Featured Publications
US National Trends in Pediatric Deaths From Prescription and Illicit Opioids, 1999-2016
Gaither JR, Shabanova V, Leventhal JM. US National Trends in Pediatric Deaths From Prescription and Illicit Opioids, 1999-2016. JAMA Network Open 2018, 1: e186558. PMID: 30646334, PMCID: PMC6324338, DOI: 10.1001/jamanetworkopen.2018.6558.Peer-Reviewed Original ResearchConceptsOpioid poisoningPediatric deathsMortality rateUS national trendsPublic health problemPediatric mortality rateNational trendsPublic health officialsIllicit opioidsPrescription opioidsAge-specific mortality ratesOpioid deathsOpioid epidemicMAIN OUTCOMEOpioidsHealth problemsOpioid crisisPoisson regressionSynthetic opioidsDisease controlMortality dataHealth officialsDeathMedical facilitiesChildren
2024
The Circumstances Surrounding Fatal Pediatric Opioid Poisonings, 2004-2020.
Gaither J, McCollum S, Bechtel K, Leventhal J, Mintz S. The Circumstances Surrounding Fatal Pediatric Opioid Poisonings, 2004-2020. Pediatrics 2024, 154 PMID: 39484873, PMCID: PMC11528886, DOI: 10.1542/peds.2024-067043n.Peer-Reviewed Original ResearchConceptsChild's own homeOpioid poisoningOwn homeHistory of maltreatmentSubstance use/abuseAge groupsDied of homicidePrimary caregiversYears of ageOpioid prescribingChildren 0Opioid fatalitiesHousehold factorsPrescription opioidsSubstance useChild maltreatmentCaregiversDecedentsReporting SystemIllicit fentanylMaltreatmentChildrenFatal opioid poisoningsAgeHomeHospital Readmissions Among Infants With Neonatal Opioid Withdrawal Syndrome
Gaither J, Drago M, Grossman M, Li Y, Shabanova V, Xu X, Leventhal J. Hospital Readmissions Among Infants With Neonatal Opioid Withdrawal Syndrome. JAMA Network Open 2024, 7: e2435074. PMID: 39316398, PMCID: PMC11423163, DOI: 10.1001/jamanetworkopen.2024.35074.Peer-Reviewed Original ResearchConceptsNeonatal opioid withdrawal syndromeOpioid withdrawal syndromeWithdrawal syndromeCohort studyHospital readmissionLow birth weightReadmission ratesRetrospective cohort studyIncreased risk of readmissionNationwide Readmissions DatabaseClinical Modification codesGestational ageOdds of readmissionMultiple gestationsFull-termInternational Classification of DiseasesRisk of readmissionHospital discharge recordsBirth weightSurvey-weighted logistic regressionType of insuranceIncreased 5-foldIncreased riskReadmissions DatabaseYear of birth
2020
Does Reducing Drinking in Patients with Unhealthy Alcohol Use Improve Pain Interference, Use of Other Substances, and Psychiatric Symptoms?
Caniglia EC, Stevens ER, Khan M, Young KE, Ban K, Marshall BDL, Chichetto NE, Gaither JR, Crystal S, Edelman EJ, Fiellin DA, Gordon AJ, Bryant KJ, Tate J, Justice AC, Braithwaite RS. Does Reducing Drinking in Patients with Unhealthy Alcohol Use Improve Pain Interference, Use of Other Substances, and Psychiatric Symptoms? Alcohol Clinical And Experimental Research 2020, 44: 2257-2265. PMID: 33030753, PMCID: PMC8077101, DOI: 10.1111/acer.14455.Peer-Reviewed Original ResearchConceptsUnhealthy alcohol useAlcohol usePain interferenceTobacco smokingUS veteransOdds ratioPsychiatric symptomsDepressive symptomsCocaine useVeterans Aging Cohort StudyAlcohol Use Disorders Identification Test (AUDIT) questionnaireCannabis useSubstance useAging Cohort StudyAnxiety symptomsSeparate logistic regression modelsChronic pain interferenceMultisite observational studyLogistic regression modelsCohort studyInverse probability weightingNext followObservational studyPotential selection biasYears postbaselineTrajectories of Self-Reported Opioid Use Among Patients With HIV Engaged in Care: Results From a National Cohort Study.
Edelman EJ, Li Y, Barry D, Brennan Braden J, Crystal S, Kerns RD, Gaither JR, Gordon KS, Manhapra A, Merlin JS, Moore BA, Oldfield BJ, Park LS, Rentsch CT, Skanderson M, Williams EC, Justice AC, Tate JP, Becker WC, Marshall BDL. Trajectories of Self-Reported Opioid Use Among Patients With HIV Engaged in Care: Results From a National Cohort Study. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2020, 84: 26-36. PMID: 32267658, PMCID: PMC7147724, DOI: 10.1097/qai.0000000000002310.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCohort StudiesFemaleHIV InfectionsHumansMaleMiddle AgedOpioid-Related DisordersUnited StatesConceptsOpioid useOpioid use trajectoriesCohort studyPain interferenceSelf-reported opioid useVeterans Aging Cohort StudyVeterans Health Administration sitesInfrequent useOpioid use frequencyMarijuana useAging Cohort StudyNational cohort studyEvidence-based treatmentsGroup-based trajectory modelsProspective cohortBaseline factorsIllness severityMultivariable analysisBenzodiazepine medicationVA carePsychoactive medicationsPrescription painkillersPsychiatric symptomsHeroin useMultinomial logistic regressionAssociation of Alcohol Screening Scores With Adverse Mental Health Conditions and Substance Use Among US Adults
Khan MR, Young KE, Caniglia EC, Fiellin DA, Maisto SA, Marshall BDL, Edelman EJ, Gaither JR, Chichetto NE, Tate J, Bryant KJ, Severe M, Stevens ER, Justice A, Braithwaite SR. Association of Alcohol Screening Scores With Adverse Mental Health Conditions and Substance Use Among US Adults. JAMA Network Open 2020, 3: e200895. PMID: 32163167, PMCID: PMC7068229, DOI: 10.1001/jamanetworkopen.2020.0895.Peer-Reviewed Original ResearchConceptsAlcohol Use Disorders Identification TestAlcohol Use Disorders Identification Test-ConsumptionAUDIT-C scoresUse of tobaccoAlcohol screeningCohort studyInjection drugsCocaine useVeterans Aging Cohort StudyVeterans Health Administration facilitiesStimulant useAlcohol useAUDIT scoresAging Cohort StudyLongitudinal cohort studyVeterans Health AdministrationAdverse mental health conditionsSite of careFull Alcohol Use Disorders Identification TestMental health conditionsAlcohol Screening ScoresSelf-reported symptomsSymptoms of depressionDisorders Identification TestUse screening tools
2019
High-dose prescribed opioids are associated with increased risk of heroin use among United States military veterans.
Banerjee G, Edelman EJ, Barry DT, Crystal S, Gordon KS, Gordon AJ, Gaither JR, Green TC, Kerns RD, Manhapra A, Moore BA, Fiellin DA, Marshall BDL. High-dose prescribed opioids are associated with increased risk of heroin use among United States military veterans. Pain 2019, 160: 2126-2135. PMID: 31145217, PMCID: PMC6699915, DOI: 10.1097/j.pain.0000000000001606.Peer-Reviewed Original ResearchConceptsHigh-dose opioid prescriptionsOpioid prescriptionsHeroin useCohort studyPrior receiptHepatitis C virus (HCV) infection statusLong-term opioid prescriptionsPast-year heroin useVeterans Aging Cohort StudyHigh-dose opioidsOpioid-prescribing patternsProspective cohort studyAging Cohort StudyOpioid use disorderCurrent national guidelinesUnhealthy alcohol useUnited States veteransUnited States military veteransVirus infection statusPosttraumatic stress disorderOpioid receiptPrescribed opioidsPain interferenceCox regressionStates veteransPredictors of timely opioid agonist treatment initiation among veterans with and without HIV
Wyse JJ, Robbins JL, McGinnis KA, Edelman EJ, Gordon AJ, Manhapra A, Fiellin DA, Moore BA, Korthuis PT, Gaither JR, Gordon K, Skanderson M, Barry DT, Crystal S, Justice A, Kraemer KL. Predictors of timely opioid agonist treatment initiation among veterans with and without HIV. Drug And Alcohol Dependence 2019, 198: 70-75. PMID: 30878769, PMCID: PMC6836871, DOI: 10.1016/j.drugalcdep.2019.01.038.Peer-Reviewed Original ResearchConceptsOpioid agonist therapyOpioid use disorderVeterans Aging Cohort StudyOAT initiationUninfected patientsClinical encountersNational observational cohortAging Cohort StudyAfrican American patientsImproved health outcomesAgonist therapyCohort studyObservational cohortTreatment initiationPredictive factorsEffective treatmentAdjusted modelUninfected controlsUse disordersPsychiatric diagnosisPWHClinical practicePatientsHealth outcomesRural residenceAssociation 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 ResearchConceptsVeterans 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/ethnic differences in the association between alcohol use and mortality among men living with HIV
Bensley KM, McGinnis KA, Fiellin DA, Gordon AJ, Kraemer KL, Bryant KJ, Edelman EJ, Crystal S, Gaither JR, Korthuis PT, Marshall BDL, Ornelas IJ, Chan KCG, Dombrowski JC, Fortney JC, Justice AC, Williams EC. Racial/ethnic differences in the association between alcohol use and mortality among men living with HIV. Addiction Science & Clinical Practice 2018, 13: 2. PMID: 29353555, PMCID: PMC6389249, DOI: 10.1186/s13722-017-0103-z.Peer-Reviewed Original ResearchConceptsLow-risk alcohol useMortality riskAlcohol useRace/ethnicityWhite PLWHMortality rateAlcohol Use Disorders Identification Test-Consumption (AUDIT-C) questionnaireVeterans Aging Cohort StudyCox proportional hazards modelHigh-risk alcohol useAUDIT-C screeningAging Cohort StudyElectronic health record dataRisk of mortalityHigh-risk relativesUnhealthy alcohol useHigher mortality riskProportional hazards modelHealth record dataHigh mortality rateEthnic groupsMale PLWHCohort studyWhite patientsGeneral outpatients
2017
Inter-rater reliability of physical abuse determinations in young children with fractures
Buesser KE, Leventhal JM, Gaither JR, Tate V, Cooperman DR, Moles RL, Silva CT, Ehrlich LJ, Sharkey MS. Inter-rater reliability of physical abuse determinations in young children with fractures. Child Abuse & Neglect 2017, 72: 140-146. PMID: 28802910, DOI: 10.1016/j.chiabu.2017.08.001.Peer-Reviewed Original ResearchConceptsChild abuse pediatriciansModerate agreementPediatric emergency departmentMedical record dataYoung childrenAbusive injuriesEmergency departmentJoint ratingsClinical detailsInter-rater reliabilityPediatric radiologistsClinical scenariosMedical providersPairs of ratersPediatric orthopaedistsLevel of agreementOrthopaedistsRecord dataCliniciansGold standardIndependent ratingsRadiologistsChildrenExtent of agreementPhysiciansLong-term alcohol use patterns and HIV disease severity
Marshall BDL, Tate JP, McGinnis KA, Bryant KJ, Cook RL, Edelman EJ, Gaither JR, Kahler CW, Operario D, Fiellin DA, Justice AC. Long-term alcohol use patterns and HIV disease severity. AIDS 2017, 31: 1313-1321. PMID: 28492393, PMCID: PMC5596310, DOI: 10.1097/qad.0000000000001473.Peer-Reviewed Original ResearchConceptsHIV disease severityVeterans Aging Cohort StudyHigh-risk drinkersDisease severityAlcohol useRisk drinkersLower riskAlcohol use trajectoriesIndex groupModerate riskIndex trajectoriesVeterans Health Administration sitesAging Cohort StudyHigh-risk groupMeasures of morbidityAlcohol Use Disorders IdentificationLow index groupAlcohol consumption trajectoriesUse trajectoriesSubset of participantsAlcohol use patternsVACS IndexCause mortalityCohort studyProspective cohort
2016
National Trends in Hospitalizations for Opioid Poisonings Among Children and Adolescents, 1997 to 2012
Gaither JR, Leventhal JM, Ryan SA, Camenga DR. National Trends in Hospitalizations for Opioid Poisonings Among Children and Adolescents, 1997 to 2012. JAMA Pediatrics 2016, 170: 1195-1201. PMID: 27802492, PMCID: PMC7245935, DOI: 10.1001/jamapediatrics.2016.2154.Peer-Reviewed Original ResearchConceptsOpioid poisoningInpatient DatabaseAge groupsSerial cross-sectional dataDischarge recordsPrescription opioid poisoningsOpioid prescribing practicesHospital discharge recordsKids' Inpatient DatabaseCharacteristics of hospitalizationsYears of ageCochran-Armitage testPediatric hospital discharge recordsOpioid exposureAnnual incidencePediatric populationPrescription opioidsNinth RevisionPrescribing practicesChildren 1Opioid storageClinical ModificationRetrospective analysisHospitalizationMAIN OUTCOMENon‐medical use of prescription opioids is associated with heroin initiation among US veterans: a prospective cohort study
Banerjee G, Edelman EJ, Barry DT, Becker WC, Cerdá M, Crystal S, Gaither JR, Gordon AJ, Gordon KS, Kerns RD, Martins SS, Fiellin DA, Marshall BD. Non‐medical use of prescription opioids is associated with heroin initiation among US veterans: a prospective cohort study. Addiction 2016, 111: 2021-2031. PMID: 27552496, PMCID: PMC5056813, DOI: 10.1111/add.13491.Peer-Reviewed Original ResearchConceptsMultivariable Cox regression modelsNon-medical useCox regression modelHeroin initiationPrescription opioidsHeroin useCohort studyUS veteransOpioid use disorder diagnosisVeterans Aging Cohort StudyProspective cohort studyAging Cohort StudyIllicit opioid usePrimary care clinicsPrimary outcome measureStrong risk factorPost-traumatic stress disorderUninfected veteransUninfected patientsOpioid useRegression modelsCare clinicsPain interferencePrior diagnosisPrimary exposureThe 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
The epidemiology of substance use disorders in US Veterans: A systematic review and analysis of assessment methods
Lan CW, Fiellin DA, Barry DT, Bryant KJ, Gordon AJ, Edelman EJ, Gaither JR, Maisto SA, Marshall BD. The epidemiology of substance use disorders in US Veterans: A systematic review and analysis of assessment methods. American Journal On Addictions 2015, 25: 7-24. PMID: 26693830, PMCID: PMC5123305, DOI: 10.1111/ajad.12319.Peer-Reviewed Original ResearchConceptsPrevalence of SUDsSubstance use disordersUS veteransUse disordersDiagnostic criteriaComprehensive electronic database searchesMajor public health challengeSignificant public health problemUS veteran populationDrug use disordersPublic health problemElectronic database searchPublic health challengePast-year prevalenceHigh prevalenceInclusion criteriaYear prevalenceVeteran populationHealth problemsSystematic reviewClinical screeningHealth challengesPrevalenceHealth conditionsHealthcare system
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 characteristicsPatientsHospitalizations Due to Firearm Injuries in Children and Adolescents
Leventhal JM, Gaither JR, Sege R. Hospitalizations Due to Firearm Injuries in Children and Adolescents. Pediatrics 2014, 133: 219-225. PMID: 24470651, DOI: 10.1542/peds.2013-1809.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentChildChild, PreschoolFemaleHospitalizationHumansMaleUnited StatesWounds, GunshotYoung AdultConceptsFirearm-related injuriesYears of ageFirearm injuriesSuicide attemptsHospitalization ratesInpatient DatabaseKids' Inpatient DatabaseFirearm-related hospitalizationsPublic health effortsNinth RevisionChildhood injuriesHospitalized casesRisk ratioInjury codesClinical ModificationHospitalizationInternational ClassificationUS childrenHealth effortsInjuryWhite malesChildrenRecent national attentionIntercensal populationMales
2012
Incidence of Serious Injuries Due to Physical Abuse in the United States: 1997 to 2009
Leventhal JM, Gaither JR. Incidence of Serious Injuries Due to Physical Abuse in the United States: 1997 to 2009. Pediatrics 2012, 130: e847-e852. PMID: 23027163, DOI: 10.1542/peds.2012-0922.Peer-Reviewed Original ResearchConceptsYears of ageInpatient DatabaseInjury codesNational incidenceSerious injuriesPhysical abuseClinical Modification diagnosisKids' Inpatient DatabaseChild protective services dataSerious physical abuseSample of dischargesNinth RevisionHospitalized childrenInternational ClassificationIncidenceSubstantiated physical abuseInjuryAgeChildrenExternal causesAbuseSmall increaseYearsService dataHospitalization