Increasing Emergency Department Patient Navigation And Buprenorphine Use: A Model For Low-Barrier Treatment.

Emergency departments (EDs) in the US treat large numbers of people with opioid use disorder (OUD), but most health systems do not equip EDs to provide OUD care. CA Bridge has supported the implementation of low-threshold, ED-initiated medications for OUD bundled with harm reduction and patient navigation in more than 80 percent of California EDs. Using grant reporting and California controlled substances prescribing data, we assessed CA Bridge implementation from July 2022 through December 2023, as well as 2022 California statewide ED buprenorphine prescribing.

Clinical Management of Medication-Assisted Treatment for Opioid Use Disorder Using a Mobile Health App Within a Primary Care Clinic: Quasi-Experimental Study.

Background: Medication-assisted treatment (MAT) is an effective strategy for treating opioid use disorder and reducing opioid-related overdose deaths, yet retention in treatment remains low. Mobile health (mHealth) platforms may be a useful tool for increasing long-term engagement in MAT programs, but evaluation studies of such platforms are limited.

Objective: This study aimed to determine whether the use of the Opioid Addiction Recovery Support (OARS) software platform increased MAT engagement for patients with opioid use disorder.

Unpacking the link between substance use disorders and 30-day unplanned readmission.

Background And Aims: Given the more than twofold increase in the prevalence of substance use disorders in the United States in the past decade, more hospital inpatients can be expected to carry substance use disorder diagnoses, necessitating evaluation of potential links to 30-day unplanned readmissions, a marker of quality of care. This study aimed to measure the association between substance use disorder diagnoses, discharge disposition and 30-day unplanned hospital readmissions.

Design: This retrospective cohort study extracted data from electronic health records of all inpatients.

Facilitators and Challenges to Adoption of a Digital Health Tool for Opioid Use Disorder Treatment in Primary Care: Mixed Methods Study.

Background: The United States is facing an opioid overdose epidemic resulting in an unprecedented number of preventable deaths. The use of medications including buprenorphine and methadone has proven effective for opioid use disorder (OUD), but many patients struggle to stay in treatment. Novel solutions, such as digital health tools, offer one option to help improve clinic management and improve treatment engagement.

Speed and smoking kill: A time-varying survival analysis linking methamphetamine use, cigarette smoking, and mortality in sexual minority men.

Background And Aims: Sexual minority men (SMM) in the US experience high rates of methamphetamine use and are disproportionately affected by HIV. Unlike prior studies among treatment-seeking populations, this study examined associations between methamphetamine use, smoking, and mortality in a community-based cohort of SMM, half of whom have HIV. Using time-varying survival models, we assessed how dynamic patterns of substance use impact mortality risk over time.

Characteristics of Patients Experiencing Opioid Overdose and Eligibility for Prehospital Treatment with Buprenorphine.

Objectives: Opioids kill tens of thousands of patients each year. While only a fraction of people with opioid use disorder (OUD) have accessed treatment in the last year, 30% of people who died from an overdose had an Emergency Medical Services (EMS) encounter within a year of their death. Prehospital buprenorphine represents an important emerging OUD treatment, yet limited data describe barriers to this treatment.

Scaling Emergency Department Opioid Use Disorder Treatment Across California to Reduce Overdose Deaths, 2019-2023.

Since April 2019, CA Bridge has worked with emergency departments (EDs) in diverse geographic and emergency care settings across California to scale up low-threshold buprenorphine access, patient navigation programs, harm reduction services, and take-home naloxone. Between April 2019 and June 2023, 268 (81.0%) of 331 acute care hospitals in California received funding and technical assistance from CA Bridge and completed data reporting.

Associations of Sleep Deficiency With Sexual Risk Behaviors and HIV Treatment Outcomes Among Men Who Have Sex With Men Living With or at High Risk of Acquiring HIV.

Background: Associations of sleep deficiency and methamphetamine use with sexual health and HIV treatment outcomes are poorly understood.

Setting: A longitudinal cohort of men who have sex with men at risk for or living with HIV (the mSTUDY) was analyzed. This analysis included 1445 study visits among 382 participants.

Emergency Department Access to Buprenorphine for Opioid Use Disorder.

Importance: Although substantial evidence supports buprenorphine for treatment of opioid use disorder (OUD) in controlled trials, prospective study of patient outcomes in clinical implementation of emergency department (ED) buprenorphine treatment is lacking.

Objective: To examine the association between buprenorphine treatment in the ED and follow-up engagement in OUD treatment 1 month later.

Design, Setting, And Participants: This multisite cohort study was conducted in 7 California EDs participating in a statewide implementation project to improve access to buprenorphine treatment.

Association of current substance use treatment with future reduced methamphetamine use in an observational cohort of men who have sex with men in Los Angeles.

Introduction: Methamphetamine use is highly prevalent among men who have sex with men (MSM), but knowledge of the long-term dynamics, and how they are affected by substance use treatment, is limited. This study aimed to describe trajectories of methamphetamine use among MSM, and to evaluate the impact of treatment for any kind of substance use on frequency of methamphetamine use.

Methods: This analysis used data from a cohort of MSM in Los Angeles, CA, who participated in semi-annual study visits from 2014 to 2022.

Financial Incentives for COVID-19 Vaccines Among People Experiencing Homelessness.

Introduction: Novel strategies are needed to address barriers to COVID-19 vaccination among people experiencing homelessness (PEH), a population that faces increased COVID-19 risk. Although growing evidence suggests that financial incentives for vaccination are acceptable to PEH, their impact on uptake is unknown. This study aimed to assess whether offering $50 gift cards was associated with the uptake of the first doses of COVID-19 vaccine among PEH in Los Angeles County.

A COVID-19 Vaccination Program to Promote Uptake and Equity for People Experiencing Homelessness in Los Angeles County.

People experiencing homelessness (PEH) have been disproportionately affected by COVID-19, yet their vaccination coverage is lower than is that of the general population. We implemented a COVID-19 vaccination program that used evidence-based and culturally tailored approaches to promote vaccine uptake and equity for PEH in Los Angeles County, California. From February 2021 through February 2022, 33 977 doses of vaccine were administered at 2658 clinics, and 9275 PEH were fully vaccinated.

COVID-19 Vaccine Acceptability and Financial Incentives among Unhoused People in Los Angeles County: a Three-Stage Field Survey.

Unhoused people have higher COVID-19 mortality and lower vaccine uptake than housed community members. Understanding vaccine hesitancy among unhoused people is key for developing programs that address their unique needs. A three-round, rapid, field-based survey was conducted to describe attitudes toward COVID-19 vaccination.

Blood and Breath Alcohol Concentration from Transdermal Alcohol Biosensor Data: Estimation and Uncertainty Quantification via Forward and Inverse Filtering for a Covariate-Dependent, Physics-Informed, Hidden Markov Model.

Transdermal alcohol biosensors that do not require active participation of the subject and yield near continuous measurements have the potential to significantly enhance the data collection abilities of alcohol researchers and clinicians who currently rely exclusively on breathalyzers and drinking diaries. Making these devices accessible and practical requires that transdermal alcohol concentration (TAC) be accurately and consistently transformable into the well-accepted measures of intoxication, blood/breath alcohol concentration (BAC/BrAC). A novel approach to estimating BrAC from TAC based on covariate-dependent physics-informed hidden Markov models with two emissions is developed.

Community Health Worker Perspectives on Engaging Unhoused Peer Ambassadors for COVID-19 Vaccine Outreach in Homeless Encampments and Shelters.

Background: COVID-19 vaccination is a priority for people experiencing homelessness. However, there are barriers to vaccine access driven in part by mistrust towards clinicians and healthcare. Community health workers (CHWs) and Peer Ambassadors (PAs) may be able to overcome mistrust in COVID-19 vaccine outreach.

Genetic Association and Expression Analyses of the Phosphatidylinositol-4-Phosphate 5-Kinase (PIP5K1C) Gene in Alcohol Use Disorder-Relevance for Pain Signaling and Alcohol Use.

Background: The gene encoding phosphatidylinositol-4-phosphate 5-kinase (PIP5K1C) has been recently implicated in pain regulation. Interestingly, a recent cross-tissue and cross-phenotypic epigenetic analysis identified the same gene in alcohol use disorder (AUD). Given the high comorbidity between AUD and chronic pain, we hypothesized that genetic variation in PIP5K1C might contribute to susceptibility to AUD.

Genome-wide association study of treatment response to venlafaxine XR in generalized anxiety disorder.

We conducted the first genome-wide association study (GWAS) in Generalized Anxiety Disorder (GAD) to identify potential predictors of venlafaxine XR treatment outcome. Ninety-eight European American patients participated in a venlafaxine XR clinical trial for GAD, with Hamilton Anxiety Scale (HAM-A) response/remission at 24 weeks as the primary outcome measure. All participants were genotyped with the Illumina PsychChip, and 266,820 common single nucleotide polymorphisms (SNPs) were analyzed.