2021
Twelve-Month Retention in Opioid Agonist Treatment for Opioid Use Disorder Among Patients With and Without HIV
Wyse JJ, McGinnis KA, Edelman EJ, Gordon AJ, Manhapra A, Fiellin DA, Moore BA, Korthuis PT, Kennedy AJ, Oldfield BJ, Gaither JR, Gordon KS, Skanderson M, Barry DT, Bryant K, Crystal S, Justice AC, Kraemer KL. Twelve-Month Retention in Opioid Agonist Treatment for Opioid Use Disorder Among Patients With and Without HIV. AIDS And Behavior 2021, 26: 975-985. PMID: 34495424, PMCID: PMC8840957, DOI: 10.1007/s10461-021-03452-0.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidCohort StudiesHIV InfectionsHumansMethadoneOpiate Substitution TreatmentOpioid-Related DisordersConceptsOpioid agonist therapyOpioid use disorderVeterans Aging Cohort StudyHIV statusUse disordersOpioid agonist treatmentAging Cohort StudyDiagnosis of HCVTwelve-month retentionPositive health outcomesOAT retentionAgonist therapyCohort studyHIV managementAgonist treatmentPredictors of retentionPatientsHealth outcomesHistory of homelessnessHIVLower likelihoodImproved likelihoodLikelihood of initiationBuprenorphineDisorders
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 mortalityPLWHMortalityHIVPatientsDoseThe OATH Syndemic: opioids and other substances, aging, alcohol, tobacco, and HIV.
Womack JA, Justice AC. The OATH Syndemic: opioids and other substances, aging, alcohol, tobacco, and HIV. Current Opinion In HIV And AIDS 2020, 15: 218-225. PMID: 32487817, PMCID: PMC7422477, DOI: 10.1097/coh.0000000000000635.Peer-Reviewed Original ResearchConceptsSubstance useTreatment of frailtyManagement of HIVAdverse drug interactionsAge-related outcomesPrescribed medicationsHIVHealth statusHealthcare teamFrailtyAdverse effectsSyndemicStigma contributesTreatmentSerious consequencesSubstance interactionsIndividual manifestationsPLWHPolypharmacyOpioidsMedicationsMultimorbidityImportant pathwaySex biasSubstancesAre 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 misclassificationOddsCauseOpioidsPolypharmacy in HIV: recent insights and future directions.
Edelman EJ, Rentsch CT, Justice AC. Polypharmacy in HIV: recent insights and future directions. Current Opinion In HIV And AIDS 2020, 15: 126-133. PMID: 31833963, PMCID: PMC7543953, DOI: 10.1097/coh.0000000000000608.Commentaries, Editorials and LettersConceptsSeverity of illnessInappropriate medicationsDrug interactionsActual adverse eventsSubstance useTotal drug burdenMechanism of injuryElectronic health recordsNonantiretroviral medicationsUpdate findingsMore medicationsAdverse eventsDrug burdenClinical managementPolypharmacyDirect biomarkerMedicationsModifiable mechanismsPWHSicker individualsHealth recordsStrong associationHIVInjuryIllness
2019
Polypharmacy, Hazardous Alcohol and Illicit Substance Use, and Serious Falls Among PLWH and Uninfected Comparators.
Womack JA, Murphy TE, Rentsch CT, Tate JP, Bathulapalli H, Smith AC, Bates J, Jarad S, Gibert CL, Rodriguez-Barradas MC, Tien PC, Yin MT, Gill TM, Friedlaender G, Brandt CA, Justice AC. Polypharmacy, Hazardous Alcohol and Illicit Substance Use, and Serious Falls Among PLWH and Uninfected Comparators. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2019, 82: 305-313. PMID: 31339866, PMCID: PMC7176040, DOI: 10.1097/qai.0000000000002130.Peer-Reviewed Original ResearchConceptsIllicit substance useHazardous alcoholSerious fallsUninfected comparatorsMedication classesOpioid prescriptionsSubstance useHIV statusMuscle relaxantsRisk factorsVeterans Aging Cohort StudyAging Cohort StudyIllicit substance abuseUnconditional logistic regressionNon-ART medicationsHazardous alcohol useSubstance use/abuseCase-control designKey risk factorsUse/abuseCohort studyMedication countInjury codesDuration of observationBaseline dateOpioid use trajectory groups and changes in a physical health biomarker among HIV-positive and uninfected patients receiving opioid agonist treatment
McGinnis KA, Fiellin DA, Skanderson M, Hser YI, Lucas GM, Justice AC, Tate JP, Group F. Opioid use trajectory groups and changes in a physical health biomarker among HIV-positive and uninfected patients receiving opioid agonist treatment. Drug And Alcohol Dependence 2019, 204: 107511. PMID: 31546119, PMCID: PMC6993986, DOI: 10.1016/j.drugalcdep.2019.06.014.Peer-Reviewed Original ResearchConceptsOpioid agonist treatmentHIV-1 RNADetectable HIV-1 RNAUninfected patientsAgonist treatmentVeterans Aging Cohort StudyResponsiveness of CD4Substance use disorder treatmentHealth effectsUrine toxicology resultsUrine toxicology testsAging Cohort StudyElectronic health record dataUse disorder treatmentHealth record dataPhysical health effectsRace/ethnicityOAT initiationCohort studyOpioid useBiomarker changesToxicology resultsNegative groupUninfected individualsDisorder treatmentPatterns 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 discoveriesReceiptHIVAssociation 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 ResearchMeSH KeywordsAnalgesics, OpioidCase-Control StudiesCommunity-Acquired InfectionsFemaleHIV InfectionsHumansMaleMiddle AgedPneumoniaUnited StatesVeteransConceptsVeterans 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 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 testingCocaineCannabisTherapyCliniciansDiscontinuationPain
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 responseOpioidsPatientsHIVThe 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
2015
Trends in Any and High-Dose Opioid Analgesic Receipt Among Aging Patients With and Without HIV
Becker WC, Gordon K, Jennifer Edelman E, Kerns RD, Crystal S, Dziura JD, Fiellin LE, Gordon AJ, Goulet JL, Justice AC, Fiellin DA. Trends in Any and High-Dose Opioid Analgesic Receipt Among Aging Patients With and Without HIV. AIDS And Behavior 2015, 20: 679-686. PMID: 26384973, PMCID: PMC5006945, DOI: 10.1007/s10461-015-1197-5.Peer-Reviewed Original ResearchLong-term Prescription of Opioids and/or Benzodiazepines and Mortality Among HIV-Infected and Uninfected Patients
Weisberg DF, Gordon KS, Barry DT, Becker WC, Crystal S, Edelman EJ, Gaither J, Gordon AJ, Goulet J, Kerns RD, Moore BA, Tate J, Justice AC, Fiellin DA. Long-term Prescription of Opioids and/or Benzodiazepines and Mortality Among HIV-Infected and Uninfected Patients. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2015, 69: 223-233. PMID: 26009831, PMCID: PMC4446730, DOI: 10.1097/qai.0000000000000591.Peer-Reviewed Original ResearchConceptsLong-term opioidsMorphine equivalent daily doseOpioid receiptRisk of deathLong-term prescriptionUninfected patientsOpioid dosesAntiretroviral therapyHazard ratioDaily dosePropensity scoreHigher opioid dosesCause mortalityHIV statusAvailable patientsMortality riskOpioidsHIVPatientsProspective analysisMortalityBenzodiazepinesDosesDeathRisk
2014
Guideline-Concordant Management of Opioid Therapy Among Human Immunodeficiency Virus (HIV)-Infected and Uninfected Veterans
Gaither JR, Goulet JL, Becker WC, Crystal S, Edelman EJ, Gordon K, Kerns RD, Rimland D, Skanderson M, Weisberg DF, Justice AC, Fiellin DA. Guideline-Concordant Management of Opioid Therapy Among Human Immunodeficiency Virus (HIV)-Infected and Uninfected Veterans. Journal Of Pain 2014, 15: 1130-1140. PMID: 25152300, PMCID: PMC4253900, DOI: 10.1016/j.jpain.2014.08.004.Peer-Reviewed Original ResearchConceptsCurrent substance use disorderGuideline-concordant careOpioid therapyUrine drug testsHuman immunodeficiency virusSubstance use disordersUninfected patientsImmunodeficiency virusUse disordersPatient/provider characteristicsPrimary care provider visitsVeterans Affairs/DepartmentGuideline-concordant managementDrug testsCare concordantGuideline concordanceUninfected veteransProvider visitsPatient characteristicsPatient groupPrimary careClinical guidelinesPain medicineProvider characteristicsPatients
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
2011
Nonmedical use of prescription opioids and pain in veterans with and without HIV
Barry DT, Goulet JL, Kerns RK, Becker WC, Gordon AJ, Justice AC, Fiellin DA. Nonmedical use of prescription opioids and pain in veterans with and without HIV. Pain 2011, 152: 1133-1138. PMID: 21354703, PMCID: PMC3086805, DOI: 10.1016/j.pain.2011.01.038.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnalgesics, OpioidChi-Square DistributionCohort StudiesFemaleHealth SurveysHIV InfectionsHumansLogistic ModelsMaleMental DisordersMiddle AgedOdds RatioOpioid-Related DisordersPainPain MeasurementPrescriptionsPsychiatric Status Rating ScalesRetrospective StudiesSelf ReportSurveys and QuestionnairesVeterans HealthYoung AdultConceptsHuman immunodeficiency virusPrescription opioidsComponent summaryHIV statusPain interferenceUse disordersForm Health Survey Mental Component SummarySF-12 Physical Component SummaryVeterans Aging Cohort StudyNonmedical usePharmacy record dataAlcohol Use Disorders Identification Test (AUDIT) scoresAging Cohort StudyPhysical component summaryMental component summaryOpioid use disorderMedian participant ageDrug use disordersLegitimate medical reasonsPast-month cigarette useChi-squared testU.S. military veteransHepatitis COpioid prescriptionsCohort study