2023
Facilitation and Preferred Models for Delivering Substance Use Disorder Treatment in HIV Clinics: Results From a Multisite Randomized Trial
Muvvala S, Gan G, Morford K, Dziura J, Esserman D, Porter E, Chan P, Cornman D, Reynolds J, Yager J, Fiellin D, Edelman E. Facilitation and Preferred Models for Delivering Substance Use Disorder Treatment in HIV Clinics: Results From a Multisite Randomized Trial. Journal Of Addiction Medicine 2023, 17: e388-e391. PMID: 37934538, PMCID: PMC10726383, DOI: 10.1097/adm.0000000000001192.Peer-Reviewed Original ResearchConceptsOpioid use disorderAlcohol use disorderTobacco use disorderHIV clinicUse disordersAddiction treatmentSubstance use disorder treatmentUse disorder treatmentMaintenance phaseRandomized trialsStaff preferencesImproved outcomesMultisite Randomized TrialImplementation facilitationDisorder treatmentControl phaseClinicCliniciansTreatment modelTreatmentDisordersSignificant differencesInterventionHigher proportionAddiction treatment models
2022
Effect of Implementation Facilitation to Promote Adoption of Medications for Addiction Treatment in US HIV Clinics
Edelman EJ, Gan G, Dziura J, Esserman D, Porter E, Becker WC, Chan PA, Cornman DH, Helfrich CD, Reynolds J, Yager JE, Morford KL, Muvvala SB, Fiellin DA. Effect of Implementation Facilitation to Promote Adoption of Medications for Addiction Treatment in US HIV Clinics. JAMA Network Open 2022, 5: e2236904. PMID: 36251291, PMCID: PMC9577676, DOI: 10.1001/jamanetworkopen.2022.36904.Peer-Reviewed Original ResearchConceptsTobacco use disorderHIV clinicOpioid use disorderUse disordersAlcohol use disorderAddiction treatmentControl periodImplementation facilitationAdoption of medicationsMulticomponent implementation strategyProvision of MOUDUS HIV clinicsMaintenance periodElectronic health record dataHealth record dataEvaluation periodAdult patientsMean ageClinical trialsMAIN OUTCOMEClinicMOUDPatientsDisordersPatient incentivesIntegrating Ambulatory Addiction Consultation Service Into a Community Mental Health Center
Jegede O, Muvvala S, Cahill J, Wade R, Jordan A. Integrating Ambulatory Addiction Consultation Service Into a Community Mental Health Center. Journal Of Addiction Medicine 2022, 17: 126-128. PMID: 36111994, DOI: 10.1097/adm.0000000000001081.Peer-Reviewed Original ResearchConceptsCommunity mental health centerAddiction consult serviceMental health centersHealth centersConsult serviceConsultation serviceModel of careEvidence-based treatmentsAcute settingAmbulatory settingAddiction treatmentCareAmbulatory systemDrugsAddiction professionalsTreatmentPatientsReplicable modelSettingPatients' perspectives of medications for addiction treatment in HIV clinics: A qualitative study
Morford KL, Muvvala SB, Chan PA, Cornman DH, Doernberg M, Porter E, Virata M, Yager JE, Fiellin DA, Edelman EJ. Patients' perspectives of medications for addiction treatment in HIV clinics: A qualitative study. Journal Of Substance Use And Addiction Treatment 2022, 139: 108767. PMID: 35341613, PMCID: PMC9187601, DOI: 10.1016/j.jsat.2022.108767.Peer-Reviewed Original ResearchConceptsSubstance use disordersHIV clinicAddiction treatmentSubstance useEvidence-based medicationsMedication treatment optionsMedication side effectsHealth Services frameworkFocus groupsHIV cliniciansTreatment optionsMultidisciplinary screeningChronic diseasesPatient educationPatient's perspectivePromoting ActionStudy populationDisorder careSide effectsUse disordersPatient receptivityQualitative studyOverall healthClinicKnowledge deficits
2021
Maternal opioid use disorder: Placental transcriptome analysis for neonatal opioid withdrawal syndrome
Radhakrishna U, Nath SK, Vishweswaraiah S, Uppala LV, Forray A, Muvvala SB, Mishra NK, Southekal S, Guda C, Govindamangalam H, Vargas D, Gardella WG, Crist RC, Berrettini WH, Metpally RP, Bahado-Singh RO. Maternal opioid use disorder: Placental transcriptome analysis for neonatal opioid withdrawal syndrome. Genomics 2021, 113: 3610-3617. PMID: 34352367, DOI: 10.1016/j.ygeno.2021.08.001.Peer-Reviewed Original ResearchConceptsNeonatal opioid withdrawal syndromeOpioid withdrawal syndromeWithdrawal syndromePrenatal opioid exposureOpioid use disorderPlacentas of infantsPlacental tissue samplesP-valueIngenuity Pathway AnalysisOpioid exposureUse disordersUnexposed controlsFDR p-valueGenes CYP1A1Tissue samplesSyndromePathway analysisCYP1A1NewbornsInfantsEtiologyApoBPlacentaGenesGRIN2AReadiness to Provide Medications for Addiction Treatment in HIV Clinics: A Multisite Mixed-Methods Formative Evaluation
Edelman EJ, Gan G, Dziura J, Esserman D, Morford KL, Porter E, Chan PA, Cornman DH, Oldfield BJ, Yager JE, Muvvala SB, Fiellin DA. Readiness to Provide Medications for Addiction Treatment in HIV Clinics: A Multisite Mixed-Methods Formative Evaluation. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2021, 87: 959-970. PMID: 33675619, PMCID: PMC8192340, DOI: 10.1097/qai.0000000000002666.Peer-Reviewed Original ResearchConceptsHIV clinicTreatment medicationsMixed-methods formative evaluationAddiction treatmentTreatment-eligible patientsSubscale scoresAddiction treatment medicationsAdverse health consequencesHIV careMedication complexityTobacco useMedicationsClinicHealth consequencesSite specialistMultidisciplinary teamworkBehavioral servicesTreatment modelOpioidsLocal championsVariable experienceInconsistent availabilityAddiction treatment modelsFocus groupsTreatmentThe effect of varenicline on smoking and drinking outcomes among Black and White adults with alcohol use disorder and co-occurring cigarette smoking: A secondary analysis of two clinical trials
Haeny AM, Gueorguieva R, Montgomery L, Bold KW, Fucito LM, Wu R, Muvvala SB, Zweben A, O'Malley SS. The effect of varenicline on smoking and drinking outcomes among Black and White adults with alcohol use disorder and co-occurring cigarette smoking: A secondary analysis of two clinical trials. Addictive Behaviors 2021, 122: 106970. PMID: 34216871, PMCID: PMC9426655, DOI: 10.1016/j.addbeh.2021.106970.Peer-Reviewed Original ResearchConceptsEffects of vareniclineAlcohol use disorderCigarette smokingClinical trialsUse disordersWhite adultsEfficacy of vareniclineNumber of drinksVareniclineSmokingPrimary analysisAlcohol treatmentSecondary analysisAlcohol useTrialsBlack participantsDrinking outcomesLinear mixed modelsAdultsWhite peopleWhite participantsMixed modelingCigarettesDisordersTreatmentPlacental DNA methylation profiles in opioid-exposed pregnancies and associations with the neonatal opioid withdrawal syndrome
Radhakrishna U, Vishweswaraiah S, Uppala LV, Szymanska M, Macknis J, Kumar S, Saleem-Rasheed F, Aydas B, Forray A, Muvvala SB, Mishra NK, Guda C, Carey DJ, Metpally RP, Crist RC, Berrettini WH, Bahado-Singh RO. Placental DNA methylation profiles in opioid-exposed pregnancies and associations with the neonatal opioid withdrawal syndrome. Genomics 2021, 113: 1127-1135. PMID: 33711455, DOI: 10.1016/j.ygeno.2021.03.006.Peer-Reviewed Original ResearchConceptsNeonatal opioid withdrawal syndromeOpioid withdrawal syndromeIngenuity Pathway AnalysisWithdrawal syndromeOpioid-exposed pregnanciesPlacental tissue samplesOpioid abusePlacental tissueTissue samplesPregnancyMethylation dysregulationGenome-wide methylation analysisSyndromeInfantsPathway analysisAUCDNA methylation profilesMethylation profilesGroupPathophysiologyTherapyStrong evidence
2020
Stitching A Solution to the Addiction Epidemic: A Longitudinal Addiction Curricular Thread across Four Years of Medical Training
Muvvala SB, Schwartz ML, Petrakis I, O'Connor P, Tetrault JM. Stitching A Solution to the Addiction Epidemic: A Longitudinal Addiction Curricular Thread across Four Years of Medical Training. Substance Use & Addiction Journal 2020, 41: 475-479. PMID: 31951809, DOI: 10.1080/08897077.2019.1709606.Peer-Reviewed Original ResearchConceptsCurricular threadPractice-based learning activitiesMedical school curriculumComprehensive needs assessmentCurriculum goalsLearning activitiesSchool curriculumCurriculum developmentClerkship directorsDidactic activitiesEducational strategiesMedical schoolsKern modelClinical simulationMedical trainingCurriculumWorkshop exercisesNeeds assessmentWork forceClinical experienceSchoolsEducationPublic health impactImplementationInstitutionsWorking with HIV clinics to adopt addiction treatment using implementation facilitation (WHAT-IF?): Rationale and design for a hybrid type 3 effectiveness-implementation study
Edelman EJ, Dziura J, Esserman D, Porter E, Becker WC, Chan PA, Cornman DH, Rebick G, Yager J, Morford K, Muvvala SB, Fiellin DA. Working with HIV clinics to adopt addiction treatment using implementation facilitation (WHAT-IF?): Rationale and design for a hybrid type 3 effectiveness-implementation study. Contemporary Clinical Trials 2020, 98: 106156. PMID: 32976995, PMCID: PMC7511156, DOI: 10.1016/j.cct.2020.106156.Peer-Reviewed Original ResearchConceptsHIV clinicImplementation facilitationAddiction treatmentHealth services research frameworkHybrid type 3Effectiveness-implementation studyEvidence-based counselingSubstantial morbidityClinical outcomesOpioid misusePromoting ActionEffectiveness outcomesClinicFacilitators of integrationType 3Implementation outcomesTreatmentOutcomesWedge designHIVResearch implementationStudy goalFacilitation studiesStaff readinessMedicationsMultiple Psychiatric Morbidity and Continued Use of Naltrexone for Alcohol Use Disorder
Muvvala SB, O'Malley SS, Rosenheck R. Multiple Psychiatric Morbidity and Continued Use of Naltrexone for Alcohol Use Disorder. American Journal On Addictions 2020, 30: 55-64. PMID: 32805083, DOI: 10.1111/ajad.13089.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAlcohol DeterrentsAlcoholismAmbulatory CareDepressive Disorder, MajorFemaleHospitalizationHumansIll-Housed PersonsMaleMental Health ServicesMiddle AgedMorbidityNaltrexonePsychotherapyPsychotropic DrugsSchizophreniaSocioeconomic FactorsUnited StatesUnited States Department of Veterans AffairsVeteransConceptsAlcohol use disorderUse of naltrexonePsychotropic prescription fillsPrescription fillsUse disordersOutpatient mental health servicesCorrelates of initiationMedical-surgical hospitalizationMultiple psychiatric morbiditiesEfficacy of naltrexonePsychotropic medication useVeterans Health AdministrationPsychiatric outpatient servicesConcurrent psychiatric disordersMajor depressive disorderMental health servicesProportion of veteransNaltrexone initiationMedication usePsychiatric morbidityDepressive disorderImportant patientPsychiatric hospitalizationMultinomial logistic regressionOutpatient servicesPerceived barriers to access care, anticipated discrimination and structural vulnerability among African Americans with substance use disorders
Jegede O, Muvvala S, Katehis E, Paul S, Soipe A, Jolayemi A. Perceived barriers to access care, anticipated discrimination and structural vulnerability among African Americans with substance use disorders. International Journal Of Social Psychiatry 2020, 67: 136-143. PMID: 32666877, DOI: 10.1177/0020764020934512.Peer-Reviewed Original ResearchConceptsSubstance use disordersStigma subscalesUse disordersPsychiatric diagnosisAfrican AmericansAfrican American patientsTreatment-related stigmaAnticipated discriminationSubstance use servicesTotal mean scoreAmerican patientsTeaching hospitalCare EvaluationMental illnessHealth disparitiesHealth inequitiesMean scoreSignificant differencesDiagnosisAssessment toolCareDisordersStigmaSubscalesDiscrimination SurveyEffects of Alcohol Cue Reactivity on Subsequent Treatment Outcomes Among Treatment‐Seeking Individuals with Alcohol Use Disorder: A Multisite Randomized, Double‐Blind, Placebo‐Controlled Clinical Trial of Varenicline
Miranda R, O’Malley S, Padovano H, Wu R, Falk DE, Ryan ML, Fertig JB, Chun TH, Muvvala SB, Litten RZ. Effects of Alcohol Cue Reactivity on Subsequent Treatment Outcomes Among Treatment‐Seeking Individuals with Alcohol Use Disorder: A Multisite Randomized, Double‐Blind, Placebo‐Controlled Clinical Trial of Varenicline. Alcohol Clinical And Experimental Research 2020, 44: 1431-1443. PMID: 32363592, PMCID: PMC7572549, DOI: 10.1111/acer.14352.Peer-Reviewed Original ResearchConceptsAlcohol use disorderEffects of vareniclineAlcohol cue reactivityClinical trialsCue-reactivity paradigmAlcohol useCue reactivityUse disordersHuman laboratoryAlcohol cue-induced cravingSubsequent treatment outcomesΑ4β2 nicotinic acetylcholine receptorsCue-induced alcoholAlcohol cue reactivity paradigmCue-induced cravingNicotinic acetylcholine receptorsHeavy alcohol useCue-elicited cravingHuman laboratory paradigmTreatment outcomesVareniclinePlaceboProspective associationsAlcohol cravingAcetylcholine receptors
2019
Medications for Maintenance Treatment of Opioid Use Disorder in Adolescents: A Narrative Review and Assessment of Clinical Benefits and Potential Risks.
Camenga DR, Colon-Rivera HA, Muvvala SB. Medications for Maintenance Treatment of Opioid Use Disorder in Adolescents: A Narrative Review and Assessment of Clinical Benefits and Potential Risks. Journal Of Studies On Alcohol And Drugs 2019, 80: 393-402. PMID: 31495374, DOI: 10.15288/jsad.2019.80.393.Peer-Reviewed Original ResearchConceptsTreatment of OUDOpioid use disorderUse disordersClinical benefitTreatment retentionUntreated opioid use disorderHeroin use disorderEvidence-based treatmentsPotential riskLittle published evidenceBuprenorphine treatmentOpioid abstinenceMaintenance treatmentAdolescent patientsTreatment needsMedicationsMethadoneNarrative reviewHealthcare professionalsPublished evidenceBuprenorphineNaltrexoneTreatmentDisordersEfficacyHow Important Is it for Psychiatrists to Be Competent in Motivational Interviewing?
Arnaout B, Muvvala S, Marienfeld C, Petrakis I. How Important Is it for Psychiatrists to Be Competent in Motivational Interviewing? Academic Psychiatry 2019, 43: 528-531. PMID: 31077011, DOI: 10.1007/s40596-019-01059-1.Peer-Reviewed Original ResearchLongitudinal Findings from a Randomized Clinical Trial of Varenicline for Alcohol Use Disorder with Comorbid Cigarette Smoking
Bold KW, Zweben A, Fucito LM, Piepmeier ME, Muvvala S, Wu R, Gueorguieva R, O'Malley SS. Longitudinal Findings from a Randomized Clinical Trial of Varenicline for Alcohol Use Disorder with Comorbid Cigarette Smoking. Alcohol Clinical And Experimental Research 2019, 43: 937-944. PMID: 30817018, PMCID: PMC7039307, DOI: 10.1111/acer.13994.Peer-Reviewed Original ResearchConceptsEnd of treatmentAlcohol use disorderHeavy drinking daysMedical managementCigarette smokingComorbid cigarette smokingUse disordersDrinking daysCo-occurring alcohol use disorderHigh ratePlacebo-controlled trialBetter clinical outcomesAssessment of alcoholPercent of participantsVarenicline treatmentClinical outcomesSmoking abstinenceParallel groupClinical trialsTimeline FollowVareniclineSmoking behaviorAlcohol treatmentPosttreatment outcomesMultisite trialWhat Role Should Psychiatrists Have in Responding to the Opioid Epidemic?
Muvvala SB, Edens EL, Petrakis IL. What Role Should Psychiatrists Have in Responding to the Opioid Epidemic? JAMA Psychiatry 2019, 76: 107-108. PMID: 30484813, DOI: 10.1001/jamapsychiatry.2018.3123.Peer-Reviewed Original Research
2018
Randomized Clinical Trial of Computerized and Clinician-Delivered CBT in Comparison With Standard Outpatient Treatment for Substance Use Disorders: Primary Within-Treatment and Follow-Up Outcomes
Kiluk BD, Nich C, Buck MB, Devore KA, Frankforter TL, LaPaglia DM, Muvvala SB, Carroll KM. Randomized Clinical Trial of Computerized and Clinician-Delivered CBT in Comparison With Standard Outpatient Treatment for Substance Use Disorders: Primary Within-Treatment and Follow-Up Outcomes. American Journal Of Psychiatry 2018, 175: 853-863. PMID: 29792052, PMCID: PMC6120780, DOI: 10.1176/appi.ajp.2018.17090978.Peer-Reviewed Original ResearchConceptsCognitive behavioral therapySubstance use disordersComputer-based cognitive behavioral therapyUse disordersMinimal clinical monitoringTreatment-seeking populationTreatment-seeking outpatientsDSM-IV-TR criteriaCBT groupFrequency of substanceStandard outpatient careCBT4CBTStand-alone treatmentDiverse sampleStandard outpatient treatmentCurrent substance use disorderBehavioral conceptsBetter learningSubstance abuseHeterogeneous sampleUp OutcomesHigh dropout ratePrevious trialsSix-month followClinical trialsEffect of Varenicline Combined With Medical Management on Alcohol Use Disorder With Comorbid Cigarette Smoking: A Randomized Clinical Trial
O’Malley S, Zweben A, Fucito LM, Wu R, Piepmeier ME, Ockert DM, Bold KW, Petrakis I, Muvvala S, Jatlow P, Gueorguieva R. Effect of Varenicline Combined With Medical Management on Alcohol Use Disorder With Comorbid Cigarette Smoking: A Randomized Clinical Trial. JAMA Psychiatry 2018, 75: 129-138. PMID: 29261824, PMCID: PMC5838706, DOI: 10.1001/jamapsychiatry.2017.3544.Peer-Reviewed Original ResearchConceptsAlcohol use disorderMedical managementUse disordersCigarette smokingWeek 9Varenicline tartrateEfficacy of vareniclinePlacebo-controlled trialBehavioral health risksComorbid cigarette smokingRace/ethnicityAlcohol dependence criteriaSmoking 2Medication adherenceOutpatient clinicPlacebo pillsMean ageEligible participantsSmoking abstinenceClinical trialsParallel groupPlaceboMAIN OUTCOMEVareniclineWeek 13Description of a Comprehensive Addiction Rotation at a Psychiatry Residency Program
Arnaout B, Muvvala S, Rohrbaugh R, Petrakis I. Description of a Comprehensive Addiction Rotation at a Psychiatry Residency Program. Academic Psychiatry 2018, 42: 313-316. PMID: 29302930, DOI: 10.1007/s40596-017-0858-2.Peer-Reviewed Original Research