The National Institutes of Health describes the Helping End Addiction Long-term (HEAL) Initiative as “an aggressive, trans-agency effort to speed scientific solutions to stem the national opioid public health crisis.” Initiated in 2018, the 2.5 billion dollar initiative funds more than 1,000 projects across the country to advance understanding and treatment of opioid, other substance use disorders and pain. Among recent awardees are several core faculty members in the Yale Program in Addiction Medicine. Projects include:
HEAL Data2Action Research Adoption Support Center
This project, helmed by mPIs Dr. Mark McGovern, PhD, Sara Becker, PhD, William Becker, MD, and C. Hendricks Brown, PhD, will establish the HEAL Data2Action Research Adoption Support Center. This Center will perform several functions, among them supporting HEAL Data2Action Innovation Projects. This support will come in the form of on-demand technical assistance, facilitation of a learning collaborative, provision of implementation support, and assistance with partner engagement. In addition, the Center will support gathering of evidence for prevention and treatment practices, development and evaluation of implementation strategies, feedback collection and scalability assessment. Dr. Becker will serve as Director of the Pain Implementation Support Core within the Center, and David Fiellin, MD, will be among core faculty in the Substance Use Disorder Implementation Support Core.
Using System Dynamics Modeling to Foster Real-Time Connections to Care
First responders prevent many overdose deaths by providing life-saving resuscitation and giving naloxone to reverse an opioid overdose. Using a modeling approach, Rebekah Heckmann, MD, MPH, MPA, Nasim Sabounchi, PhD, and team will assess the impact of Good Samaritan Laws, intended to protect people from certain criminal penalties if calling 911 to respond to an overdose, on overdose mortality. Heckmann and team will develop and test a telehealth platform to be used at the time of an opioid overdose to connect patients with access to medication for opioid use disorder, harm reduction services, and recovery support.
In supplement to ongoing HEAL-funded research in the NIDA Clinical Trial Network (CTN) New England Consortium Node (mPI Gail D'Onofrio, MD, MS), a new project led by Edouard Coupet II, MD, MS and Dr. D'Onofrio will seek to elicit potential targets for emergency department-based interventions to improve engagement in addiction treatment among Black and Latino individuals with untreated opioid use disorder. To accomplish this, Dr. Coupet and team will conduct semi-structured interviews of Black, Latino, and non-Latino White participants as well as as supplemental analyses of previously identified predictors of worse treatment outcomes. Findings will inform development of an ED-based intervention to enhance treatment engagement within this population, subsequent to an ED visit.
Individuals experiencing homelessness are more likely to use both fentanyl and stimulants and experience drug-related harms as compared to stably housed counterparts. mPIs Ryan McNeil, PhD, and Kelly R. Knight, PhD, will examine fentanyl-stimulant polysubstance use patterns in relation to housing status. McNeil, Knight, Kimberly Sue, MD, PhD, and colleagues will additionally examine use of overdose prevention and substance use disorder treatment interventions in homeless individuals who use both fentanyl and stimulants, including how polysubstance use patterns shape risk of overdose over time.
The Food and Drug Administration recently issued a warning concerning the use of transmucosal buprenorphine and adverse dental outcomes. There is a significant gap in understanding of this issue. With a supplement to ongoing activities of the IMPOWR-YOU Research Center (mPIs William Becker, MD, Declan Barry, PhD, and David Fiellin, MD) and building on prior work to assess the impact of prescribed opioids on infectious outcomes, Becker, E. Jennifer Edelman, MD, MHS; Kirsha Gordon, PhD, and colleagues will utilize Veterans Health Administration data to examine the association between long-term opioid agonist (full or partial) receipt and tooth decay, cavities, oral infections, and loss of teeth.
Prior Yale Program in Addiction Medicine affiliated HEAL awards include:
- The Role of Family Functioning in Race/Ethnicity on the Efficacy of an Opioid Misuse Prevention Videogame Intervention for Adolescents (Lynn E. Fiellin, MD; Uche Aneni, MD, MHS)
- HEAL Initiative: Integrative Management of Chronic Pain and OUD for Whole Recovery (IMPOWR): Research Centers (William Becker, MD; Declan Barry, PhD; David Fiellin, MD)
- Transitions Clinic Network: Post Incarceration Addiction Treatment, Healthcare, andSocial Support (TCH PATHS) Study (Emily A. Wang, MD, MA)
- Gaunfacine Target Engagement and Validation to Improve Substance Use Outcomes in Women (Rajita Sinha, PhD)
- A Digital Intervention to Prevent the Initiation of Opioid Misuse in Adolescents in School-Based Health Centers (Lynn E. Fiellin, MD)
- Video-Telecare Collaborative Pain Management to Improve Function and Reduce Opioid Risk in Patients with End Stage Renal Disease Receiving Hemodialysis (William Becker, MD; Susan T. Crowley, MD; Denise Esserman, MD; Alicia Heapy, PhD)
- The Collaboration Linking Opioid Use Disorder and Sleep (CLOUDS) Study (Henry Klar Yaggi, MD, PhD; Nancy S. Redeker, RN, PhD, FAHA, FAAN); Dustin Scheinost, PhD; Declan Barry, PhD)
- Pain Management Collaboratory Coordinating Center (Robert D. Kerns, PhD; Cynthia. A Brandt, MD, MPH)
- Long-acting Buprenophine vs. Naltrexone Opioid Treatments in CJS-Involved Adults (Joshua D. Lee, MD, MSc; David J. Farabee, PhD; Lisa A. Marsch, PhD; Robert P. Schwartz, MD; Sandra A. Springer, MD; Elizabeth N. Waddell, PhD)
Language presented in this article is adapted from the NIH HEAL Initiative Funded Projects website.