2024
Pain, Substance Use Disorders, Mental Health, and Buprenorphine Treatment among Patients With and Without HIV
Miller E, McGinnis K, Edelman E, Feinberg T, Gordon K, Kerns R, Marshall B, Patterson J, McRae M. Pain, Substance Use Disorders, Mental Health, and Buprenorphine Treatment among Patients With and Without HIV. AIDS And Behavior 2024, 28: 3994-4004. PMID: 39264485, PMCID: PMC11586311, DOI: 10.1007/s10461-024-04494-w.Peer-Reviewed Original ResearchMental health classesSubstance use disordersOpioid use disorderHIV statusBuprenorphine initiationVeterans Aging Cohort StudyInitiate buprenorphineMental health diagnosesAging Cohort StudyBuprenorphine treatmentMultiple pain conditionsAssociated with HIV statusInfluence treatment retentionUse disorderTreatment of opioid use disorderHigher comorbidity burdenAge of patientsClinical encountersMental healthHealth diagnosisBlack veteransHealth classesLatent class analysisCohort studyPrescription data
2023
Long-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
2022
Self-Reported Cannabis Use and HIV Viral Control among Patients with HIV Engaged in Care: Results from a National Cohort Study
Bahji A, Li Y, Vickers-Smith R, Crystal S, Kerns RD, Gordon KS, Macmadu A, Skanderson M, So-Armah K, Sung ML, Bhondoekhan F, Marshall BDL, Edelman EJ. Self-Reported Cannabis Use and HIV Viral Control among Patients with HIV Engaged in Care: Results from a National Cohort Study. International Journal Of Environmental Research And Public Health 2022, 19: 5649. PMID: 35565045, PMCID: PMC9101884, DOI: 10.3390/ijerph19095649.Peer-Reviewed Original ResearchConceptsDetectable viral loadPast-year cannabis useViral loadAntiretroviral therapyCannabis useCohort studyUnadjusted analysesViral controlDetectable HIV viral loadVeterans Aging Cohort StudyHIV viral controlHIV viral loadAging Cohort StudyFirst study visitHIV-1 RNANational cohort studyBenefits of cannabisSelf-reported cannabis usePast-year useMean ageStudy visitHigher oddsPWHSignificant associationSubstance useLong-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 riskPatientsLongitudinal analysis of the prevalence and correlates of heavy episodic drinking and self‐reported opioid use among a national cohort of patients with HIV
Oldfield BJ, Li Y, Vickers‐Smith R, Barry DT, Crystal S, Gordon KS, Kerns RD, Williams EC, Marshall BDL, Edelman EJ. Longitudinal analysis of the prevalence and correlates of heavy episodic drinking and self‐reported opioid use among a national cohort of patients with HIV. Alcohol Clinical And Experimental Research 2022, 46: 600-613. PMID: 35257397, PMCID: PMC9018502, DOI: 10.1111/acer.14801.Peer-Reviewed Original ResearchConceptsSelf-reported opioid useOpioid useHeavy episodic drinkingNational cohortRisk factorsDepressive symptomsVeterans Aging Cohort StudyVeterans Health Administration sitesOpioid-related risksHIV disease progressionModifiable risk factorsPast-year cigarette smokingAging Cohort StudyGreater illness severityEpisodic drinkingOpioid-related overdoseHigh-risk drinkingCohort studyProspective cohortIllness severityCigarette smokingClinical correlatesDisease progressionLower oddsMultinomial logistic regression
2021
Sociodemographic and clinical correlates of gabapentin receipt with and without opioids among a national cohort of patients with HIV
Oldfield BJ, Li Y, Vickers-Smith R, Becker WC, Barry DT, Crystal S, Gordon KS, Kerns RD, Rentsch CT, Marshall BDL, Edelman EJ. Sociodemographic and clinical correlates of gabapentin receipt with and without opioids among a national cohort of patients with HIV. AIDS Care 2021, 34: 1053-1063. PMID: 34114904, PMCID: PMC8664891, DOI: 10.1080/09540121.2021.1939851.Peer-Reviewed Original ResearchConceptsOpioid useHigh dosesSelf-reported opioid useVeterans Aging Cohort StudyHigh-dose opioidsMean daily doseAging Cohort StudyHigh-dose benzodiazepinesNational prospective cohortOpioid doseOpioid receiptCohort studyFoot painProspective cohortDaily doseIndependent predictorsChronic painPain interferenceClinical variablesClinical correlatesNational cohortMultinomial logistic regressionPWHLogistic regressionOpioids
2020
Neuropsychological assessments and psychotherapeutic services in Veterans with multiple sclerosis: Rates of utilization and their associations with socio-demographics and clinical characteristics using Veterans Health Administration-based data
Gromisch ES, Kulas JF, Altalib H, Kerns RD, Mattocks KM, Brandt CA, Haskell S. Neuropsychological assessments and psychotherapeutic services in Veterans with multiple sclerosis: Rates of utilization and their associations with socio-demographics and clinical characteristics using Veterans Health Administration-based data. Multiple Sclerosis And Related Disorders 2020, 43: 102220. PMID: 32480347, DOI: 10.1016/j.msard.2020.102220.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationCo-occurring conditionsMultiple sclerosisWomen Veterans Cohort StudyService utilizationClinical characteristicsMood disordersService useHealth AdministrationVHA Corporate Data WarehouseNeuropsychological assessmentAlcohol-related disordersTraumatic brain injuryMental health servicesPsychotherapeutic servicesCorporate Data WarehouseRace/ethnicityCohort studyDiagnosis dateBrain injuryComprehensive careSleep disordersInitial appointmentSubsequent logistic regressionCognitive disordersTrajectories 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 ResearchConceptsOpioid 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 regressionAre we missing opioid-related deaths among people with HIV?
Becker WC, Gordon KS, Edelman EJ, Goulet JL, Kerns RD, Marshall BDL, Fiellin DA, Justice AC, Tate JP. Are we missing opioid-related deaths among people with HIV? Drug And Alcohol Dependence 2020, 212: 108003. PMID: 32417360, PMCID: PMC9580216, DOI: 10.1016/j.drugalcdep.2020.108003.Peer-Reviewed Original ResearchConceptsVeterans Aging Cohort StudyOpioid useOverdose deathsLife-limiting conditionsUnnatural deathsGreater oddsAging Cohort StudyVACS IndexOpioid exposureCohort studyHIV infectionHIV statusRisk factorsOdds ratioDeath filesIndex causeHIVDisease severityDeathDecedentsIllicit useDifferential misclassificationOddsCauseOpioidsThe Relationship Between Body Mass Index and Pain Intensity Among Veterans with Musculoskeletal Disorders: Findings from the MSD Cohort Study
Higgins DM, Buta E, Heapy AA, Driscoll MA, Kerns RD, Masheb R, Becker WC, Hausmann LRM, Bair MJ, Wandner L, Janke EA, Brandt CA, Goulet JL. The Relationship Between Body Mass Index and Pain Intensity Among Veterans with Musculoskeletal Disorders: Findings from the MSD Cohort Study. Pain Medicine 2020, 21: 2563-2572. PMID: 32186722, PMCID: PMC7778330, DOI: 10.1093/pm/pnaa043.Peer-Reviewed Original ResearchConceptsBody mass indexVeterans Health AdministrationPain intensityMass indexFunction of BMILow back pain groupOdds of painBack pain groupOverweight/obesityElectronic health record dataHealth record dataUS military veteransMusculoskeletal disorder diagnosisCohort studyOsteoarthritis groupPain groupMean ageNational cohortHigh prevalenceMSD diagnosisMusculoskeletal disordersPainHealth AdministrationDisorder diagnosisCross-sectional data
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 veterans
2018
Impact of Cigarette Smoking Status on Pain Intensity Among Veterans With and Without Hepatitis C
Lynch SM, Wilson SM, DeRycke EC, Driscoll MA, Becker WC, Goulet JL, Kerns RD, Mattocks KM, Brandt CA, Bathulapalli H, Skanderson M, Haskell SG, Bastian LA. Impact of Cigarette Smoking Status on Pain Intensity Among Veterans With and Without Hepatitis C. Pain Medicine 2018, 19: s5-s11. PMID: 30203017, DOI: 10.1093/pm/pny146.Peer-Reviewed Original ResearchConceptsHepatitis C virusSevere pain intensityPain intensityElectronic medical recordsCurrent smokersSmoking statusVeterans Health Administration primary care clinicsOperations Enduring Freedom/Iraqi Freedom/New DawnIndependent risk factorInteraction of smokingNumeric rating scalePrimary care clinicsHigher pain intensityCigarette smoking statusICD-9 codesOEF/OIF/OND veteransCross-sectional analysisCohort studyCurrent smokingHepatitis C.Severe painPain managementTobacco smokingCare clinicsChronic painDuration 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 rateUse of Non-Pharmacological Pain Treatment Modalities Among Veterans with Chronic Pain: Results from a Cross-Sectional Survey
Edmond SN, Becker WC, Driscoll MA, Decker SE, Higgins DM, Mattocks KM, Kerns RD, Haskell SG. Use of Non-Pharmacological Pain Treatment Modalities Among Veterans with Chronic Pain: Results from a Cross-Sectional Survey. Journal Of General Internal Medicine 2018, 33: 54-60. PMID: 29633141, PMCID: PMC5902341, DOI: 10.1007/s11606-018-4322-0.Peer-Reviewed Original ResearchConceptsNPM usePain treatment modalitiesWomen Veterans Cohort StudySample of veteransCohort studyClinical correlatesTreatment modalitiesMultivariable associationsLogistic regressionBaseline surveyBivariate associationsDescriptive statisticsVeteransCorrelatesAssociationPainDesignWeParticipantsParticipantsStrong evidencePrevalenceMonths
2017
Examining Gender as a Correlate of Self-Reported Pain Treatment Use Among Recent Service Veterans with Deployment-Related Musculoskeletal Disorders
Driscoll MA, Higgins D, Shamaskin-Garroway A, Burger A, Buta E, Goulet JL, Heapy A, Kerns RD, Brandt CA, Haskell SG. Examining Gender as a Correlate of Self-Reported Pain Treatment Use Among Recent Service Veterans with Deployment-Related Musculoskeletal Disorders. Pain Medicine 2017, 18: 1767-1777. PMID: 28379576, DOI: 10.1093/pm/pnx023.Peer-Reviewed Original ResearchConceptsPain treatment modalitiesChronic painSelf-reported useCIH servicesPain treatmentPain careMusculoskeletal conditionsTreatment modalitiesRehabilitation therapyIntegrative health servicesInterventional pain treatmentsChronic pain treatmentWomen Veterans Cohort StudyVeterans Health AdministrationMental health conditionsSelf-rated healthGender differencesSample of veteransCorrelates of SelfCohort studyPain severityCare utilizationSpecialty careTreatment useInterventional strategies
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 ResearchConceptsSubstance 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 mortalityMortalityCigarette Smoking Status and Receipt of an Opioid Prescription Among Veterans of Recent Wars
Bastian LA, Driscoll MA, Heapy AA, Becker WC, Goulet JL, Kerns RD, DeRycke EC, Perez E, Lynch SM, Mattocks K, Kroll-Desrosiers AR, Brandt CA, Skanderson M, Bathulapalli H, Haskell SG. Cigarette Smoking Status and Receipt of an Opioid Prescription Among Veterans of Recent Wars. Pain Medicine 2016, 18: 1089-1097. PMID: 27659441, DOI: 10.1093/pm/pnw223.Peer-Reviewed Original ResearchConceptsCurrent pain intensityOpioid prescriptionsPain intensitySmoking statusOEF/OIF/OND veteransCurrent smokersFormer smokersOpioid useVeterans Health Administration primary care clinicsOperations Enduring Freedom/Iraqi Freedom/New DawnMild pain intensityMore opioid prescriptionsSevere pain intensityNumeric rating scalePrimary care clinicsCigarette smoking statusCross-sectional analysisOpioid receiptFormer smokingCohort studyCurrent smokingCare clinicsChronic painCigarette smokersSmoking cessationNon‐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 exposureAssociation between pain outcomes and race and opioid treatment: Retrospective cohort study of Veterans
Burgess DJ, Gravely AA, Nelson DB, Bair MJ, Kerns RD, Higgins DM, Farmer MM, Partin MR. Association between pain outcomes and race and opioid treatment: Retrospective cohort study of Veterans. The Journal Of Rehabilitation Research And Development 2016, 53: 13-24. PMID: 26933921, DOI: 10.1682/jrrd.2014.10.0252.Peer-Reviewed Original ResearchConceptsRetrospective cohort studyIndex visitOpioid prescriptionsPain outcomesCohort studyMusculoskeletal painPain treatmentPain interferenceBenefits of opioidsElectronic medical record dataGreater pain interferencePharmacologic pain treatmentsChronic noncancer painVeterans Affairs patientsChronic musculoskeletal painMedical record dataNoncancer painOpioid treatmentMost patientsVA patientsVA SurveyAlternative treatmentPatientsSignificant associationPain
2014
Racial Differences in Prescription of Opioid Analgesics for Chronic Noncancer Pain in a National Sample of Veterans
Burgess DJ, Nelson DB, Gravely AA, Bair MJ, Kerns RD, Higgins DM, van Ryn M, Farmer M, Partin MR. Racial Differences in Prescription of Opioid Analgesics for Chronic Noncancer Pain in a National Sample of Veterans. Journal Of Pain 2014, 15: 447-455. PMID: 24440840, DOI: 10.1016/j.jpain.2013.12.010.Peer-Reviewed Original ResearchConceptsChronic noncancer painPain intensity ratingsPrescription of opioidsNoncancer painOpioid prescriptionsRacial differencesVeterans Affairs Health Care SystemIntensity ratingsElectronic medical record dataRetrospective cohort studyPain intensity scoresPrimary care patientsMedical record dataYears of agePossible racial differencesHealth care facilitiesSignificant racial differencesSystem-level factorsHealth care systemPatients 65Cohort studyJoint painPatient ageCare patientsOpioid analgesics