Publications
Rationale, Design and Methods of the Cul-CM Study: A Protocol for Cultural Adaptation of Contingency Management in Adults With Stimulant Use Disorder
Stimulant use disorder is a growing contributor to drug poisoning and mortality in the U.S., disproportionately affecting Black communities because of stimulant-opioid polysubstance use and structural barriers to treatment. Contingency management (CM) is the most effective evidence-based treatment for stimulant use disorder but remains poorly implemented in some communities. The Cultural Adaptation of Contingency Management…
Read MoreAnxiety, Bipolar, Depressive, and Schizophrenia Diagnoses Among Patients Receiving Addiction Treatment in the United States, 2006-2022: A Descriptive Study
Background: This study examined trends in selected mental health diagnoses among patients admitted to specialty addiction treatment programs in the United States from 2006 to 2022. Methods: Joinpoint regression was used to examine annual data from the publicly available Treatment Episode Data Set – Admissions. Sample selection criteria included having a primary substance listed and…
Read MoreDesigning a Patient-Centered Care Navigation Intervention Within a Health Care System for SUD Care: A Qualitative Study
Healthcare systems face challenges connecting patients with substance use disorder (SUD) to timely, appropriate treatment. Researchers conducted qualitative interviews to identify barriers and facilitators to SUD treatment and optimize care navigation within a large integrated health care system. Semi-structured interviews included 21 patients seeking SUD treatment and eight clinicians working in a mental health access…
Read MorePeer Support Specialist Credentialing in States With Medicaid Coverage of Peer Support Services for Substance Use Disorder
Objective: To examine state variation in credentialing requirements for peer support specialists (PSSs) providing Medicaid-covered substance use disorder services. Methods: A systematic search identified PSS credentialing requirements in 40 states. Requirements were analyzed across 10 credentialing components, including education, training, work experience, examinations, and certification maintenance. Results: Credentialing requirements varied widely across states. Most required…
Read MoreMethadone Dose and Patient-Directed Discharge in Hospitalized Patients With Opioid Use Disorder
In a retrospective cohort study of 554 hospitalized adults with opioid use disorder (2019–2022), higher early methadone dosing was associated with lower rates of patient-directed discharge (PDD). Among patients receiving methadone within 24 hours of emergency department presentation (n = 325), each additional 10 mg of methadone was associated with reduced odds of PDD at…
Read MoreAdapting substance use treatment for black adolescents in the US legal system: protocol for a mixed-method, exploratory, feasibility and acceptability study using the eight-step ADAPT-ITT framework
The Cultural Adaptation of a Substance Use Treatment (CAST) Project is a community-led mixed-methods study focused on developing a culturally responsive substance use intervention for Black youth impacted by the legal system. The study examines how racial discrimination influences substance use and mental health outcomes while centering the perspectives of youth, parents, and community stakeholders.…
Read MoreTravel Time to Opioid Treatment Programs in Connecticut—Still Waiting for Methadone
Methadone is a life-saving treatment for opioid use disorder, yet in the United States it imposes an exceptional burden on patients due to restrictive and outdated regulations. Unlike other chronic therapies, methadone access is limited to specialized opioid treatment programs (OTPs), requiring frequent in-person visits that create substantial travel, time, and stigma-related barriers. Drawing on…
Read MoreDesign of a Cluster-Randomized, Hybrid Type 1 Effectiveness-Implementation Trial of a Care Navigation Intervention to Increase Substance Use Disorder Treatment Engagement
Background: Practical and motivational barriers can deter people from engaging in substance use disorder (SUD) treatment, even those who seek treatment. Care navigation is a psychosocial intervention that seeks to facilitate patients’ timely access to care by identifying and intervening upon barriers. Few trials have tested the effectiveness of care navigation when embedding in real-world…
Read MoreTracking Implementation Determinants Over Time Using the IFASIS: Multi-Site Analysis of Opioid Treatment Programs Implementing a Digital Contingency Management Platform
Background: Contingency management (CM) is the most effective treatment for stimulant use, but is underutilized due to implementation challenges. Digital CM platforms have shown promise in addressing barriers to implementation, but there is limited understanding of factors impacting delivery of a digital CM platform over time. The goal of this longitudinal study was to measure…
Read MoreChallenges With Buprenorphine Initiation in the Fentanyl Era—Adapting Effectively to the Moment
Buprenorphine is a cornerstone medication for opioid use disorder (OUD) but carries a known risk of precipitated withdrawal (PW) during initiation, a concern that appears to be increasing in the era of nonpharmaceutical fentanyl (NPF). Kawasaki and colleagues report findings from a 2023–2024 nationally representative survey of 396 US buprenorphine prescribers examining challenges with buprenorphine…
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