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 testingCocaineCannabisTherapyCliniciansDiscontinuationPainBrief Counseling for Veterans with Musculoskeletal Disorder, Risky Substance Use, and Service Connection Claims
Rosen MI, Becker WC, Black AC, Martino S, Edens EL, Kerns RD. Brief Counseling for Veterans with Musculoskeletal Disorder, Risky Substance Use, and Service Connection Claims. Pain Medicine 2018, 20: 528-542. PMID: 29800338, PMCID: PMC6387983, DOI: 10.1093/pm/pny071.Peer-Reviewed Original ResearchMeSH KeywordsAdultCounselingFemaleHumansMaleMusculoskeletal DiseasesPainPain ManagementPilot ProjectsSubstance-Related DisordersUnited StatesVeteransConceptsRisky substance useMusculoskeletal disordersSubstance useMean pain severityCourse of illnessPain severity ratingsProportion of veteransScreening Brief InterventionCounseling armPain severityPain treatmentTAU conditionWeek 12Brief counselingEarly interventionOutcome assessmentBrief interventionStudy therapistsTelephone callsVeteransCounseling interventionCounselingInterventionSeverity ratingsDisorders
2017
Gender Differences in Demographic and Clinical Correlates among Veterans with Musculoskeletal Disorders
Higgins DM, Fenton BT, Driscoll MA, Heapy AA, Kerns RD, Bair MJ, Carroll C, Brennan PL, Burgess DJ, Piette JD, Haskell SG, Brandt CA, Goulet JL. Gender Differences in Demographic and Clinical Correlates among Veterans with Musculoskeletal Disorders. Women's Health Issues 2017, 27: 463-470. PMID: 28325585, DOI: 10.1016/j.whi.2017.01.008.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnxietyChronic PainCohort StudiesFemaleHumansMaleMiddle AgedMigraine DisordersMusculoskeletal DiseasesMusculoskeletal PainPain ManagementSeverity of Illness IndexSex FactorsSocioeconomic FactorsSubstance-Related DisordersUnited StatesUnited States Department of Veterans AffairsVeteransConceptsMusculoskeletal disordersClinical correlatesPain intensity numeric rating scalePain-related disabilityNumeric rating scaleGreater pain intensityDiagnosis of fibromyalgiaBack pain conditionsMental health conditionsSubstance use disordersGender differencesNeck painPain serviceSevere painPain conditionsPain intensityChronic painTemporomandibular disordersPainful conditionsCardiovascular diseaseMigraine headacheHigh riskLower oddsMSD diagnosisUse disordersImpact of the Opioid Safety Initiative on opioid-related prescribing in veterans
Lin LA, Bohnert ASB, Kerns RD, Clay MA, Ganoczy D, Ilgen MA. Impact of the Opioid Safety Initiative on opioid-related prescribing in veterans. Pain 2017, 158: 833-839. PMID: 28240996, DOI: 10.1097/j.pain.0000000000000837.Peer-Reviewed Original ResearchConceptsOpioid Safety InitiativeVeterans Health AdministrationConcurrent benzodiazepineDaily opioid dosageElectronic medical record dataOutpatient opioid prescriptionsSafe opioid prescribingOpioid prescribing practicesMedical record dataInterrupted time series analysisSafety initiativesOpioid dosageOpioid prescribingOpioid prescriptionsOpioid regimensOutpatient prescribingVHA patientsPrescribing practicesVHA facilitiesAdverse outcomesSafe prescribingSystem-wide initiativesPrescribingPatientsOpioids
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 ResearchMeSH KeywordsAdultAnalgesics, OpioidDrug PrescriptionsFemaleFollow-Up StudiesGuideline AdherenceHumansMaleMiddle AgedMortalityPainSubstance-Related DisordersVeteransConceptsSubstance 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 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
2014
Persistent Pain and Comorbidity Among Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn Veterans
Higgins DM, Kerns RD, Brandt CA, Haskell SG, Bathulapalli H, Gilliam W, Goulet JL. Persistent Pain and Comorbidity Among Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn Veterans. Pain Medicine 2014, 15: 782-790. PMID: 24548466, DOI: 10.1111/pme.12388.Peer-Reviewed Original ResearchMeSH KeywordsAdultAfghan Campaign 2001-Chronic PainComorbidityDepressive DisorderFemaleHumansIraq War, 2003-2011Logistic ModelsLongitudinal StudiesMaleMiddle AgedMultivariate AnalysisObesityPrevalenceStress Disorders, Post-TraumaticSubstance-Related DisordersUnited StatesUnited States Department of Veterans AffairsVeteransConceptsVeterans Health AdministrationTraumatic brain injuryPersistent painBody mass indexMental health conditionsChronic painOperation Enduring FreedomHealth conditionsElectronic medical record dataChronic pain conditionsPredictors of incidentMedical record dataLongitudinal clinical dataImportant clinical implicationsSubstance use disordersOEF/OIF/OND veteransPost-traumatic stress disorderArmy service membersLogistic regression modelsPain conditionsComorbid conditionsClinical evidenceMass indexBrain injuryClinical data
2007
Systematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addiction.
Martell BA, O'Connor PG, Kerns RD, Becker WC, Morales KH, Kosten TR, Fiellin DA. Systematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addiction. Annals Of Internal Medicine 2007, 146: 116-27. PMID: 17227935, DOI: 10.7326/0003-4819-146-2-200701160-00006.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidChronic DiseaseClinical Trials as TopicDrug PrescriptionsHumansLow Back PainPrevalenceSubstance-Related DisordersUnited StatesConceptsChronic back painSubstance use disordersEfficacy of opioidsBack painMedication-taking behaviorUse disordersOpioid treatmentOpioid medicationsStudy qualityShort-term pain reliefCurrent substance use disorderCochrane Central RegisterLifetime substance use disorderControlled Clinical TrialsLong-term efficacyPoor study qualityEnglish-language studiesTransdermal opioidsOpioid prescribingPain reliefCentral RegisterDifferent opioidsReduced painClinical trialsNonsignificant reduction