A5053008018- HIV, Drug Use, Sexual Risk
- Opioid Use Disorder Treatment
- HIV/AIDS Research and Interventions
- Substance Abuse Treatment and Outcomes
- Adipose Tissue and Metabolism
- HIV-related health complications and treatments
- Pain Management and Opioid Use
- Adipokines, Inflammation, and Metabolic Diseases
- Poisoning and overdose treatments
- Sex work and related issues
- Cardiovascular Disease and Adiposity
- Forensic Toxicology and Drug Analysis
- Hepatitis C virus research
- Digital Mental Health Interventions
- HIV Research and Treatment
- Cardiovascular and exercise physiology
- Cancer Genomics and Diagnostics
- Ubiquitin and proteasome pathways
- American Environmental and Regional History
- Family and Patient Care in Intensive Care Units
- Homelessness and Social Issues
- Pneumocystis jirovecii pneumonia detection and treatment
- Mobile Health and mHealth Applications
- Early Childhood Education and Development
- Grief, Bereavement, and Mental Health
Boston Medical Center
2018-2025
Boston University
2018-2025
Boston Health Care for the Homeless Program
2025
National Patient Safety Foundation
2025
Paris Junior College
2024
Guy's and St Thomas' NHS Foundation Trust
2024
National Institute on Drug Abuse
2024
Massachusetts Department of Public Health
2021-2024
Thomas Foundation
2024
Beth Israel Deaconess Medical Center
2024
Background: To reduce the spread of coronavirus disease 2019 (COVID-19), many substance use disorder treatment programs have transitioned to telemedicine. Emergency regulatory changes allow buprenorphine initiation without an in-person visit. We describe videoconferencing for combined with street outreach engage 2 patients experiencing homelessness severe opioid (OUD). Case Presentation: Patient 1 was a 30-year-old man OUD who had relapsed injection heroin/fentanyl after incarceration. A...
<h3>Importance</h3> Although HIV preexposure prophylaxis (PrEP) implementation among persons who inject drugs has been inadequate, national monitoring programs do not include data on PrEP, and specific trends in PrEP use are well understood. <h3>Objective</h3> To estimate uptake commercially insured with opioid or stimulant disorder by injection drug (IDU) status. <h3>Design, Setting, Participants</h3> This cross-sectional study used deidentified from the MarketScan Commercial Claims...
Background: Despite an increased awareness of non-binary identity in the current social landscape, experiences and needs this heterogeneous community are poorly understood represented research literature. Evidence indicates that exclusion is not uncommon for individuals expressing a gender identity, with reflections literature may turn have impact on their psychological wellbeing. Aim: As increasingly presenting at UK clinics requesting medical interventions, aim study was to better...
Federal regulations restrict methadone for opioid use disorder (OUD) treatment to licensed programs (OTPs). However, providers in other settings can administer withdrawal under the "72-hour rule" while linking further care. Prior work has demonstrated that initiation a low-barrier bridge clinic is associated with high OTP linkage and 1-month retention rates. We describe 2 novel applications of 72-hour rule which management facilitated inpatient hospitalization outpatient buprenorphine induction.
Objective: To describe the implementation of outpatient alcohol withdrawal management in a low-barrier substance use disorder (SUD) bridge clinic and short-term clinical outcomes. Methods: A Boston, MA implemented benzodiazepine tapers for patients at low risk seizures or delirium tremens. We conducted retrospective chart review who received one more doses between April 2021 January 2023. described patient characteristics evaluated rates taper completion, complications, medication (AUD)...
Methadone for opioid use disorder (OUD) treatment is restricted to licensed programs (OTPs) with substantial barriers entry. Underutilized regulations allow non-OTP providers administer methadone withdrawal up 72 h while arranging ongoing care. Our low-barrier bridge clinic implemented a new pathway treat and facilitate OTP linkage utilizing the "72-hour rule."Patients presenting hospital-based were evaluated OUD, withdrawal, goals. Eligible patients offered management rapid referral. OTPs...
The Grayken Center for Addiction at Boston Medical includes programs across the care continuum people with substance use disorders (SUDs), serving both inpatients and outpatients. These had to innovate quickly during COVID-19 outbreak maintain access care. Federal state regulatory flexibility allowed these initiate treatment experiencing homelessness maximize patient safety through physical distancing practices. Programs switched telehealth high levels of acceptability retention. Some also...
The COVID-19 pandemic has exacerbated pre-existing health inequities in vulnerable and marginalized patient populations. Continuing professional development (CPD) can be a critical driver of change to improve quality care, inequities, system change. In order for CPD address these disparities care populations most affected the system, programs must first issues equity inclusion their education delivery. Despite need equitable inclusive programs, there remains paucity tools frameworks...
HIV and other sexually transmitted infections (STIs) are on the rise nationally internationally. The coronavirus 2019 (COVID-19) pandemic drove a shift toward telemedicine prioritization of symptomatic treatment over asymptomatic screening. impact in safety-net settings, which faced disproportionate baseline STI/HIV rates rooted structural inequities, where many patients lack resources, is not yet known. This study describes COVID-19 testing at an urban hospital. We used descriptive...
More than 1 in 7 patients with human immunodeficiency virus (HIV) infection the United States are unaware of their serostatus despite recommendations US agencies that all adults through age 65 be screened for HIV at least once. To facilitate universal screening, an electronic medical record (EMR) reminder was created our primary care practice. Screening rates before and after implementation were assessed to determine impact on screening rates.A retrospective cohort analysis performed 18-65...
Tent encampments in the neighborhood surrounding Boston Medical Center (BMC) grew to include 336 individuals at points between 2019 and 21, prompting public health concerns. BMC, City of Boston, Commonwealth Massachusetts partnered 2/2022 offer low-barrier transitional housing encampment residents provide co-located clinical stabilization services for community members with substance use disorders (SUDs) experiencing homelessness.To meet needs some people who had been living encampments, BMC...
Objective: To study the infection-related needs of patients with substance use disorders initiating care at a low-barrier-to-access program (LBAP) by describing proportion human immunodeficiency virus (HIV), hepatitis B and C (HBV, HCV), syphilis, gonorrhea, chlamydia determining rates treatment and/or linkage to care. Methods: We reviewed records who completed an intake visit LBAP in Boston, MA during first 9 months after implementation standardized laboratory panel (January 30,...
Abstract Introduction Immediate access to naloxone is needed prevent fatal opioid-related overdoses in the presence of fentanyl analogs saturating opioid supply. Peer models engage impacted populations who are not accessing through standard venues, yet compensating peers utilize syringe service programs with cash stipends distribute within networks people use drugs well described. Methods As part HEALing Communities Study, program-based interventions were developed Holyoke and Gloucester,...
People who experience a nonfatal opioid overdose and receive naloxone are at high risk of subsequent death but gaps in access to medications for use disorder. The immediate post-naloxone period offers an opportunity buprenorphine initiation. Limited data indicate that administration by emergency medical services (EMS) after reversal is safe feasible. We describe case which partnership between low-barrier substance disorder (SUD) observation unit EMS allowed initiation with extended-release...
Benzodiazepine-involved overdose deaths are rising, driven by increasing use of nonprescribed benzodiazepine pills. For patients who wish to stop use, rapid inpatient tapers typically the only option treat withdrawal. Substance disorder bridge clinics can provide high-touch care needed manage outpatient in at high risk due other substance disorders.