HIV and Substance Use Syndemic

OUD affects individuals from urban, suburban, and rural communities alike, with persons at low income levels, residents of rural areas, and persons with mental illness being among those at highest risk of prescription opioid misuse and abuse patterns.

It is therefore a public health priority to ensure expansion of evidence-based treatments for persons with OUD to reduce opioid overdose and the transmission of HIV and HCV.We have three aims for O-SWG activity:

1. To improve collaborations of the researchers and clinicians with considerable expertise in opioid research at Yale and its partners to forge more interdisciplinary research to tackle vital issues in the opioid epidemics in the U.S. and abroad, with specialattention to New England.
2. To nurture young investigators and those new to the opioid research arena in developing excellent research ideas and proposals.
3. To link regionally with important state, academic, and service agency partners, alongside communitiesand practitioners, for community-participatory research endeavors. This includes our special relationship with UCONN and UPR.

An innovative element of our work is new interdisciplinary attention to the question of primary prevention of opioid misuse. Why has the desire for the euphoric and pain-dulling effects opioids increased in so many places in the US during this third crisis? The answers are complex and most likely not easily remediated because they lie in social and economic transformations over the last three decades. Large numbers of young and middle-aged people are unemployed or underemployed, adrift without adequate social support, and seeking escape within the context of an eroded social safety net. Until these problems are addressed, we must mitigate the immediate problems of often-untreated opioid use disorder, relapse, and overdose. This will require destigmatizing opioid use disorder by recognizing it as a treatable chronic disease, with a favorable prognosis if properly treated. The research agenda for novel approaches, interventions, and efforts for scale-up is highlighted here as the basis for our O-SWG aims and workplan.