2024
Buprenorphine for Opioid Use Disorder—An Essential Medical Treatment
Weimer M, Morford K. Buprenorphine for Opioid Use Disorder—An Essential Medical Treatment. JAMA Internal Medicine 2024, 184: 1248-1249. PMID: 39186298, DOI: 10.1001/jamainternmed.2024.3977.Peer-Reviewed Original ResearchLong-Term Use of Muscle Relaxant Medications for Chronic Pain
Oldfield B, Gleeson B, Morford K, Adams Z, Funaro M, Becker W, Merlin J. Long-Term Use of Muscle Relaxant Medications for Chronic Pain. JAMA Network Open 2024, 7: e2434835. PMID: 39298168, PMCID: PMC11413720, DOI: 10.1001/jamanetworkopen.2024.34835.Peer-Reviewed Original ResearchConceptsLow back painBack painSkeletal muscle relaxantsChronic painRandomized clinical trialsNeck painCohort studyEfficacy of long-term useLong-term useSystematically searched Ovid MEDLINEMuscle relaxant medicationsModerate risk of biasOpioid prescribing guidelinesRisk of biasQuality of cohort studiesWeb of SciencePainful crampsRelaxant medicationsChronic pain syndromesPainful spasmsOvid MEDLINEPrescribing guidelinesSystematic reviewIncreased prescriptionModerate riskHepatitis C virus and integrated care for substance use disorders
Mahoney B, Morford K, Biegacki E, Tetrault J. Hepatitis C virus and integrated care for substance use disorders. Clinical Liver Disease 2024, 23: e0241. PMID: 38952692, PMCID: PMC11216679, DOI: 10.1097/cld.0000000000000241.Peer-Reviewed Original ResearchTo the Editor: Let This Be the Last Call to Action to Train Residents in Addiction.
Chan C, Binder M, Levander X, Morford K. To the Editor: Let This Be the Last Call to Action to Train Residents in Addiction. Journal Of Graduate Medical Education 2024, 16: 369-370. PMID: 38882438, PMCID: PMC11173032, DOI: 10.4300/jgme-d-24-00147.1.Peer-Reviewed Original ResearchThe MATE Act: Progress for substance use education, but is checking a box enough?
Morford K, Tetrault J, Fiellin D. The MATE Act: Progress for substance use education, but is checking a box enough? Journal Of General Internal Medicine 2024, 39: 1496-1498. PMID: 38308156, PMCID: PMC11169132, DOI: 10.1007/s11606-024-08652-7.Peer-Reviewed Original Research
2023
Medical improvisation-based motivational interviewing for internal medicine residents: Mixed-methods evaluation of a novel course
Chan C, Cabaniss P, Morford K, Martino S, Martin A, Windish D. Medical improvisation-based motivational interviewing for internal medicine residents: Mixed-methods evaluation of a novel course. Medical Teacher 2023, 45: 1411-1418. PMID: 37378496, DOI: 10.1080/0142159x.2023.2225725.Peer-Reviewed Original ResearchRecognition and Treatment of Wounds in Persons Using Xylazine: A Case Report From New Haven, Connecticut
Dowton A, Doernberg M, Heiman E, Barelli P, Golden M, Wang H, Leventhal J, Morford K, Sue K. Recognition and Treatment of Wounds in Persons Using Xylazine: A Case Report From New Haven, Connecticut. Journal Of Addiction Medicine 2023, 17: 739-741. PMID: 37934550, DOI: 10.1097/adm.0000000000001198.Peer-Reviewed Original ResearchConceptsOpioid use disorderUse disordersDrug useCase report presentsIndex of suspicionInjection drug useDrug supplyCare management strategiesHarm reduction strategiesOverdose presentationsCutaneous manifestationsWithdrawal syndromeClinical complicationsCase reportIntravenous useWound carePatientsTreatment of woundsInfectious diseasesChronic woundsXylazineSkin woundsWoundsMore reportingDiagnosisFacilitation and Preferred Models for Delivering Substance Use Disorder Treatment in HIV Clinics: Results From a Multisite Randomized Trial
Muvvala S, Gan G, Morford K, Dziura J, Esserman D, Porter E, Chan P, Cornman D, Reynolds J, Yager J, Fiellin D, Edelman E. Facilitation and Preferred Models for Delivering Substance Use Disorder Treatment in HIV Clinics: Results From a Multisite Randomized Trial. Journal Of Addiction Medicine 2023, 17: e388-e391. PMID: 37934538, PMCID: PMC10726383, DOI: 10.1097/adm.0000000000001192.Peer-Reviewed Original ResearchConceptsOpioid use disorderAlcohol use disorderTobacco use disorderHIV clinicUse disordersAddiction treatmentSubstance use disorder treatmentUse disorder treatmentMaintenance phaseRandomized trialsStaff preferencesImproved outcomesMultisite Randomized TrialImplementation facilitationDisorder treatmentControl phaseClinicCliniciansTreatment modelTreatmentDisordersSignificant differencesInterventionHigher proportionAddiction treatment models
2022
The impact of benzodiazepine exposure on treatment retention in an open-access methadone program: A retrospective cohort study
Morford K, Tetrault J, Zhou B, Li F, Gleeson B, Edelman E, Stein M, Barry D, Madden L. The impact of benzodiazepine exposure on treatment retention in an open-access methadone program: A retrospective cohort study. Drug And Alcohol Dependence 2022, 241: 109707. PMID: 36423462, PMCID: PMC9777057, DOI: 10.1016/j.drugalcdep.2022.109707.Peer-Reviewed Original ResearchConceptsBenzodiazepine exposureRetrospective cohort studyKaplan-Meier analysisTreatment retentionCohort studyCox regressionTreatment durationMedian treatment durationMultivariable Cox regressionCohort of patientsOpioid treatment programsOpioid use disorderLog-rank testSame-day accessDrug Administration recommendationsTreatment discontinuationUrine toxicologyMeier analysisMethadone programsUse disordersPatientsAdministration recommendationsTreatment entryTreatment programTreatment barriersGrief at the Heart of the Opioid Overdose Crisis: Past Lessons and Present Implications
Morford KL, Batchelor HM, Tetrault JM. Grief at the Heart of the Opioid Overdose Crisis: Past Lessons and Present Implications. Journal Of Addiction Medicine 2022, 16: 613-615. PMID: 35165230, DOI: 10.1097/adm.0000000000000976.Peer-Reviewed Original ResearchConceptsOpioid use disorderOpioid overdose crisisOverdose crisisImmunodeficiency syndrome (AIDS) epidemicCare of peopleTreatment outcomesOverdose deathsUse disordersEmotional burdenSocial support networksContext of stigmaHarmful consequencesSupport networksRole of griefGriefPatientsOverdoseCliniciansEffect of Implementation Facilitation to Promote Adoption of Medications for Addiction Treatment in US HIV Clinics
Edelman EJ, Gan G, Dziura J, Esserman D, Porter E, Becker WC, Chan PA, Cornman DH, Helfrich CD, Reynolds J, Yager JE, Morford KL, Muvvala SB, Fiellin DA. Effect of Implementation Facilitation to Promote Adoption of Medications for Addiction Treatment in US HIV Clinics. JAMA Network Open 2022, 5: e2236904. PMID: 36251291, PMCID: PMC9577676, DOI: 10.1001/jamanetworkopen.2022.36904.Peer-Reviewed Original ResearchConceptsTobacco use disorderHIV clinicOpioid use disorderUse disordersAlcohol use disorderAddiction treatmentControl periodImplementation facilitationAdoption of medicationsMulticomponent implementation strategyProvision of MOUDUS HIV clinicsMaintenance periodElectronic health record dataHealth record dataEvaluation periodAdult patientsMean ageClinical trialsMAIN OUTCOMEClinicMOUDPatientsDisordersPatient incentivesXylazine and Overdoses: Trends, Concerns, and Recommendations.
Alexander RS, Canver BR, Sue KL, Morford KL. Xylazine and Overdoses: Trends, Concerns, and Recommendations. American Journal Of Public Health 2022, 112: 1212-1216. PMID: 35830662, PMCID: PMC9342814, DOI: 10.2105/ajph.2022.306881.Peer-Reviewed Original ResearchConceptsIllicit drug supplyDrug supplyNovel treatment strategiesPublic health interventionsPublic health systemHarm reduction strategiesTreatment strategiesOverdose deathsHealth interventionsStriking prevalenceHealth systemXylazineExposure levelsPrevalencePotential riskPotential toxicityOpioidsOverdosesPatients' perspectives of medications for addiction treatment in HIV clinics: A qualitative study
Morford KL, Muvvala SB, Chan PA, Cornman DH, Doernberg M, Porter E, Virata M, Yager JE, Fiellin DA, Edelman EJ. Patients' perspectives of medications for addiction treatment in HIV clinics: A qualitative study. Journal Of Substance Use And Addiction Treatment 2022, 139: 108767. PMID: 35341613, PMCID: PMC9187601, DOI: 10.1016/j.jsat.2022.108767.Peer-Reviewed Original ResearchConceptsSubstance use disordersHIV clinicAddiction treatmentSubstance useEvidence-based medicationsMedication treatment optionsMedication side effectsHealth Services frameworkFocus groupsHIV cliniciansTreatment optionsMultidisciplinary screeningChronic diseasesPatient educationPatient's perspectivePromoting ActionStudy populationDisorder careSide effectsUse disordersPatient receptivityQualitative studyOverall healthClinicKnowledge deficitsImplementation Facilitation and adoption of addiction treatments in HIV clinics: a randomized trial
Edelman EJ, Gan, G, Dziura D, Esserman D, Porter E, Becker WC, Chan PA, Cornman DH, Helfrich CD, Reynolds J, Yager JE, Morford KL, Muvvala SB, and Fiellin DA. Implementation Facilitation and adoption of addiction treatments in HIV clinics: a randomized trial. JAMA Network Open, in press.Peer-Reviewed Original ResearchBenzodiazepines and Related Sedatives
Peng L, Morford KL, Levander XA. Benzodiazepines and Related Sedatives. Medical Clinics Of North America 2022, 106: 113-129. PMID: 34823725, DOI: 10.1016/j.mcna.2021.08.012.ChaptersConceptsLong-term benzodiazepine useQuality of evidenceRisk of overdoseSignificant adverse effectsCognitive behavioral therapySedative useBenzodiazepine useBenzodiazepine discontinuationPharmacologic propertiesBenzodiazepine taperWithdrawal managementPhysical dependenceBehavioral treatmentBehavioral therapyBenzodiazepinesDetoxification facilityNovel psychoactive substancesAdverse effectsDesigner benzodiazepinesPsychoactive substancesMost benefitDiscontinuationMedicationsSedativesOverdose
2021
Low Dose Initiation of Buprenorphine: A Narrative Review and Practical Approach
Cohen SM, Weimer MB, Levander XA, Peckham AM, Tetrault JM, Morford KL. Low Dose Initiation of Buprenorphine: A Narrative Review and Practical Approach. Journal Of Addiction Medicine 2021, 16: 399-406. PMID: 34954746, DOI: 10.1097/adm.0000000000000945.Peer-Reviewed Original ResearchConceptsLow dose initiationFull opioid agonistsDose initiationOpioid withdrawal symptomsOpioid agonistsBuprenorphine doseWithdrawal symptomsHigh potency synthetic opioidsOpioid use disorderAppropriate clinical situationsMu-opioid receptorsBuprenorphine initiationOpioid withdrawalStarting doseOutpatient settingCare coordinationDose changesOverdose deathsCurrent evidenceUse disordersBuprenorphineTherapeutic levelsClinical situationsSynthetic opioidsNarrative reviewTraining Medical Students, Residents, and Fellows in Opioid Use Disorder Treatment
Morford K, Falker C, Tetrault J. Training Medical Students, Residents, and Fellows in Opioid Use Disorder Treatment. 2021, 161-171. DOI: 10.1007/978-3-030-80818-1_11.Peer-Reviewed Original ResearchMedical educationCompetency-based assessmentOpioid use disorderEducational gapMedical studentsRole modelingTrainee assessmentEffective workforceCore contentEarly clinical experienceEducational interventionTraining materialsTraining levelEducationSpecific instructionsFirst-line treatment optionOpioid use disorder treatmentKey recommendationsLarge treatment gapClinical experienceOpioid-related morbidityEvidence-based treatmentsUse disorder treatmentCurriculumInstitutional strengthReadiness to Provide Medications for Addiction Treatment in HIV Clinics: A Multisite Mixed-Methods Formative Evaluation
Edelman EJ, Gan G, Dziura J, Esserman D, Morford KL, Porter E, Chan PA, Cornman DH, Oldfield BJ, Yager JE, Muvvala SB, Fiellin DA. Readiness to Provide Medications for Addiction Treatment in HIV Clinics: A Multisite Mixed-Methods Formative Evaluation. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2021, 87: 959-970. PMID: 33675619, PMCID: PMC8192340, DOI: 10.1097/qai.0000000000002666.Peer-Reviewed Original ResearchConceptsHIV clinicTreatment medicationsMixed-methods formative evaluationAddiction treatmentTreatment-eligible patientsSubscale scoresAddiction treatment medicationsAdverse health consequencesHIV careMedication complexityTobacco useMedicationsClinicHealth consequencesSite specialistMultidisciplinary teamworkBehavioral servicesTreatment modelOpioidsLocal championsVariable experienceInconsistent availabilityAddiction treatment modelsFocus groupsTreatmentPeer coaching in an interprofessional academic primary care clinic
Morford K, Milligan T, Brienza R. Peer coaching in an interprofessional academic primary care clinic. Journal Of Interprofessional Education & Practice 2021, 23: 100418. DOI: 10.1016/j.xjep.2021.100418.Peer-Reviewed Original ResearchPrimary care clinicsAcademic primary care clinicCare clinicsMotivational interviewing strategiesDirect clinical observationBrief didactic sessionInternal medicine residentsPeer coachesNurse practitionersClinical observationsChief medical residentsCollaborative communication stylePatient encountersPractice settingsClinic observationsClinicMedicine residentsMedical residentsEvaluation questionnaireInterprofessional learning environmentDidactic sessionsInsight ScaleHealth professionsInterprofessional settingSkill demonstrationLaw enforcement assisted diversion: Qualitative evaluation of barriers and facilitators of program implementation
Joudrey PJ, Nelson CR, Lawson K, Morford KL, Muley D, Watson C, Okafor M, Wang EA, Crusto C. Law enforcement assisted diversion: Qualitative evaluation of barriers and facilitators of program implementation. Journal Of Substance Use And Addiction Treatment 2021, 129: 108476. PMID: 34080562, PMCID: PMC8380645, DOI: 10.1016/j.jsat.2021.108476.Peer-Reviewed Original ResearchConceptsSubstance use disordersChronic diseasesIntegrated Promoting ActionHealth Services frameworkHealth care providersSubstance use treatmentPositive longitudinal relationshipPromoting ActionCare providersUse disordersUse treatmentSubstance useSemi-structured interviewsLead professionalsProcedural complexityLongitudinal relationshipDiseaseResearch implementationOngoing trainingProgram implementationDiversionNew HavenLead programFacilitatorsQualitative evaluation