Featured Publications
Association Between Exposure to Complementary and Integrative Therapies and Opioid Analgesic Daily Dose Among Patients on Long-term Opioid Therapy
Black AC, Zeliadt SB, Kerns RD, Skanderson M, Wang R, Gelman H, Douglas JH, Becker WC. Association Between Exposure to Complementary and Integrative Therapies and Opioid Analgesic Daily Dose Among Patients on Long-term Opioid Therapy. The Clinical Journal Of Pain 2022, 38: 405-409. PMID: 35440528, DOI: 10.1097/ajp.0000000000001039.Peer-Reviewed Original ResearchConceptsLong-term opioid therapyMorphine equivalent daily doseVeterans Health AdministrationDaily doseCIH exposureOpioid doseOpioid therapyWhole health systemCIH useVHA electronic health recordsIntegrative health modalitiesOpioid analgesic doseMean starting doseMental health diagnosesElectronic health recordsAnalgesic doseCIH therapiesNonopioid treatmentCohort entryOpioid taperingStarting doseAdverse eventsPain intensityChiropractic careVHA facilitiesClassification of Patients for Whom Benefit of Long-term Opioid Therapy No Longer Outweighs Harm: Protocol for a Delphi Study
Van Cleve R, Edmond S, Snow J, Black AC, Pomeranz JL, Becker W. Classification of Patients for Whom Benefit of Long-term Opioid Therapy No Longer Outweighs Harm: Protocol for a Delphi Study. JMIR Research Protocols 2022, 11: e33310. PMID: 35254277, PMCID: PMC8933798, DOI: 10.2196/33310.Peer-Reviewed Original ResearchLong-term opioid therapyINTERNATIONAL REGISTERED REPORT IDENTIFIERNew diagnostic entityDiagnostic entityOpioid therapySubset of patientsOpioid use disorderClassification of patientsInternal Review BoardChronic painOutweigh harmsClinical guidancePossible diagnostic criteriaDiagnostic criteriaUse disordersPatientsDelphi studyVeterans AffairsReview boardTherapyClinical phenomenaArt ConferenceThird roundDelphi techniqueParticipantsInitial development of patient-reported instrument assessing harm, efficacy, and misuse of long-term opioid therapy
Becker WC, Fiellin DA, Black AC, Kostovich CT, Kerns RD, Fraenkel L. Initial development of patient-reported instrument assessing harm, efficacy, and misuse of long-term opioid therapy. The Journal Of Rehabilitation Research And Development 2016, 53: 127-136. PMID: 27006339, PMCID: PMC4806533, DOI: 10.1682/jrrd.2014.11.0285.Peer-Reviewed Original ResearchConceptsLong-term opioid therapyPatient-reported instrumentOpioid therapyFurther item reductionIneffective medicationsClinical outcomesPrimary careFrequent reassessmentPatient comprehensionItem reductionGold standardEfficacyTherapyInterdisciplinary teamLevel checksCognitive interviewsMisuseHarmMedicationsPatientsLong-term opioid therapy trajectories and overdose in patients with and without cancer.
Merlin J, Black A, Midboe A, Troszak L, Asch S, Bohnert A, Fenton B, Giannitrapani K, Glassman P, Kerns R, Silveira M, Lorenz K, Abel E, Becker W. Long-term opioid therapy trajectories and overdose in patients with and without cancer. BMJ Oncology 2023, 2: e000023. PMID: 38259328, PMCID: PMC10802123, DOI: 10.1136/bmjonc-2022-000023.Peer-Reviewed Original ResearchLong-term opioid therapyVeterans Health Administration databaseRetrospective cohort studyCornerstone of managementOpioid overdose riskHealth Administration databaseOpioid-related overdosesPresence of cancerRole of cancerOpioid receiptOpioid therapyCohort studyConclusions PatientsMost patientsObjective painOpioid risksDose/Opioid overdoseOverdose riskInternational ClassificationLower riskPatientsEffect of trajectoriesCancerAdministration database
2024
Prescription Opioid Dose Change Prior to Fatal Opioid-Detected Overdose.
Kazemitabar M, Howell B, Becker W, Lin H, Grau L, Heimer R, D'Onofrio G, Hawk K, Fiellin D, Black A. Prescription Opioid Dose Change Prior to Fatal Opioid-Detected Overdose. Journal Of Studies On Alcohol And Drugs 2024 PMID: 38775307, DOI: 10.15288/jsad.24-00026.Peer-Reviewed Original ResearchPrescribed opioidsOpioid dose changesRapid dose increaseNon-HispanicOverdose deathsToxicological resultsNon-prescription opioidsBlack non-HispanicMorphine equivalentsOpioid therapyWhite non-HispanicDose changesDaily doseMean ageDispensed opioidsPrescription opioidsPrescribing patternsOpioidDose increaseOpioid overdose crisisIncreasing dosesStudy investigated patternsEffect of timeEffects of ageSecondary analysis
2023
Changes in opioid prescribing in veterans with headache during the COVID‐19 pandemic: A regression discontinuity in time analysis
Wang K, Fenton B, Skanderson M, Black A, Becker W, Seng E, Anthony S, Guirguis A, Altalib H, Kimber A, Lorenze N, Scholten J, Graham G, Sandbrink F, Sico J. Changes in opioid prescribing in veterans with headache during the COVID‐19 pandemic: A regression discontinuity in time analysis. Headache The Journal Of Head And Face Pain 2023, 63: 1295-1303. PMID: 37596904, DOI: 10.1111/head.14605.Peer-Reviewed Original ResearchMorphine equivalent daily dosesVeterans Health AdministrationNumber of prescriptionsOpioid prescribingOpioid prescriptionsLong-term opioid therapyMME/dayRetrospective cohort studyEquivalent daily dosesCOVID-19 pandemicOpioid therapyPre-pandemic periodCohort studyDaily doseChronic painOutpatient visitsPrevious diagnosisDaily dosesMean ageSubgroup analysisHeadache disordersOpioid accessHealth AdministrationPrescribingCoronavirus disease
2022
Delphi study to explore a new diagnosis for “ineffective” long-term opioid therapy for chronic pain
Edmond S, Snow J, Pomeranz J, Van Cleve R, Black A, Compton P, Becker W. Delphi study to explore a new diagnosis for “ineffective” long-term opioid therapy for chronic pain. Pain 2022, 164: 870-876. PMID: 36448976, DOI: 10.1097/j.pain.0000000000002783.Peer-Reviewed Original ResearchConceptsLong-term opioid therapyNew diagnostic entityDiagnostic criteriaPotential diagnostic criteriaDiagnostic entityOpioid therapyChronic painOpioid use disorderCertain patientsNew diagnosisUse disordersDelphi studyPainDisorder criteriaSubgroup of expertsRound 2PatientsTherapyThree-quartersRefining criteriaDelphi panelistsExpert panelistsSubgroupsLikert-type scaleRapid qualitative analysisLong-Term Opioid Therapy and Overdose in Patients With and Without Cancer (CO203A)
Merlin J, Black A, Troszak L, Giannitrapani K, Lorenz K. Long-Term Opioid Therapy and Overdose in Patients With and Without Cancer (CO203A). Journal Of Pain And Symptom Management 2022, 63: 1065-1066. DOI: 10.1016/j.jpainsymman.2022.04.013.Peer-Reviewed Original ResearchLong-term opioid therapyOpioid therapyOpioid prescriptionsOpioid overdoseElectronic health record databaseTerm opioid therapyCancer pain managementRetrospective cohort studyCox proportional hazardsOpioid overdose riskHealth record databaseYears of ageRole of cancerOpioid receiptCohort studyMost patientsPain managementOutpatient visitsInpatient admissionsVHA careOpioid risksDose/Inclusion criteriaOverdose riskLatent growth mixture modelingLong-term Opioid Therapy and Overdose in Patients with and without Cancer
Merlin J, Black A, Midboe A, Troszak L, Asch S, Bohnert A, Fenton B, Giannitrapani K, Glassman P, Kerns R, Silveira M, Lorenz K, Becker W. Long-term Opioid Therapy and Overdose in Patients with and without Cancer. Journal Of Pain 2022, 23: 60. DOI: 10.1016/j.jpain.2022.03.225.Peer-Reviewed Original ResearchLong-term opioid therapyOpioid therapyCox proportional hazard modelingElectronic health record databaseCancer pain managementRetrospective cohort studyProportional hazard modelingOpioid overdose riskHealth record databasePresence of cancerRole of cancerOpioid receiptCohort entryCohort studyHazard ratioMost patientsPain managementOpioid risksDose/Inclusion criteriaOpioid overdoseOverdose riskLatent growth mixture modelingLower riskPatients