Voluntary faculty are typically clinicians or others who are employed outside of the School but make significant contributions to department programs at the medical center or at affiliate institutions.
Voluntary rank detailsJulio Nunes, MD
Clinical InstructorAbout
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A common misconception is that buprenorphine and methadone just replace one addiction with another. The problem is the old goal of abstinence from all substances. If instead the goal is well-being, reconnecting with family, working, parenting, avoiding arrest, then what matters are outcomes. And the outcomes are clear: these medications should be offered to every patient who needs them.
Julio Nunes, from interview with Health Journalist Emma Yasinski ("The Road Back")
Biography
Julio C. Nunes, MD is a research-track Psychiatry Resident at Yale University and Chief Resident of Outpatient and Addiction Services at the West Haven VA. His work focuses on addiction, chronic pain, and health disparities, with an emphasis on translating research into patient-centered policy, advocacy, and practice. He is a Laughlin Fellow of the American College of Psychiatrists and a Leadership Fellow of the American Psychiatric Association.
As a member of Yale’s Pain and Addiction Interaction Neurosciences (PAIN) Laboratory and a former research fellow at the Stanford Center for Clinical Research, Dr. Nunes has authored more than 40 peer-reviewed publications, chapters, and commentaries. His scholarship has been recognized by the American Academy of Addiction Psychiatry, the College on Problems of Drug Dependence, the National Institute on Drug Abuse, and the American Society of Hispanic Psychiatry.
Nunes also serves on the board of Doctors for Drug Policy Reform and recently partnered with U.S. Senator Edward Markey’s office on the dissemination of the Modernizing Opioid Treatment Access Act, legislation aimed at expanding access to methadone through community pharmacies.
Education is another core commitment. Dr. Nunes is a recurrent lecturer at the Yale School of Medicine, has led national workshops on addiction and chronic pain, and received Yale Psychiatry’s Resident Teaching Award as a PGY-1.
Originally from Brazil and Mexico, he brings a global perspective to questions of access and equity in mental health and addiction treatment. Across his clinical work, research, teaching, and advocacy, his goal is to make addiction care more equitable, compassionate, and accessible.
Departments & Organizations
- Pain and Addiction Interaction Neurosciences (PAIN) Lab
Education & Training
- Postdoctoral Research Fellow
- Stanford University, Center for Clinical Research (2022)
- MD
- Federal University of the State of Rio de Janeiro, School of Medicine and Surgery (2020)
Academic Achievements & Community Involvement
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Activities
activity American Psychiatric Association
05/01/2024 - PresentProfessional OrganizationsFellowactivity College on Problems of Drug Dependence
06/01/2024 - PresentProfessional OrganizationsMemberactivity American Academy of Addiction Psychiatry
10/01/2023 - PresentProfessional OrganizationsMemberactivity Doctors for Drug Policy Reform
06/15/2025 - PresentAdvisory BoardsBoard of DirectorsDetailsDoctors for Drug Policy Reformwww.d4dpr.org
Honors
honor Laughlin Fellowship
08/20/2025National AwardAmerican College of Psychiatrists (ACP)DetailsUnited Stateshonor Travel Award for Early Career Investigators
06/01/2025National AwardCollege on Problems of Drug Dependence (CPDD)DetailsUnited Stateshonor Don Quixote Award - Critical Research Issues in Latinx Mental Health
03/13/2025National AwardAmerican Society of Hispanic Psychiatry (ASHP)DetailsUnited Stateshonor Leadership Fellowship
05/07/2024National AwardAmerican Psychiatric Association Foundation (APAF)DetailsUnited Stateshonor John Renner Travel Award
08/17/2023National AwardAmerican Academy of Addiction Psychiatry (AAAP)
Research
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Overview
Medical Research Interests
Public Health Interests
ORCID
0000-0001-9622-3361
Research at a Glance
Yale Co-Authors
Publications Timeline
Research Interests
Gabriel P. A. Costa, MD
Joao P. De Aquino, MD
Brian Pittman
Jeremy Weleff, DO
Mehmet Sofuoglu, MD, PhD
Ismene Petrakis, MD
Chronic Pain
Analgesics, Opioid
Publications
Featured Publications
Assessing pain in persons with opioid use disorder: Approaches, techniques and special considerations
Nunes J, Costa G, Weleff J, Rogan M, Compton P, De Aquino J. Assessing pain in persons with opioid use disorder: Approaches, techniques and special considerations. British Journal Of Clinical Pharmacology 2024, 90: 2985-3002. PMID: 38556851, DOI: 10.1111/bcp.16055.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsCitationsAltmetricConceptsOpioid use disorderAssess painPain assessmentPain experienceConcomitant chronic painChronic opioid therapyQuantitative sensory testingVisual analogue scalePain assessment methodsPain assessment toolsComplex psychosocial backgroundImprove pain assessmentOpioid therapyOpioid usePain responseChronic painAnalogue scaleTraditional self-report methodsPainRisk factorsUse disorderOpioidNarrative reviewSelf-report methodsMultidisciplinary teamThe impact of cannabis on non-medical opioid use among individuals receiving pharmacotherapies for opioid use disorder: a systematic review and meta-analysis of longitudinal studies
Costa G, Nunes J, Heringer D, Anand A, De Aquino J. The impact of cannabis on non-medical opioid use among individuals receiving pharmacotherapies for opioid use disorder: a systematic review and meta-analysis of longitudinal studies. The American Journal Of Drug And Alcohol Abuse 2024, 50: 12-26. PMID: 38225727, DOI: 10.1080/00952990.2023.2287406.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsCitationsAltmetricMeSH Keywords and ConceptsConceptsNon-medical opioid useOpioid use disorderOpioid useCannabis useOpioid use disorder pharmacotherapyUse disorderImpact of cannabis useAverage follow-up timeFollow-up timeMeta-analysisEvidence of moderate heterogeneityImpact of cannabisPooled odds ratioOpioids non-medicallyRandom-effects modelMeta-analysis of longitudinal studiesCannabis abstinenceTreatment modalitiesOdds ratioModerate heterogeneityPharmacotherapyCannabisOpioidComprehensive searchPublication biasGeneral Anxiety Disorder-7 Questionnaire as a marker of low socioeconomic status and inequity.
Nunes JC, Carroll MK, Mahaffey KW, Califf RM, Doraiswamy PM, Short S, Shah SH, Swope S, Williams D, Hernandez AF, Hong DS. General Anxiety Disorder-7 Questionnaire as a marker of low socioeconomic status and inequity. Journal Of Affective Disorders 2022, 317: 287-297. PMID: 36031002, DOI: 10.1016/j.jad.2022.08.085.Peer-Reviewed Original ResearchThe bidirectional relationship between pain and tobacco use: Insights from the longitudinal Population Assessment of Tobacco and Health (PATH) study
Costa G, Nunes J, Suh R, Sofuoglu M, De Aquino J. The bidirectional relationship between pain and tobacco use: Insights from the longitudinal Population Assessment of Tobacco and Health (PATH) study. Drug And Alcohol Dependence 2025, 268: 112552. PMID: 39848133, PMCID: PMC11832315, DOI: 10.1016/j.drugalcdep.2025.112552.Peer-Reviewed Original ResearchCitationsAltmetricMeSH Keywords and ConceptsConceptsDaily smokingDaily cigarette smokingChronic painDevelopment of painCigarette smokingTobacco smokePopulation Assessment of Tobacco and Health StudyBaseline painAlternative tobacco product usePersistent painTobacco product useDevelopment of persistent painYears of longitudinal dataHealth StudyTobacco useNo/low painPreventable causeSmoking outcomesBidirectional relationshipSurvival analysisSmokingPopulation AssessmentAge categoriesIncreased riskSurvey populationPain interference, alcohol use, and metabolic health: Insights from a nationally representative study
Costa G, Suh R, Nunes J, Pittman B, Sofuoglu M, Petrakis I, De Aquino J. Pain interference, alcohol use, and metabolic health: Insights from a nationally representative study. Alcohol Clinical And Experimental Research 2025, 49: 1768-1777. PMID: 40568749, DOI: 10.1111/acer.70108.Peer-Reviewed Original ResearchCitationsAltmetricMeSH Keywords and ConceptsConceptsNational Health and Nutrition Examination SurveyPain interferenceHeavy alcohol useAlcohol usePhysical activityHealth and Nutrition Examination SurveyMetabolic dysfunctionSleep durationNutrition Examination SurveyQuasi-Poisson regression modelCross-sectional analysisTherapeutic approachesComplex patient populationHours of sleepExamination SurveyUS adultsPrimary exposureSecondary analysisChronic painMetabolic healthInteractive associationsClinical outcomesPathophysiological domainsHigher TyGPatient populationThe Role of Childhood Trauma in Chronic Pain and Substance Use Among Individuals Receiving Methadone Treatment for Opioid Use Disorder
Costa G, Ra J, Meyerovich J, Pittman B, Nunes J, De Aquino J. The Role of Childhood Trauma in Chronic Pain and Substance Use Among Individuals Receiving Methadone Treatment for Opioid Use Disorder. Journal Of Addiction Medicine 2025, 20: 351-358. PMID: 40728216, PMCID: PMC13166079, DOI: 10.1097/adm.0000000000001553.Peer-Reviewed Original ResearchAltmetricConceptsOpioid use disorderChildhood Trauma QuestionnaireChildhood traumaSubstance useCannabis initiationUse disorderBrief Pain InventoryEmotional abuseAge of cannabis initiationPain severityChronic painHigher childhood trauma scoresHistory of childhood traumaLikelihood of cannabis useLevels of emotional abuseChildhood trauma exposureChildhood trauma scoresTrauma-focused assessmentAlcohol consumptionHigher alcohol useOpioid use disorder treatment programsTrauma exposureTrauma QuestionnaireCannabis useTrauma subscalesReducing Stigma and Expanding Methadone Access in the U.S.: the Modernizing Opioid Treatment Access Act and Beyond
Nunes JC & Adinoff B. Reducing Stigma and Expanding Methadone Access in the U.S.: the Modernizing Opioid Treatment Access Act and Beyond. The American Journal of Drug and Alcohol Abuse. 2025:1–6. https://doi.org/10.1080/00952990.2025.2525405Peer-Reviewed Case Reports and Technical NotesCannabis use frequency is associated with emotion dysregulation among persons receiving long-term opioid therapy for chronic pain: A psychophysiological study
De Aquino J, Costa G, Nunes J, Hudak J, Odette M, Garland E. Cannabis use frequency is associated with emotion dysregulation among persons receiving long-term opioid therapy for chronic pain: A psychophysiological study. Drug And Alcohol Dependence 2025, 275: 112812. PMID: 40779835, PMCID: PMC12396927, DOI: 10.1016/j.drugalcdep.2025.112812.Peer-Reviewed Original ResearchAltmetricMeSH Keywords and ConceptsConceptsEmotion regulation capacitiesLong-term opioid therapyCannabis use frequencySkin conductance responsesFrequent cannabis useCannabis useChronic painPain severityEmotion dysregulationCognitive reappraisalOpioid therapyAssociated with more frequent cannabis useReappraisal of negative stimuliAssociated with emotion dysregulationRegulation capacityPatterns of cannabis useHeavy cannabis useEmotion regulation interventionAssociated with more daysBrief Pain InventoryNegative stimuliPassive viewingCorrugator electromyographyPsychophysiological measuresConductance responsesShe Just Wanted to Watch Her Daughter’s Soccer Game: Why Methadone Reform Can’t Wait
Nunes JC. She Just Wanted to Watch Her Daughter’s Soccer Game: Why Methadone Reform Can’t Wait. Psychiatric News. 2025.Commentaries, Editorials and Letters
2025
Pharmacotherapies for Binge Eating Disorder: Systematic Review and Network Meta‐Analysis
Costa G, Assunção B, Belfort‐DeAguiar R, Nunes J. Pharmacotherapies for Binge Eating Disorder: Systematic Review and Network Meta‐Analysis. Obesity Reviews 2025, 26: e13936. PMID: 40344489, DOI: 10.1111/obr.13936.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsCitationsAltmetricMeSH Keywords and ConceptsConceptsBinge Eating DisorderTolerability of pharmacological interventionsBinge-eating episode frequencyEating disorder scoresMedication discontinuation ratesOverall effect sizePharmacological treatment optionsBinge-eating episodesCompulsive overeatingPsychiatric diagnosisDisorder scoresEpisode frequencyLisdexamfetamineAssessment instrumentsRecurrent episodesEffect sizeAdverse eventsPhysical healthDasotralineDiscontinuation ratesRemission rateDerSimonian-Laird random-effects modelPharmacological interventionsLandscape of pharmacotherapyBinge
Teaching & Mentoring
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Teaching
Didactic Assessment of Pain in Persons with Opioid Use Disorder
LecturerLecture SettingDetails7/1/2024 - PresentForGraduate4 Average Instructional Hours Per YearThis course is provided to second year medical students rotating in psychiatry as part of the "Top 10" teaching sessions. In this class we: (1) discuss the multidimensional nature of pain, and how opioid use disorder may impact pain assessment; (2) summarize how specific biological, psychological, and social factors affect the experience of pain among persons with opioid use disorder; and (3) compare various forms of pain assessments.
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