2024
T50 Receipt of Prescribed Opioids and Benzodiazepines After Non-Fatal Overdose and Risk of Subsequent Overdose
Howell B, Black A, Lin H, Lauretta G, Heimer R, Hawk K, D'Onofrio G, Fiellin D, Becker W. T50 Receipt of Prescribed Opioids and Benzodiazepines After Non-Fatal Overdose and Risk of Subsequent Overdose. Drug And Alcohol Dependence 2024, 260: 110499. DOI: 10.1016/j.drugalcdep.2023.110499.Peer-Reviewed Original ResearchUsing qualitative system dynamics modeling to understand overdose bystander behavior in the context of Connecticut’s Good Samaritan Laws and identify effective policy options
Thompson R, Sabounchi N, Ali S, Heimer R, D’Onofrio G, Heckmann R. Using qualitative system dynamics modeling to understand overdose bystander behavior in the context of Connecticut’s Good Samaritan Laws and identify effective policy options. Harm Reduction Journal 2024, 21: 124. PMID: 38937759, PMCID: PMC11210010, DOI: 10.1186/s12954-024-00990-3.Peer-Reviewed Original ResearchConceptsSamaritan lawsGood Samaritan lawsBystander behaviorGroup model buildingFear of legal consequencesKnowledge of protectionResponses to opioid overdosesCriminal liabilityDrug arrestsLegal consequencesLaw enforcementNaloxone useLawStakeholder-engaged processOpioid overdoseHealth care providersFatal opioid overdoseSustainable system changeOpioid-related outcomesBystander experiencesSamaritanCare providersHarm reductionPotential bystandersPolicy determinationPrescription Opioid Dose Change Prior to Fatal Opioid-Detected Overdose.
Kazemitabar M, Howell B, Becker W, Lin H, Grau L, Heimer R, D'Onofrio G, Hawk K, Fiellin D, Black A. Prescription Opioid Dose Change Prior to Fatal Opioid-Detected Overdose. Journal Of Studies On Alcohol And Drugs 2024 PMID: 38775307, DOI: 10.15288/jsad.24-00026.Peer-Reviewed Original ResearchPrescribed opioidsOpioid dose changesRapid dose increaseNon-HispanicOverdose deathsToxicological resultsNon-prescription opioidsBlack non-HispanicMorphine equivalentsOpioid therapyWhite non-HispanicDose changesDaily doseMean ageDispensed opioidsPrescription opioidsPrescribing patternsOpioidDose increaseOpioid overdose crisisIncreasing dosesStudy investigated patternsEffect of timeEffects of ageSecondary analysisAccessibility of Opioid Treatment Programs Based on Conventional vs Perceived Travel Time Measures
Kim J, Lee J, Thornhill T, Dennett J, Lu H, Howell B, Grau L, Fiellin D, Heimer R, Gonsalves G. Accessibility of Opioid Treatment Programs Based on Conventional vs Perceived Travel Time Measures. JAMA Network Open 2024, 7: e240209. PMID: 38376839, PMCID: PMC10879949, DOI: 10.1001/jamanetworkopen.2024.0209.Peer-Reviewed Original ResearchConceptsTransit travel timeAccessibility metricsTravel timeTravel componentsAccessibility scoresTransportation burdenTravel burdenOut-of-vehicleComponents of travelConventional accessibility measuresSpatial regression modelsTravel time measurementsPublic transitTransit schedulesAccessibility measuresDeparture timeTravel time analysisTrip durationTravelOperating hoursTime analysisCross-sectional studyOpioid use disorderPolicy recommendationsDecision-making
2023
Receipt of opioid use disorder treatments prior to fatal overdoses and comparison to no treatment in Connecticut, 2016–17
Heimer R, Black A, Lin H, Grau L, Fiellin D, Howell B, Hawk K, D'Onofrio G, Becker W. Receipt of opioid use disorder treatments prior to fatal overdoses and comparison to no treatment in Connecticut, 2016–17. Drug And Alcohol Dependence 2023, 254: 111040. PMID: 38043226, PMCID: PMC10872282, DOI: 10.1016/j.drugalcdep.2023.111040.Peer-Reviewed Original ResearchConceptsNon-medication treatmentsRelative riskOpioid overdose deathsIncidence rateMOUD treatmentOverdose deathsOpioid use disorder treatmentResults Incidence ratesRetrospective cohort studyDifferent treatment modalitiesPopulation-level effortsUse disorder treatmentFatal opioid poisoningsCohort studyOpioid poisoningTreatment modalitiesConclusion ExposurePoisoning deathsFatal overdosesTreatment exposureDisorder treatmentDeathTreatmentMethadoneRisk“It’s starting to weigh on me”: Exploring the Experiences and Support Needs of Harm Reduction Staff in Connecticut using the Social-Ecological Model
Hill K, Dunham K, Grau L, Heimer R. “It’s starting to weigh on me”: Exploring the Experiences and Support Needs of Harm Reduction Staff in Connecticut using the Social-Ecological Model. Harm Reduction Journal 2023, 20: 168. PMID: 37964261, PMCID: PMC10644636, DOI: 10.1186/s12954-023-00898-4.Peer-Reviewed Original ResearchConceptsSocial ecological modelSupport needsHarm reduction workersHarm reduction programmingHarm reduction servicesThematic analysis approachProvision of supportStigmatized populationsMeans of supportReduction workersInterpersonal levelCommunity levelHarm reductionDay roleReduction servicesOverdose crisisReduction programmingStaff wellbeingRole-related stressorsRole-related stressFeelings of stressBoundary settingEmotional supportPotential supportIndividual levelSevere acute respiratory coronavirus virus 2 (SARS-CoV-2) RNA and viable virus contamination of hospital emergency department surfaces and association with patient coronavirus disease 2019 (COVID-19) status and aerosol-generating procedures
Roberts S, Barbell E, Barber D, Dahlberg S, Heimer R, Jubanyik K, Parwani V, Pettigrew M, Tanner J, Ulrich A, Wade M, Wyllie A, Yolda-Carr D, Martinello R, Tanner W. Severe acute respiratory coronavirus virus 2 (SARS-CoV-2) RNA and viable virus contamination of hospital emergency department surfaces and association with patient coronavirus disease 2019 (COVID-19) status and aerosol-generating procedures. Infection Control And Hospital Epidemiology 2023, 45: 244-246. PMID: 37767709, PMCID: PMC10877528, DOI: 10.1017/ice.2023.183.Peer-Reviewed Original ResearchExperiences of stigma, mental health, and coping strategies in Lebanon among Lebanese and displaced Syrian men who have sex with men: A qualitative study
Abboud S, Seal D, Pachankis J, Khoshnood K, Khouri D, Fouad F, Heimer R. Experiences of stigma, mental health, and coping strategies in Lebanon among Lebanese and displaced Syrian men who have sex with men: A qualitative study. Social Science & Medicine 2023, 335: 116248. PMID: 37742387, DOI: 10.1016/j.socscimed.2023.116248.Peer-Reviewed Original ResearchMental healthAvailable mental health servicesMental health servicesSexual health risksMental health resourcesMental health risksHealth risksAdverse childhood experiencesSocial support interventionsQualitative studyExperiences of stigmaHealth servicesRecent exposureSupport interventionsLarger studyHealth resourcesMSMCommon stigmaSocial isolationMenHigh rateSexSyrian menChildhood experiencesHealthXylazine in the drug supply: Emerging threats and lessons learned in areas with high levels of adulteration
Quijano T, Crowell J, Eggert K, Clark K, Alexander M, Grau L, Heimer R. Xylazine in the drug supply: Emerging threats and lessons learned in areas with high levels of adulteration. International Journal Of Drug Policy 2023, 120: 104154. PMID: 37574646, DOI: 10.1016/j.drugpo.2023.104154.Peer-Reviewed Original ResearchHarm reduction service providersDrug supplySedative-analgesic drugsFatal opioid overdosesOpioid overdose fatalitiesPresence of fentanylMedical examiner dataIllicit drug supplyInjection of xylazineFentanyl test stripsPrevention needsOpioid usersAnalgesic drugsOpioid overdosesOverdose deathsOverdose fatalitiesXylazineHealth threatSurvey of peopleDrugsSignificant predictorsFentanylConvenience surveyTest stripsTwo-thirdsTechnical violations and infractions are drivers of disengagement from methadone treatment among people with opioid use disorder discharged from Connecticut jails 2014–2018
Marotta P, Hass A, Viera A, Doernberg M, Barbour R, Grau L, Heimer R. Technical violations and infractions are drivers of disengagement from methadone treatment among people with opioid use disorder discharged from Connecticut jails 2014–2018. Substance Abuse Treatment, Prevention, And Policy 2023, 18: 43. PMID: 37420271, PMCID: PMC10329353, DOI: 10.1186/s13011-023-00541-2.Peer-Reviewed Original ResearchConcordance between controlled substance receipt and post-mortem toxicology in opioid-detected overdose deaths: A statewide analysis
Howell B, Black A, Grau L, Lin H, Greene C, Lee H, Heimer R, Hawk K, D'Onofrio G, Fiellin D, Becker W. Concordance between controlled substance receipt and post-mortem toxicology in opioid-detected overdose deaths: A statewide analysis. Drug And Alcohol Dependence 2023, 244: 109788. PMID: 36738634, PMCID: PMC9975083, DOI: 10.1016/j.drugalcdep.2023.109788.Peer-Reviewed Original ResearchConceptsPost-mortem toxicologyOverdose deathsChief Medical ExaminerBenzodiazepine prescribingBenzodiazepine prescriptionsPrimary outcomePreventable deathsOpioid overdosesOpioidsAddiction servicesBenzodiazepinesMental healthStudy periodDeathMedical examinersConcordanceStatewide analysisSubstantial numberReceiptDaysDepartmentMedicationsToxicologyFentanylPrescribing
2022
Impact of prerelease methadone on mortality among people with HIV and opioid use disorder after prison release: results from a randomized and participant choice open-label trial in Malaysia
Bazazi A, Culbert G, Wegman M, Heimer R, Kamarulzaman A, Altice F. Impact of prerelease methadone on mortality among people with HIV and opioid use disorder after prison release: results from a randomized and participant choice open-label trial in Malaysia. BMC Infectious Diseases 2022, 22: 837. PMID: 36368939, PMCID: PMC9652918, DOI: 10.1186/s12879-022-07804-6.Peer-Reviewed Original ResearchConceptsOpioid use disorderOpioid agonist therapyInfectious etiologyMost deathsUse disordersSample of menPrison releaseOpen-label trialT-lymphocyte countsPredictors of mortalityNational death recordsCrude mortality rateProportional hazards modelCovariate-adjusted modelsLow CD4Methadone initiationModified intentionAgonist therapySurvival benefitTreat analysisMethodsThis studyHIVHazards modelMortality rateMethadone168 Impact of Connecticut’s Good Samaritan Laws in Preventing Opioid Overdose Deaths – An Applied System Dynamics Approach
Ali S, Sabounchi N, Thompson R, Heimer R, D’Onofrio G, Heckmann R. 168 Impact of Connecticut’s Good Samaritan Laws in Preventing Opioid Overdose Deaths – An Applied System Dynamics Approach. Annals Of Emergency Medicine 2022, 80: s76-s77. DOI: 10.1016/j.annemergmed.2022.08.192.Peer-Reviewed Original ResearchDevelopment and pilot-testing of a hepatitis C reinfection prevention intervention for patients in treatment for hepatitis C infection
Viera A, Grau L, Fisher J, Farnum S, Tetrault J, Scott G, Heimer R. Development and pilot-testing of a hepatitis C reinfection prevention intervention for patients in treatment for hepatitis C infection. Drug And Alcohol Dependence Reports 2022, 3: 100038. PMID: 36845980, PMCID: PMC9948939, DOI: 10.1016/j.dadr.2022.100038.Peer-Reviewed Original Research
2021
Reported history and correlates of drug overdose among people who inject drugs in Lebanon
Khoshnood K, Sheb F, Khouri D, Aaraj E, Barbour R, Crawford F, Mokhbat J, Parpia A, Heimer R. Reported history and correlates of drug overdose among people who inject drugs in Lebanon. Eastern Mediterranean Health Journal 2021, 27: 571-579. DOI: 10.26719/2021.27.6.571.Peer-Reviewed Original ResearchSubstance use treatmentCorrelates of drugDrug overdoseOpioid overdoseDrug treatmentNon-fatal opioid overdoseUse treatmentOverdose prevention programsInfectious disease test resultsBetter epidemiologic dataDisease test resultsDrug use historySexual risk behaviorsHistory of incarcerationEffective treatment programsRespondent-driven samplingEligible PWIDDrug injectionEpidemiologic dataFirst drugAverage ageLebanese menHistory of arrestPrevention programsRisk behaviors
2020
Co-Located hepatitis C virus infection treatment within an opioid treatment program promotes opioid agonist treatment retention
Severe B, Tetrault JM, Madden L, Heimer R. Co-Located hepatitis C virus infection treatment within an opioid treatment program promotes opioid agonist treatment retention. Drug And Alcohol Dependence 2020, 213: 108116. PMID: 32599493, DOI: 10.1016/j.drugalcdep.2020.108116.Peer-Reviewed Original ResearchOpioid treatment programsOpioid use disorderOpioid agonist treatmentHCV treatmentOUD treatmentTreatment retentionHepatitis C virus infection treatmentControl groupSurvival analysisHepatitis C virus infectionTreatment programHCV care continuumC virus infectionChronic HCV infectionOutcomes of interestHCV infectionAgonist treatmentPatient retentionCare continuumVirus infectionTreatment groupsUse disordersPatientsBaseline covariatesInfection treatmentPhysician and patient prediction of adherence to antiretroviral therapy in HIV positive people in Saint-Petersburg, Russia
Vetrova M, Aleksandrova O, Paschenko A, Toropov S, Rassokhin V, Abyshev R, Levina O, Niccolai L, Heimer R. Physician and patient prediction of adherence to antiretroviral therapy in HIV positive people in Saint-Petersburg, Russia. AIDS Care 2020, 33: 473-477. PMID: 32148065, DOI: 10.1080/09540121.2020.1738005.Peer-Reviewed Original ResearchConceptsAntiretroviral therapyHIV-positive peopleART initiationPositive peopleHIV viral suppressionPatient predictionsAccuracy of providerReview of pharmacyART retentionHIV physiciansViral suppressionPhysicians' predictionsTreatment outcomesART outcomesPatientsAdherenceLaboratory dataTherapyLongitudinal analysisOutcomesProvidersInitiationPhysiciansCare
2018
Early stages of HIV treatment cascade in people living with HIV in Saint-Petersburg, Russia
Vetrova M, Aleksandrova O, Paschenko A, Toropov S, Rassokhin V, Abyshev R, Levina O, Niccolai L, Heimer R. Early stages of HIV treatment cascade in people living with HIV in Saint-Petersburg, Russia. AIDS Care 2018, 30: 857-862. PMID: 29325435, DOI: 10.1080/09540121.2017.1417536.Peer-Reviewed Original ResearchConceptsAntiretroviral therapyUndetectable VLART outcomesInitiation of ARTPilot studyProportion of PLWHMedical chart reviewHIV epidemic controlSuccessful treatment outcomeProportion of peopleChart reviewHIV treatmentDrug abuse statusDisease progressionTreatment outcomesOlder ageTreatment effectivenessART effectivenessEpidemic controlPLWHIllicit drugsHIVSignificant differencesAbuse statusOutcomes
2017
Sex Work, Injection Drug Use, and Abscesses: Associations in Women, But Not Men
Burke D, Wurcel A, Landy D, Skeer M, Heimer R, Chui K, Stopka T. Sex Work, Injection Drug Use, and Abscesses: Associations in Women, But Not Men. Open Forum Infectious Diseases 2017, 4: s109-s109. PMCID: PMC5632174, DOI: 10.1093/ofid/ofx163.113.Peer-Reviewed Original ResearchInjection drug useDrug useRisk of abscessMultivariable logistic regressionCross-sectional studyTufts Medical CenterFurther longitudinal studiesTimes higher oddsCommon health issueGender-specific associationsHarm reduction interventionsSex workTufts University SchoolCross-sectional designFemale PWIDInjection drugsOdds ratioHigher oddsMedical CenterAbscessWhite raceHigh riskReduction interventionsPWIDLogistic regression
2016
P.3.028 Treatment outcomes of newly initiated antiretroviral therapy in HIV-infected people in Saint-Petersburg, Russia
Vetrova M, Heimer R, Niccolai L, Aleksandrova O, Paschenko A, Toropov S. P.3.028 Treatment outcomes of newly initiated antiretroviral therapy in HIV-infected people in Saint-Petersburg, Russia. European Neuropsychopharmacology 2016, 26: s71-s72. DOI: 10.1016/s0924-977x(16)70078-2.Peer-Reviewed Original Research