioid therapyUninfected patientsOpioid useDaily doseCox regressionMortality outcomesTherapy doseHigh doseMale veteransOverdose fatalitiesOverdose mortalityPLWHMortalityHIVPatientsDoseAre we missing opioid-related deaths among people with HIV?
Becker WC, Gordon KS, Edelman EJ, Goulet JL, Kerns RD, Marshall BDL, Fiellin DA, Justice AC, Tate JP. Are we missing opioid-related deaths among people with HIV? Drug And Alcohol Dependence 2020, 212: 108003. PMID: 32417360, PMCID: PMC9580216, DOI: 10.1016/j.drugalcdep.2020.108003.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnalgesics, OpioidCohort StudiesDrug OverdoseFemaleHIV InfectionsHumansMaleMiddle AgedOpioid-Related DisordersRisk FactorsVeteransConceptsVeterans Aging Cohort StudyOpioid useOverdose deathsLife-limiting conditionsUnnatural deathsGreater oddsAging Cohort StudyVACS IndexOpioid exposureCohort studyHIV infectionHIV statusRisk factorsOdds ratioDeath filesIndex causeHIVDisease severityDeathDecedentsIllicit useDifferential misclassificationOddsCauseOpioids
2019
High-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 veteransSignature Informed Consent for Long-Term Opioid Therapy in Patients With Cancer: Perspectives of Patients and Providers
Giannitrapani KF, Fereydooni S, Azarfar A, Silveira MJ, Glassman PA, Midboe AM, Bohnert ABS, Zenoni MA, Kerns RD, Pearlman RA, Asch SM, Becker W, Lorenz KA. Signature Informed Consent for Long-Term Opioid Therapy in Patients With Cancer: Perspectives of Patients and Providers. Journal Of Pain And Symptom Management 2019, 59: 49-57. PMID: 31476361, DOI: 10.1016/j.jpainsymman.2019.08.020.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidAttitude of Health PersonnelCancer PainDecision MakingHumansInformed ConsentPatient Education as TopicVeteransConceptsLong-term opioid therapyCancer-related painOpioid therapyVeterans Health Administration medical centersInformed consentAppropriate literacy levelPerspectives of patientsPatient-provider relationshipCancer-related concernsOpioid useOpioid prescribersPatient interviewsPatient educationMedical CenterPatientsPainProvider perspectivesTherapyCancerConsentLiteracy levelsProvidersPotential disadvantagesEmergent themesOpioidsEnhancing Motivation for Change in the Management of Chronic Painful Conditions: a Review of Recent Literature
Ankawi B, Kerns RD, Edmond SN. Enhancing Motivation for Change in the Management of Chronic Painful Conditions: a Review of Recent Literature. Current Pain And Headache Reports 2019, 23: 75. PMID: 31388839, DOI: 10.1007/s11916-019-0813-x.Peer-Reviewed Original ResearchConceptsNon-pharmacological treatmentChronic painPsychosocial influencesMotivational factorsTreatment adherenceRecent empirical researchHeadache disordersHealth treatmentIntervention feasibilityMotivationRecent FindingsResearchLong-term opioid therapyEmpirical researchChronic painful conditionsInitiation of treatmentDisordersInterventionOpioid therapyTreatment initiationTreatment outcomesPainful conditionsReviewThe purposeElectronic treatmentCommon factorsPainAnalgesic prescribing trends in a national sample of older veterans with osteoarthritis
Trentalange M, Runels T, Bean A, Kerns RD, Bair MJ, Brody AA, Brandt CA, Hwang U. Analgesic prescribing trends in a national sample of older veterans with osteoarthritis. Pain 2019, Publish Ahead of Print: &na;. PMID: 30913167, PMCID: PMC9486693, DOI: 10.1097/j.pain.0000000000001509.Peer-Reviewed Original ResearchConceptsPain intensity ratingsAnalgesic prescriptionPrescribing trendsOlder veteransIntensity ratingsNonopioid analgesic prescribingPatterns of opioidPre-post observational studyReported pain intensityInterrupted time seriesOlder U.S. veteransAcetaminophen prescriptionsAnalgesic classTotal prescribingAnalgesic prescribingOpioid prescribingPain intensityDrug prescribingObservational studyPrescribingU.S. veteransPrescribing programmeOsteoarthritisStudy periodBinomial regression models
2018
International Stakeholder Community of Pain Experts and Leaders Call for an Urgent Action on Forced Opioid Tapering
Darnall BD, Juurlink D, Kerns RD, Mackey S, Van Dorsten B, Humphreys K, Gonzalez-Sotomayor JA, Furlan A, Gordon AJ, Gordon DB, Hoffman DE, Katz J, Kertesz SG, Satel S, Lawhern RA, Nicholson KM, Polomano RC, Williamson OD, McAnally H, Kao MC, Schug S, Twillman R, Lewis TA, Stieg RL, Lorig K, Mallick-Searle T, West RW, Gray S, Ariens SR, Potter J, Cowan P, Kollas CD, Laird D, Ingle B, Grove J, Wilson M, Lockman K, Hodson F, Palackdharry CS, Fillingim RB, Fudin J, Barnhouse J, Manhapra A, Henson SR, Singer B, Ljosenvoor M, Griffith M, Doctor JN, Hardin K, London C, Mankowski J, Anderson A, Ellsworth L, Budzinski L, Brandt B, Hartley G, Heck D, Zobrosky MJ, Cheek C, Wilson M, Laux CE, Datz G, Dunaway J, Schonfeld E, Cady M, LeDantec-Boswell T, Craigie M, Sturgeon J, Flood P, Giummarra M, Whelan J, Thorn BE, Martin RL, Schatman ME, Gregory MD, Kirz J, Robinson P, Marx JG, Stewart JR, Keck PS, Hadland SE, Murphy JL, Lumley MA, Brown KS, Leong MS, Fillman M, Broatch JW, Perez A, Watford K, Kruska K, You D, Ogbeide S, Kukucka A, Lawson S, Ray JB, Martin T, Lakehomer JB, Burke A, Cohen RI, Grinspoon P, Rubenstein MS, Sutherland S, Walters K, Lovejoy T. International Stakeholder Community of Pain Experts and Leaders Call for an Urgent Action on Forced Opioid Tapering. Pain Medicine 2018, 20: 429-433. PMID: 30496540, PMCID: PMC6657573, DOI: 10.1093/pm/pny228.Peer-Reviewed Original ResearchTesting implementation facilitation of a primary care-based collaborative care clinical program using a hybrid type III interrupted time series design: a study protocol
Midboe AM, Martino S, Krein SL, Frank JW, Painter JT, Chandler M, Schroeder A, Fenton BT, Troszak L, Erhardt T, Kerns RD, Becker WC. Testing implementation facilitation of a primary care-based collaborative care clinical program using a hybrid type III interrupted time series design: a study protocol. Implementation Science 2018, 13: 145. PMID: 30486877, PMCID: PMC6262952, DOI: 10.1186/s13012-018-0838-2.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidCooperative BehaviorEvidence-Based PracticeHumansImplementation ScienceInservice TrainingInterrupted Time Series AnalysisPain ManagementPractice Patterns, Physicians'Primary Health CareProgram EvaluationResearch DesignUnited StatesUnited States Department of Veterans AffairsWork EngagementConceptsCollaborative care interventionVeterans Health AdministrationImplementation facilitationPrimary careCare interventionsHigh-dose opioid therapyMorphine equivalent daily doseVHA health care systemClinical programsImplementation facilitation strategyOutpatient opioid prescriptionsOpioid prescribing practicesPain management servicesCollaborative care programEquivalent daily dosePrimary care clinicsPrimary care providersRE-AIM frameworkInterrupted time seriesOpioid overdose crisisHealth care systemInterrupted time series designEligible patientsMedication taperingOpioid therapyAn evaluation of the feasibility, acceptability, and preliminary efficacy of cognitive-behavioral therapy for opioid use disorder and chronic pain
Barry DT, Beitel M, Cutter CJ, Fiellin DA, Kerns RD, Moore BA, Oberleitner L, Madden LM, Liong C, Ginn J, Schottenfeld RS. An evaluation of the feasibility, acceptability, and preliminary efficacy of cognitive-behavioral therapy for opioid use disorder and chronic pain. Drug And Alcohol Dependence 2018, 194: 460-467. PMID: 30508769, PMCID: PMC6312460, DOI: 10.1016/j.drugalcdep.2018.10.015.Peer-Reviewed Original ResearchConceptsOpioid use disorderCognitive behavioral therapyChronic painPreliminary efficacyDrug counselingUse disordersImproved pain outcomesProportion of patientsMethadone-maintained patientsNonmedical opioid useEnd of treatmentPrimary study aimPatient satisfaction ratingsManualized cognitive behavioral therapyOpioid usePain outcomesPain interferenceClinical trialsStandard drug counselingPatientsMean sessionSecondary aimStudy aimPainPilot studyOpioid Use Among Veterans of Recent Wars Receiving Veterans Affairs Chiropractic Care
Lisi AJ, Corcoran KL, DeRycke EC, Bastian LA, Becker WC, Edmond SN, Goertz CM, Goulet JL, Haskell SG, Higgins DM, Kawecki T, Kerns RD, Mattocks K, Ramsey C, Ruser CB, Brandt CA. Opioid Use Among Veterans of Recent Wars Receiving Veterans Affairs Chiropractic Care. Pain Medicine 2018, 19: s54-s60. PMID: 30203014, DOI: 10.1093/pm/pny114.Peer-Reviewed Original ResearchConceptsOEF/OIF/OND veteransOpioid prescriptionsChiropractic visitsOpioid useChiropractic careOperations Enduring Freedom/Iraqi Freedom/New DawnMore opioid prescriptionsVA chiropractic servicesPercentage of veteransCross-sectional analysisOpioid receiptClinic visitsClinical characteristicsCurrent smokingSevere painChiropractic clinicChiropractic servicesVisitsHigher likelihoodVeteransPrescriptionCareFurther studiesAdministrative dataOne-thirdProject STEP: Implementing the Veterans Health Administration’s Stepped Care Model of Pain Management
Edmond SN, Moore BA, Dorflinger LM, Goulet JL, Becker WC, Heapy AA, Sellinger JJ, Lee AW, Levin FL, Ruser CB, Kerns RD. Project STEP: Implementing the Veterans Health Administration’s Stepped Care Model of Pain Management. Pain Medicine 2018, 19: s30-s37. PMID: 30203015, DOI: 10.1093/pm/pny094.Peer-Reviewed Original ResearchConceptsVA Connecticut Healthcare SystemPrimary care providersVeterans Health AdministrationPain careStepped care modelCare providersPain managementCare modelHealth care utilization dataMultimodal pain careNonopioid analgesic prescribingLong-term opioidsElectronic health record dataPain intensity ratingsHealth record dataClinical health psychologyNonpharmacological servicesAnalgesic prescribingOpioid prescribingPharmacological managementNonpharmacological approachesNonpharmacological treatmentsReferral practicesPhysical therapyCare practicesDuration 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 rateRacial 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 testingCocaineCannabisTherapyCliniciansDiscontinuationPainMaking Integrated Multimodal Pain Care a Reality: A Path Forward
Kerns RD, Krebs EE, Atkins D. Making Integrated Multimodal Pain Care a Reality: A Path Forward. Journal Of General Internal Medicine 2018, 33: 1-3. PMID: 29633131, PMCID: PMC5902350, DOI: 10.1007/s11606-018-4361-6.Peer-Reviewed Original ResearchAssociation Between Facility-Level Utilization of Non-pharmacologic Chronic Pain Treatment and Subsequent Initiation of Long-Term Opioid Therapy
Carey EP, Nolan C, Kerns RD, Ho PM, Frank JW. Association Between Facility-Level Utilization of Non-pharmacologic Chronic Pain Treatment and Subsequent Initiation of Long-Term Opioid Therapy. Journal Of General Internal Medicine 2018, 33: 38-45. PMID: 29633137, PMCID: PMC5902343, DOI: 10.1007/s11606-018-4324-y.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnalgesics, OpioidChronic PainComorbidityHospitals, VeteransHumansMiddle AgedPain ManagementRetrospective StudiesUnited StatesVeteransConceptsLong-term opioid therapyNon-pharmacologic treatmentsFacility-level variationNon-opioid medicationsChronic painOpioid therapyTreatment modalitiesVeterans Health Administration facilitiesPatient-reported painChronic pain treatmentChronic pain careImproved patient outcomesUtilization patternsOpioid treatmentPrior calendar yearMedication utilizationPatient characteristicsPain treatmentPain careKey ResultsAmongPrimary carePatient outcomesPainGreater utilizationAdministration facilities