2024
Integrating methadone into primary care settings in Ukraine: effects on provider stigma and knowledge
Bromberg D, Machavariani E, Madden L, Dumchev K, LaMonaca K, Earnshaw V, Pykalo I, Filippovych M, Haddad M, Dvoriak S, Altice F. Integrating methadone into primary care settings in Ukraine: effects on provider stigma and knowledge. Journal Of The International AIDS Society 2024, 27: e26202. PMID: 38379179, PMCID: PMC10879646, DOI: 10.1002/jia2.26202.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidHIV InfectionsHumansMethadonePrimary Health CareSubstance Abuse, IntravenousUkraineConceptsPrimary care clinicsStigma reduction interventionsOpioid agonist therapyClinicians' attitudesStigma constructsHIV preventionReduction interventionsEvidence-based HIV preventionCluster randomized controlled trialEvidence-based carePrimary care settingIntegrated care sitesDirect providersRandomized controlled trialsProvider stigmaCare clinicsCare sitesHIV careCare settingsHealth outcomesClinical staffSubstance use disordersLinear mixed-effects modelsTreatment continuumImprove attitudes
2023
High perceived stress in patients on opioid agonist therapies during rapid transitional response to the COVID-19 pandemic in Ukraine
Galvez S, Altice F, Meteliuk A, Ivasiy R, Machavariani E, Farnum S, Fomenko T, Islam Z, Madden L. High perceived stress in patients on opioid agonist therapies during rapid transitional response to the COVID-19 pandemic in Ukraine. Frontiers In Public Health 2023, 11: 1231581. PMID: 38098837, PMCID: PMC10720365, DOI: 10.3389/fpubh.2023.1231581.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidCOVID-19HumansOpioid-Related DisordersPandemicsStress, PsychologicalSubstance Abuse, IntravenousUkraineConceptsOpioid agonist therapyOpioid use disorderAgonist therapyOAT patientsCOVID-19 pandemicSubstance useTake-home dosingAdditional psychosocial supportHigher perceived stressHigh riskPerceived Stress ScalePsychiatric disordersUse disordersPatientsPatient stressPsychosocial supportCertain subgroupsSevere levelsHigh levelsHealthcare deliveryStress ScalePerceived stressTherapyExtraordinary high levelsDisordersDesign, implementation and preliminary results of a type-2 hybrid cluster-randomized trial of integrating screening and treatment for major depressive disorder into specialty clinics providing opioid agonist therapies in Ukraine
Machavariani E, Bromberg D, Dumchev K, Dvoriak S, Zeziulin O, Morozova O, Esserman D, Pykalo I, Saichuk N, Ivasiy R, Haddad M, Altice F. Design, implementation and preliminary results of a type-2 hybrid cluster-randomized trial of integrating screening and treatment for major depressive disorder into specialty clinics providing opioid agonist therapies in Ukraine. Contemporary Clinical Trials 2023, 131: 107248. PMID: 37263492, PMCID: PMC10527419, DOI: 10.1016/j.cct.2023.107248.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidDepressive Disorder, MajorHumansOpioid-Related DisordersSubstance Abuse, IntravenousUkraineConceptsOpioid agonist therapyMajor depressive disorderCo-occurring disordersAgonist therapyDepressive disorderSpecialty clinicPsychiatric disordersPatient-level outcomesPrevalent psychiatric disordersCluster-randomized trialPoor health outcomesProvider-level dataMDD treatmentTreatment algorithmExperimental armHigh prevalenceDelivery outcomesHealth outcomesSerial surveysClinicPatientsProject ECHOSubstance useMonthsDisorders
2022
Impact of prerelease methadone on mortality among people with HIV and opioid use disorder after prison release: results from a randomized and participant choice open-label trial in Malaysia
Bazazi A, Culbert G, Wegman M, Heimer R, Kamarulzaman A, Altice F. Impact of prerelease methadone on mortality among people with HIV and opioid use disorder after prison release: results from a randomized and participant choice open-label trial in Malaysia. BMC Infectious Diseases 2022, 22: 837. PMID: 36368939, PMCID: PMC9652918, DOI: 10.1186/s12879-022-07804-6.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidHIV InfectionsHumansMalaysiaMaleMethadoneOpiate Substitution TreatmentOpioid-Related DisordersPrisonersPrisonsConceptsOpioid use disorderOpioid agonist therapyInfectious etiologyMost deathsUse disordersSample of menPrison releaseOpen-label trialT-lymphocyte countsPredictors of mortalityNational death recordsCrude mortality rateProportional hazards modelCovariate-adjusted modelsLow CD4Methadone initiationModified intentionAgonist therapySurvival benefitTreat analysisMethodsThis studyHIVHazards modelMortality rateMethadoneCollaborative learning and response to opioid misuse and HIV prevention in Ukraine during war
Altice FL, Bromberg DJ, Klepikov A, Barzilay EJ, Islam Z, Dvoriak S, Farnum SO, Madden LM. Collaborative learning and response to opioid misuse and HIV prevention in Ukraine during war. The Lancet Psychiatry 2022, 9: 852-854. PMID: 36244353, PMCID: PMC9806953, DOI: 10.1016/s2215-0366(22)00318-2.Peer-Reviewed Original ResearchInterest without uptake: A mixed-methods analysis of methadone utilization in Kyrgyz prisons
Liberman AR, Bromberg DJ, Litz T, Kurmanalieva A, Galvez S, Rozanova J, Azbel L, Meyer JP, Altice FL. Interest without uptake: A mixed-methods analysis of methadone utilization in Kyrgyz prisons. PLOS ONE 2022, 17: e0276723. PMID: 36282864, PMCID: PMC9595522, DOI: 10.1371/journal.pone.0276723.Peer-Reviewed Original ResearchMeSH KeywordsAcquired Immunodeficiency SyndromeAnalgesics, OpioidHumansMethadoneOpiate Substitution TreatmentOpioid-Related DisordersPrisonersPrisonsConceptsKyrgyz prisonsCriminal justice systemDepth qualitative interviewsMethadone utilizationMethadone treatmentMixed-method analysisBrief interventionJustice systemPrison systemCriminal subcultureQualitative interviewsEastern EuropeEvidence-based HIV prevention strategiesCentral AsiaKyrgyz RepublicQualitative findingsPrison releaseHIV prevention strategiesPrisonInjection drug useMedication-assisted therapyMethadone uptakeInterpersonal relationshipsAttitudesHealth-related concernsReinfection and Risk Behaviors After Treatment of Hepatitis C Virus Infection in Persons Receiving Opioid Agonist Therapy : A Cohort Study.
Grebely J, Dore GJ, Altice FL, Conway B, Litwin AH, Norton BL, Dalgard O, Gane EJ, Shibolet O, Nahass R, Luetkemeyer AF, Peng CY, Iser D, Gendrano IN, Kelly MM, Hwang P, Asante-Appiah E, Haber BA, Barr E, Robertson MN, Platt H. Reinfection and Risk Behaviors After Treatment of Hepatitis C Virus Infection in Persons Receiving Opioid Agonist Therapy : A Cohort Study. Annals Of Internal Medicine 2022, 175: 1221-1229. PMID: 35939812, DOI: 10.7326/m21-4119.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAnalgesics, OpioidCohort StudiesHepatitis C, ChronicHumansReinfectionRisk-TakingSubstance Abuse, IntravenousConceptsOpioid agonist therapyLong-term extension studyHCV reinfectionDrug useExtension studyAgonist therapySuccessful treatmentHepatitis C virus (HCV) reinfectionHepatitis C virus infectionBenefits of cureC virus infectionChronic HCV infectionRate of reinfectionUrine drug screeningOngoing drug useClinical trial sitesSubsidiary of MerckHCV infectionCohort studyVirus reinfectionDohme Corp.Treatment completionGenotype 1Virus infectionHigh riskHealth-related quality of life in people receiving opioid agonist treatment and treatment for hepatitis C virus infection
Dalgard O, Litwin AH, Shibolet O, Grebely J, Nahass R, Altice FL, Conway B, Gane EJ, Luetkemeyer AF, Peng CY, Iser D, Gendrano IN, Kelly MM, Haber BA, Platt H, Puenpatom A. Health-related quality of life in people receiving opioid agonist treatment and treatment for hepatitis C virus infection. Journal Of Addictive Diseases 2022, 41: 213-224. PMID: 35920743, DOI: 10.1080/10550887.2022.2088978.Peer-Reviewed Original ResearchMeSH KeywordsAdultAmidesAnalgesics, OpioidAntiviral AgentsHepacivirusHepatitis C, ChronicHumansQuality of LifeConceptsElbasvir/grazoprevirHepatitis C virus infectionC virus infectionOpioid agonist therapyHealth-related qualityEnd of treatmentHCV infectionAgonist therapyVirus infectionChronic hepatitis C virus (HCV) infectionImproved health-related qualityMental component summary scoresTreatment week 4Placebo-controlled studyOpioid agonist treatmentMedical Outcomes StudyComponent summary scoresSF-36v2 scoresTreatment differencesImproved HRQOLViral eradicationActing antiviralsOpioid dependenceAgonist treatmentGeneral healthThe development and initial validation of the Russian version of the BASIS-24
Madden L, Farnum S, Bromberg D, Barry D, Mazhnaya A, Fomenko T, Meteliuk A, Marcus R, Rozanova J, Poklad I, Dvoriak S, Altice F. The development and initial validation of the Russian version of the BASIS-24. Addiction Science & Clinical Practice 2022, 17: 65. PMID: 36435811, PMCID: PMC9701377, DOI: 10.1186/s13722-022-00343-0.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidHIV InfectionsHumansOpioid-Related DisordersReproducibility of ResultsRussiaConceptsBASIS-24Addiction treatmentHIV prevention goalsSubset of patientsOpioid use disorderSymptom Identification ScaleMental health statusResultsCronbach’s alpha coefficientsMOUD patientsSeverity InstrumentTuberculosis epidemicEffective treatmentUse disordersHealth statusHealthcare professionalsMental healthPrevention goalsRelationships subscaleTreatment deliveryExploratory principal component analysisOpioidsHIVPatientsAlpha coefficientEECA region
2021
Successful transfer of stable patients on opioid agonist therapies from specialty addiction treatment to primary care settings in Ukraine: A pilot study
Meteliuk A, Galvez S, Fomenko T, Kalandiia H, Iaryi V, Farnum SO, Islam Z, Altice FL, Madden LM. Successful transfer of stable patients on opioid agonist therapies from specialty addiction treatment to primary care settings in Ukraine: A pilot study. Journal Of Substance Use And Addiction Treatment 2021, 134: 108619. PMID: 34579978, DOI: 10.1016/j.jsat.2021.108619.Peer-Reviewed Original ResearchConceptsOpioid agonist therapyPrimary care clinicsPrimary care settingOAT coverageAgonist therapyStable patientsCare clinicsSubstance useCare settingsNegative urine drug testsSpecialty addictions treatmentUrine drug testsSymptom Identification ScaleMental health symptomsAddiction treatment clinicsHIV transmissionPrimary careTreatment clinicsOAT patientsBASIS-24PatientsHealth symptomsEmotional labilityAddiction treatmentPilot studyPurposeful Fentanyl Use and Associated Factors among Opioid-Dependent People Who Inject Drugs
Chandra DK, Altice FL, Copenhaver MM, Zhou X, Didomizio E, Shrestha R. Purposeful Fentanyl Use and Associated Factors among Opioid-Dependent People Who Inject Drugs. Substance Use & Misuse 2021, 56: 979-987. PMID: 33769199, DOI: 10.1080/10826084.2021.1901931.Peer-Reviewed Original ResearchConceptsOpioid-dependent PWIDFentanyl useOpioid-dependent peopleIndependent correlatesSevere depressionSex-related risk behaviorsMethadone-maintained patientsMultivariable logistic regressionOpioid-related mortalityRecent cocaine useCross-sectional surveySelf-reported drugMethadone dosageYoung PWIDDaily injectionsMethadone clinicsAssociated FactorsFentanyl exposureHigh prevalencePWIDSynthetic opioidsCocaine useYounger ageRisk behaviorsLogistic regressionModelling the intervention effect of opioid agonist treatment on multiple mortality outcomes in people who inject drugs: a three-setting analysis
Stone J, Degenhardt L, Grebely J, Larney S, Altice FL, Smyrnov P, Rahimi-Movaghar A, Alavi M, Young AM, Havens JR, Miller WC, Hickman M, Vickerman P. Modelling the intervention effect of opioid agonist treatment on multiple mortality outcomes in people who inject drugs: a three-setting analysis. The Lancet Psychiatry 2021, 8: 301-309. PMID: 33640039, PMCID: PMC8255389, DOI: 10.1016/s2215-0366(20)30538-1.Peer-Reviewed Original ResearchConceptsOpioid agonist treatmentDrug-related deathsOAT coverageDrug-related harmAgonist treatmentHepatitis C virus transmissionC virus transmissionOverall health benefitsUK National InstituteNational InstituteHIV 0OAT retentionHIV mortalityInjury 3Opioid dependenceMortality outcomesUS National InstitutesHCV-2Overdose deathsSignificant additional effectIntervention effectsDrug abuseHealth benefitsMortalityDeathThe opioid crisis and HIV in the USA: deadly synergies
Hodder SL, Feinberg J, Strathdee SA, Shoptaw S, Altice FL, Ortenzio L, Beyrer C. The opioid crisis and HIV in the USA: deadly synergies. The Lancet 2021, 397: 1139-1150. PMID: 33617769, DOI: 10.1016/s0140-6736(21)00391-3.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAnalgesics, OpioidBlack or African AmericanCase-Control StudiesDisease OutbreaksEvidence-Based MedicineFemaleFentanylHealth Services AccessibilityHispanic or LatinoHIV InfectionsHumansMaleNeedle SharingOpiate OverdoseOpioid EpidemicOpioid-Related DisordersSocial StigmaUnited StatesWhite PeopleYoung AdultConceptsNew HIV diagnosesHIV diagnosisOpioid epidemicHIV preventionMultiple evidence-based interventionsGreat public health problemRecent HIV outbreaksOpioid overdose death ratesOpioid use disorderLarge central metropolitan areasPublic health problemOverdose death ratesComprehensive health careEvidence-based interventionsDeadly synergyHIV acquisitionSynthetic opioid fentanylSyringe sharingHIV outbreakUse disordersOpioid fentanylTreatment servicesHealth problemsOpioid crisisDeath rateWillingness to initiate pre-exposure prophylaxis (PrEP) and its use among opioid-dependent individuals in drug treatment
Ni Z, Altice FL, Wickersham JA, Copenhaver MM, DiDomizio EE, Nelson LE, Shrestha R. Willingness to initiate pre-exposure prophylaxis (PrEP) and its use among opioid-dependent individuals in drug treatment. Drug And Alcohol Dependence 2021, 219: 108477. PMID: 33422864, PMCID: PMC7946167, DOI: 10.1016/j.drugalcdep.2020.108477.Peer-Reviewed Original ResearchConceptsOpioid-dependent individualsPre-exposure prophylaxisPrEP useHIV riskHealthcare providersSex-related risk behaviorsMultivariable logistic regression analysisAwareness of PrEPUrban methadone clinicMultiple logistic regressionDisproportionate HIV burdenLogistic regression analysisCross-sectional surveyHIV burdenHIV infectionHIV testingIndependent correlatesMethadone clinicsDrug treatmentRisk behaviorsLogistic regressionPrEPPrevious useHigher likelihoodProphylaxis
2020
Rapid transitional response to the COVID-19 pandemic by opioid agonist treatment programs in Ukraine
Meteliuk A, Galvez de Leon SJ, Madden LM, Pykalo I, Fomenko T, Filippovych M, Farnum SO, Dvoryak S, Islam ZM, Altice FL. Rapid transitional response to the COVID-19 pandemic by opioid agonist treatment programs in Ukraine. Journal Of Substance Use And Addiction Treatment 2020, 121: 108164. PMID: 33191004, PMCID: PMC7769928, DOI: 10.1016/j.jsat.2020.108164.Peer-Reviewed Original ResearchConceptsOpioid agonist therapyTake-home dosingInterim guidanceShort-term overall mortalityOpioid agonist treatment programPerson clinical encountersOAT deliveryAgonist therapyOverall mortalityCOVID-19 transmissionPatient dropoutOAT patientsNaloxone distributionOverdose educationClinical practiceClinic interactionsTreatment programClinical encountersPatientsCliniciansCOVID-19COVID-19 pandemicOverdosesDosingPrevious yearThe real‐world impact of dosing of methadone and buprenorphine in retention on opioid agonist therapies in Ukraine
Farnum SO, Makarenko I, Madden L, Mazhnaya A, Marcus R, Prokhorova T, Bojko MJ, Rozanova J, Dvoriak S, Islam Z, Altice FL. The real‐world impact of dosing of methadone and buprenorphine in retention on opioid agonist therapies in Ukraine. Addiction 2020, 116: 83-93. PMID: 32428276, PMCID: PMC7674222, DOI: 10.1111/add.15115.Peer-Reviewed Original ResearchConceptsOpioid agonist therapyOAT discontinuationAgonist therapyTreatment retentionIndependent predictorsHIV epidemicCost-effective HIV prevention strategyMethadone maintenance treatment patientsObservational longitudinal cohort studySpecialty addictions treatmentBuprenorphine maintenance treatmentHigh dosageHIV prevention strategiesLongitudinal cohort studyOpioid-dependent peopleTreatment discontinuationCohort studyMaintenance treatmentMale sexTreatment patientsPrevention strategiesDiscontinuationYounger ageCenter settingAddiction treatment
2019
Effect of expanding opioid agonist therapies on the HIV epidemic and mortality in Ukraine: a modelling study
Tan J, Altice FL, Madden LM, Zelenev A. Effect of expanding opioid agonist therapies on the HIV epidemic and mortality in Ukraine: a modelling study. The Lancet HIV 2019, 7: e121-e128. PMID: 31879250, PMCID: PMC7289179, DOI: 10.1016/s2352-3018(19)30373-x.Peer-Reviewed Original ResearchConceptsOpioid agonist therapyNew HIV infectionsHigh HIV burdenHIV infectionMinistry of HealthOAT coverageAgonist therapyHIV burdenHIV incidenceBuprenorphine maintenance therapyPublic Health CenterMaintenance therapyHIV outcomesHIV prevalenceHIV transmissionMedication procurementHIV epidemicHealth centersHIV preventionTreatment goalsPWIDOAT expansionDisease controlSexual riskInfectionCost‐effectiveness of expanding the capacity of opioid agonist treatment in Ukraine: dynamic modeling analysis
Morozova O, Crawford FW, Cohen T, Paltiel AD, Altice FL. Cost‐effectiveness of expanding the capacity of opioid agonist treatment in Ukraine: dynamic modeling analysis. Addiction 2019, 115: 437-450. PMID: 31478285, PMCID: PMC7015766, DOI: 10.1111/add.14797.Peer-Reviewed Original ResearchConceptsOpioid agonist treatmentOpioid use disorderOAT coverageAgonist treatmentGross domestic productOpioid use initiationOpioid addiction epidemicOAT accessHIV epidemicUse disordersAddiction epidemicCapita gross domestic productPay thresholdsTreatment demandUse initiationAddiction treatmentIncremental costBaseline capacityTreatmentPotential peer effectsDomestic productTreatment spilloversEpidemicPeer effectsCoverage levelsGlobal patterns of opioid use and dependence: harms to populations, interventions, and future action
Degenhardt L, Grebely J, Stone J, Hickman M, Vickerman P, Marshall BDL, Bruneau J, Altice FL, Henderson G, Rahimi-Movaghar A, Larney S. Global patterns of opioid use and dependence: harms to populations, interventions, and future action. The Lancet 2019, 394: 1560-1579. PMID: 31657732, PMCID: PMC7068135, DOI: 10.1016/s0140-6736(19)32229-9.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidDrug OverdoseGlobal HealthHealth Knowledge, Attitudes, PracticeHumansOpioid-Related DisordersPrevalenceRisk FactorsConceptsOpioid agonist treatmentOpioid useExtramedical opioid useIllicit opioid useRisk Factor StudyHepatitis C virusDrug-related harmRange of interventionsHIV mortalityOverall mortalityAgonist treatmentExtramedical usePatient acceptabilityC virusHigh prevalenceOpioid overdoseHigh-income countriesGlobal burdenOpioidsMultiple healthEffective interventionsInterventionTreatment qualityDrugsHIV
2018
Opioid Agonist Treatment and Improved Outcomes at Each Stage of the HIV Treatment Cascade in People Who Inject Drugs in Ukraine
Mazhnaya A, Marcus R, Bojko MJ, Zelenev A, Makarenko I, Pykalo I, Filippovych S, Dvoriak S, Altice FL. Opioid Agonist Treatment and Improved Outcomes at Each Stage of the HIV Treatment Cascade in People Who Inject Drugs in Ukraine. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2018, 79: 288-295. PMID: 30312275, PMCID: PMC8215524, DOI: 10.1097/qai.0000000000001827.Peer-Reviewed Original ResearchConceptsOpioid agonist treatmentHIV treatment cascadeTreatment cascadeAgonist treatmentIndependent factorsHepatitis C virus testingOpioid-dependent PWIDOpioid use disorderClinical care settingsLogistic regression modelsOAT coverageAntiretroviral therapyHIV careUNAIDS 90HIV preventionImproved outcomesTreatment strategiesCare settingsVirus testingNationwide studyPWIDUse disordersOAT expansionHIVCare