2023
Concordance between controlled substance receipt and post-mortem toxicology in opioid-detected overdose deaths: A statewide analysis
Howell B, Black A, Grau L, Lin H, Greene C, Lee H, Heimer R, Hawk K, D'Onofrio G, Fiellin D, Becker W. Concordance between controlled substance receipt and post-mortem toxicology in opioid-detected overdose deaths: A statewide analysis. Drug And Alcohol Dependence 2023, 244: 109788. PMID: 36738634, PMCID: PMC9975083, DOI: 10.1016/j.drugalcdep.2023.109788.Peer-Reviewed Original ResearchConceptsPost-mortem toxicologyOverdose deathsChief Medical ExaminerBenzodiazepine prescribingBenzodiazepine prescriptionsPrimary outcomePreventable deathsOpioid overdosesOpioidsAddiction servicesBenzodiazepinesMental healthStudy periodDeathMedical examinersConcordanceStatewide analysisSubstantial numberReceiptDaysDepartmentMedicationsToxicologyFentanylPrescribingReceipt of opioid use disorder treatments prior to fatal overdoses and comparison to no treatment in Connecticut, 2016–17
Heimer R, Black A, Lin H, Grau L, Fiellin D, Howell B, Hawk K, D'Onofrio G, Becker W. Receipt of opioid use disorder treatments prior to fatal overdoses and comparison to no treatment in Connecticut, 2016–17. Drug And Alcohol Dependence 2023, 254: 111040. PMID: 38043226, PMCID: PMC10872282, DOI: 10.1016/j.drugalcdep.2023.111040.Peer-Reviewed Original ResearchConceptsNon-medication treatmentsRelative riskOpioid overdose deathsIncidence rateMOUD treatmentOverdose deathsOpioid use disorder treatmentResults Incidence ratesRetrospective cohort studyDifferent treatment modalitiesPopulation-level effortsUse disorder treatmentFatal opioid poisoningsCohort studyOpioid poisoningTreatment modalitiesConclusion ExposurePoisoning deathsFatal overdosesTreatment exposureDisorder treatmentDeathTreatmentMethadoneRisk“It’s starting to weigh on me”: Exploring the Experiences and Support Needs of Harm Reduction Staff in Connecticut using the Social-Ecological Model
Hill K, Dunham K, Grau L, Heimer R. “It’s starting to weigh on me”: Exploring the Experiences and Support Needs of Harm Reduction Staff in Connecticut using the Social-Ecological Model. Harm Reduction Journal 2023, 20: 168. PMID: 37964261, PMCID: PMC10644636, DOI: 10.1186/s12954-023-00898-4.Peer-Reviewed Original ResearchConceptsSocial ecological modelSupport needsHarm reduction workersHarm reduction programmingHarm reduction servicesThematic analysis approachProvision of supportStigmatized populationsMeans of supportReduction workersInterpersonal levelCommunity levelHarm reductionDay roleReduction servicesOverdose crisisReduction programmingStaff wellbeingRole-related stressorsRole-related stressFeelings of stressBoundary settingEmotional supportPotential supportIndividual levelXylazine in the drug supply: Emerging threats and lessons learned in areas with high levels of adulteration
Quijano T, Crowell J, Eggert K, Clark K, Alexander M, Grau L, Heimer R. Xylazine in the drug supply: Emerging threats and lessons learned in areas with high levels of adulteration. International Journal Of Drug Policy 2023, 120: 104154. PMID: 37574646, DOI: 10.1016/j.drugpo.2023.104154.Peer-Reviewed Original ResearchHarm reduction service providersDrug supplySedative-analgesic drugsFatal opioid overdosesOpioid overdose fatalitiesPresence of fentanylMedical examiner dataIllicit drug supplyInjection of xylazineFentanyl test stripsPrevention needsOpioid usersAnalgesic drugsOpioid overdosesOverdose deathsOverdose fatalitiesXylazineHealth threatSurvey of peopleDrugsSignificant predictorsFentanylConvenience surveyTest stripsTwo-thirdsTechnical violations and infractions are drivers of disengagement from methadone treatment among people with opioid use disorder discharged from Connecticut jails 2014–2018
Marotta P, Hass A, Viera A, Doernberg M, Barbour R, Grau L, Heimer R. Technical violations and infractions are drivers of disengagement from methadone treatment among people with opioid use disorder discharged from Connecticut jails 2014–2018. Substance Abuse Treatment, Prevention, And Policy 2023, 18: 43. PMID: 37420271, PMCID: PMC10329353, DOI: 10.1186/s13011-023-00541-2.Peer-Reviewed Original Research
2024
Prescription Opioid Dose Change Before Fatal Opioid-Detected Overdose.
Kazemitabar M, Howell B, Becker W, Lin H, Grau L, Heimer R, D'Onofrio G, Hawk K, Fiellin D, Black A. Prescription Opioid Dose Change Before Fatal Opioid-Detected Overdose. Journal Of Studies On Alcohol And Drugs 2024, 85: 815-819. PMID: 38775307, DOI: 10.15288/jsad.24-00026.Peer-Reviewed Original ResearchPrescribed opioidsOpioid dose changesRapid dose increaseNon-HispanicOverdose deathsToxicological resultsNon-prescription opioidsBlack non-HispanicMorphine equivalentsOpioid therapyWhite non-HispanicDose changesDaily doseMean ageDispensed opioidsPrescription opioidsPrescribing patternsOpioidDose increaseOpioid overdose crisisIncreasing dosesStudy investigated patternsEffect of timeEffects of ageSecondary analysisAccessibility of Opioid Treatment Programs Based on Conventional vs Perceived Travel Time Measures
Kim J, Lee J, Thornhill T, Dennett J, Lu H, Howell B, Grau L, Fiellin D, Heimer R, Gonsalves G. Accessibility of Opioid Treatment Programs Based on Conventional vs Perceived Travel Time Measures. JAMA Network Open 2024, 7: e240209. PMID: 38376839, PMCID: PMC10879949, DOI: 10.1001/jamanetworkopen.2024.0209.Peer-Reviewed Original ResearchConceptsTransit travel timeAccessibility metricsTravel timeTravel componentsAccessibility scoresTransportation burdenTravel burdenOut-of-vehicleComponents of travelConventional accessibility measuresSpatial regression modelsTravel time measurementsPublic transitTransit schedulesAccessibility measuresDeparture timeTravel time analysisTrip durationTravelOperating hoursTime analysisCross-sectional studyOpioid use disorderPolicy recommendationsDecision-making
2022
Development and pilot-testing of a hepatitis C reinfection prevention intervention for patients in treatment for hepatitis C infection
Viera A, Grau L, Fisher J, Farnum S, Tetrault J, Scott G, Heimer R. Development and pilot-testing of a hepatitis C reinfection prevention intervention for patients in treatment for hepatitis C infection. Drug And Alcohol Dependence Reports 2022, 3: 100038. PMID: 36845980, PMCID: PMC9948939, DOI: 10.1016/j.dadr.2022.100038.Peer-Reviewed Original Research
2014
Processing length bias of time intervals between the last episode and the interview in Gamma-Poisson models of behavior
Zelterman D, Suvorova A, Paschenko A, Musina V, Tulupyev A, Tulupyeva T, Krasnoselskikh T, Grau L, Heimer R. Processing length bias of time intervals between the last episode and the interview in Gamma-Poisson models of behavior. SPIIRAS Proceedings 2014, 1: 160-185. DOI: 10.15622/sp.16.6.Peer-Reviewed Original ResearchRegression diagnostics in the rate analysis based on data about the last episodes
Zelterman D, Suvorova A, Paschenko A, Musina V, Tulupyev A, Tulupyeva T, Grau L, Heimer R. Regression diagnostics in the rate analysis based on data about the last episodes. SPIIRAS Proceedings 2014, 2: 33-46. DOI: 10.15622/sp.17.2.Peer-Reviewed Original Research
2011
Chronic pain, Addiction severity, and misuse of opioids in Cumberland County, Maine
Heimer R, Dasgupta N, Irwin KS, Kinzly M, Harvey AP, Givens A, Grau LE. Chronic pain, Addiction severity, and misuse of opioids in Cumberland County, Maine. Addictive Behaviors 2011, 37: 346-349. PMID: 22138379, DOI: 10.1016/j.addbeh.2011.11.017.Peer-Reviewed Original ResearchConceptsAddiction Severity IndexBrief Pain InventoryChronic painOpioid abuseBPI scoresMisuse of opioidsCommon co-occurring conditionsSubstance abuse treatment programsCommunity-based sampleCo-occurring conditionsSubstance abuse treatmentStreet-recruited sampleOrder of onsetRespondent-driven samplingPain InventoryPain managementIllicit opioidsOpioid misuseRegular physicianOpioid abusersDaily livingPainDrug misusePrior monthTreatment programPrevalence, characteristics, and predictors of police training initiatives by US SEPs: Building an evidence base for structural interventions
Beletsky L, Grau LE, White E, Bowman S, Heimer R. Prevalence, characteristics, and predictors of police training initiatives by US SEPs: Building an evidence base for structural interventions. Drug And Alcohol Dependence 2011, 119: 145-149. PMID: 21705159, PMCID: PMC3192926, DOI: 10.1016/j.drugalcdep.2011.05.034.Peer-Reviewed Original ResearchConceptsSyringe exchange programsInjection drug usersNeedle stick injuriesCommunity-based prevention initiativesPublic health benefitsStick injuriesHIV transmissionPublic health rationaleDrug usersMost program managersMultivariate analysisSyringe possessionPrevention initiativesEvidence baseHealth benefitsCommunity healthOccupational healthHealth rationaleMultivariate modelingPrevalenceStructural interventionsSEP operationsPredictorsHealthPrevious year
2010
Epidemiologic trends and geographic patterns of fatal opioid intoxications in Connecticut, USA: 1997–2007
Green TC, Grau LE, Carver HW, Kinzly M, Heimer R. Epidemiologic trends and geographic patterns of fatal opioid intoxications in Connecticut, USA: 1997–2007. Drug And Alcohol Dependence 2010, 115: 221-228. PMID: 21131140, PMCID: PMC3095753, DOI: 10.1016/j.drugalcdep.2010.11.007.Peer-Reviewed Original ResearchConceptsPrescription opioidsOpioid typeIntoxication deathsRisk factorsDrug intoxication deathsHeroin-related deathsOpioid-related deathsFatal opioid overdoseChief Medical ExaminerOpioid intoxicationOpioid deathsDrug poisoningInjury deathsEpidemiologic trendsOpioid overdoseOpioidsDeath locationPrevention effortsDeathMedical examinersRegression analysisSignificant increasePublic healthEpidemiologyHeroinDrug Network Characteristics and HIV Risk Among Injection Drug Users in Russia: The roles of Trust, Size, and Stability
Cepeda JA, Odinokova VA, Heimer R, Grau LE, Lyubimova A, Safiullina L, Levina OS, Niccolai LM. Drug Network Characteristics and HIV Risk Among Injection Drug Users in Russia: The roles of Trust, Size, and Stability. AIDS And Behavior 2010, 15: 1003-1010. PMID: 20872063, PMCID: PMC3112286, DOI: 10.1007/s10461-010-9816-7.Peer-Reviewed Original ResearchHIV Disclosure, Condom Use, and Awareness of HIV Infection Among HIV-Positive, Heterosexual Drug Injectors in St. Petersburg, Russian Federation
Grau LE, White E, Niccolai LM, Toussova OV, Verevochkin SV, Kozlov AP, Heimer R. HIV Disclosure, Condom Use, and Awareness of HIV Infection Among HIV-Positive, Heterosexual Drug Injectors in St. Petersburg, Russian Federation. AIDS And Behavior 2010, 15: 45-57. PMID: 20700645, PMCID: PMC3023022, DOI: 10.1007/s10461-010-9775-z.Peer-Reviewed Original ResearchPrevalence and predictors of transitions to and away from syringe exchange use over time in 3 US cities with varied syringe dispensing policies
Green TC, Bluthenthal RN, Singer M, Beletsky L, Grau LE, Marshall P, Heimer R. Prevalence and predictors of transitions to and away from syringe exchange use over time in 3 US cities with varied syringe dispensing policies. Drug And Alcohol Dependence 2010, 111: 74-81. PMID: 20537814, PMCID: PMC3087197, DOI: 10.1016/j.drugalcdep.2010.03.022.Peer-Reviewed Original ResearchConceptsSyringe exchange programsSEP usersSEP useThree-City cohort studyPolicy change analysisSyringe exchange usePredictors of transitionSecondary syringe exchangePolice contactCohort studyFemale sexHIV riskSyringe availabilityExchange useSyringe exchangeDrug usersDrug paraphernaliaHealth interventionsUS citiesLatino ethnicityIDUsPolicyContextual factorsMultinomial regressionTypology[The study of characteristics of overdose among users of opioid drug injections].
Iliuk R, Krupitskiĭ E, Torban M, Kozlov A, Blinnikova K, Heimer R, Green T, Grau L. [The study of characteristics of overdose among users of opioid drug injections]. S S Korsakov Journal Of Neurology And Psychiatry 2010, 110: 33-43. PMID: 21322146.Peer-Reviewed Original ResearchConceptsOpioid overdose riskMore health problemsNonfatal overdosesRole of alcoholDrug injectionOverdose riskEarly diagnosisComorbid disordersOverdose preventionSomatic disordersHealth problemsOverdoseLonger abstinenceMental disordersOverdose situationsDeath casesDisordersSufficient helpOverdosesAdditional predictorsFamily psychotherapyDrug qualityHigher numberDiagnosisAbstinence
2009
Getting the message straight: effects of a brief hepatitis prevention intervention among injection drug users
Grau LE, Green TC, Singer M, Bluthenthal RN, Marshall PA, Heimer R. Getting the message straight: effects of a brief hepatitis prevention intervention among injection drug users. Harm Reduction Journal 2009, 6: 36. PMID: 20003518, PMCID: PMC2804675, DOI: 10.1186/1477-7517-6-36.Peer-Reviewed Original ResearchRisk reduction materialsSyringe exchange programsInjection drug usersHygiene suppliesDrug usersHealth promotion behaviorsAppropriate useHealth promotion materialsSEP clientsPrevention interventionsHepatitis riskBlood flowInjection practicesPromotion behaviorsInjection siteBrief interventionIntervention effectivenessIntervention packetInterventionPassive introductionPromotion materialsExchange programsOne-quarterSubstantial numberVerbal remindersPsychosocial and contextual correlates of opioid overdose risk among drug users in St. Petersburg, Russia
Grau LE, Green TC, Torban M, Blinnikova K, Krupitsky E, Ilyuk R, Kozlov AP, Heimer R. Psychosocial and contextual correlates of opioid overdose risk among drug users in St. Petersburg, Russia. Harm Reduction Journal 2009, 6: 17. PMID: 19630963, PMCID: PMC2724502, DOI: 10.1186/1477-7517-6-17.Peer-Reviewed Original Research
2008
Social and structural aspects of the overdose risk environment in St. Petersburg, Russia
Green TC, Grau LE, Blinnikova KN, Torban M, Krupitsky E, Ilyuk R, Kozlov A, Heimer R. Social and structural aspects of the overdose risk environment in St. Petersburg, Russia. International Journal Of Drug Policy 2008, 20: 270-276. PMID: 18774283, PMCID: PMC2696401, DOI: 10.1016/j.drugpo.2008.07.002.Peer-Reviewed Original ResearchConceptsDrug usersRisk behaviorsIntervention feasibilityOpioid overdosesModerate-risk behaviorAbstinence-based treatmentMost drug usersOpioid injectorsSuboptimal responseOverdose response trainingTreatment modalitiesCommon causeOverdose riskNaloxone distributionOverdose mortalityModifiable aspectsAmbulance staffRisk environmentOverdosesTreatment providersMortalityStructural interventionsKey informant interviewsMore ambulancesIntervention