2024
Using qualitative system dynamics modeling to understand overdose bystander behavior in the context of Connecticut’s Good Samaritan Laws and identify effective policy options
Thompson R, Sabounchi N, Ali S, Heimer R, D’Onofrio G, Heckmann R. Using qualitative system dynamics modeling to understand overdose bystander behavior in the context of Connecticut’s Good Samaritan Laws and identify effective policy options. Harm Reduction Journal 2024, 21: 124. PMID: 38937759, PMCID: PMC11210010, DOI: 10.1186/s12954-024-00990-3.Peer-Reviewed Original ResearchConceptsSamaritan lawsGood Samaritan lawsBystander behaviorGroup model buildingFear of legal consequencesKnowledge of protectionResponses to opioid overdosesCriminal liabilityDrug arrestsLegal consequencesLaw enforcementNaloxone useLawStakeholder-engaged processOpioid overdoseHealth care providersFatal opioid overdoseSustainable system changeOpioid-related outcomesBystander experiencesSamaritanCare providersHarm reductionPotential bystandersPolicy determination
2023
Receipt 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 levelTechnical 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
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 healthEpidemiologyHeroin
2009
Peridomestic Lyme Disease Prevention Results of a Population-Based Case–Control Study
Connally NP, Durante AJ, Yousey-Hindes KM, Meek JI, Nelson RS, Heimer R. Peridomestic Lyme Disease Prevention Results of a Population-Based Case–Control Study. American Journal Of Preventive Medicine 2009, 37: 201-206. PMID: 19595558, DOI: 10.1016/j.amepre.2009.04.026.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAnimalsCase-Control StudiesChildChild, PreschoolConnecticutEnvironment DesignEnvironmental ExposureFemaleHumansHygieneInfantLogistic ModelsLyme DiseaseMaleMatched-Pair AnalysisMiddle AgedPopulation SurveillanceProspective StudiesResidence CharacteristicsRisk FactorsSurveys and QuestionnairesTicksYoung AdultConceptsCase-control studyLyme diseaseDisease prevention initiativesConditional logistic regressionDisease prevention measuresErythema migransPotential confoundersRecreational exposureLogistic regressionProspective ageDiseaseCase onsetPrevention resultsPrevention measuresPersonal protectionRiskHoursConfoundersMigransTicksInfectionStudyConnecticut communitiesMonths
2008
Economic Evaluation of Delivering Hepatitis B Vaccine to Injection Drug Users
Hu Y, Grau LE, Scott G, Seal KH, Marshall PA, Singer M, Heimer R. Economic Evaluation of Delivering Hepatitis B Vaccine to Injection Drug Users. American Journal Of Preventive Medicine 2008, 35: 25-32. PMID: 18541174, PMCID: PMC2483306, DOI: 10.1016/j.amepre.2008.03.028.Peer-Reviewed Original ResearchConceptsInjection drug usersSyringe exchange programsHBV vaccinationDrug usersHepatitis B vaccination coverageActive injection drug usersAcute HBV infectionHepatitis B infectionHepatitis B vaccineQuality-adjusted life yearsAbsence of vaccinationLocal health departmentsDifferent vaccination strategiesVaccination program costsB infectionHBV infectionB vaccineFirst doseVaccination scheduleVaccination coverageVaccination strategiesCost-saving strategyVaccination campaignHigh riskMedical costsCommunity coverage and HIV prevention: Assessing metrics for estimating HIV incidence through syringe exchange
Heimer R. Community coverage and HIV prevention: Assessing metrics for estimating HIV incidence through syringe exchange. International Journal Of Drug Policy 2008, 19: 65-73. PMID: 18207726, PMCID: PMC2367433, DOI: 10.1016/j.drugpo.2007.12.004.Peer-Reviewed Original Research
1998
Reactivity of Human Sera to Different Strains of Granulocytic Ehrlichiae in Immunodiagnostic Assays
Magnarelli L, IJdo J, Dumler J, Heimer R, Fikrig E. Reactivity of Human Sera to Different Strains of Granulocytic Ehrlichiae in Immunodiagnostic Assays. The Journal Of Infectious Diseases 1998, 178: 1835-1838. PMID: 9815246, DOI: 10.1086/314516.Peer-Reviewed Original ResearchConceptsNCH-1 strainIndirect IFAHuman granulocytic ehrlichiosis (HGE) agentHuman granulocytic ehrlichiosisWestern blot analysisInfected neutrophilsPromyelocytic leukemia cellsHuman promyelocytic leukemia cellsAntibody detectionGranulocytic ehrlichiosisEhrlichia equiDifferent strainsHuman isolatesLeukemia cellsSerumImmunodiagnostic assaysBlot analysisGranulocytic ehrlichiaeIFA analysisHuman serumIFAEhrlichiaeAssaysSeropositivityPatientsCan Syringe Exchange Serve as a Conduit to Substance Abuse Treatment?
Heimer R. Can Syringe Exchange Serve as a Conduit to Substance Abuse Treatment? Journal Of Substance Use And Addiction Treatment 1998, 15: 183-191. PMID: 9633030, DOI: 10.1016/s0740-5472(97)00220-1.Peer-Reviewed Original ResearchSyringe Use and Reuse: Effects of Syringe Exchange Programs in Four Cities
Heimer R, Khoshnood K, Bigg D, Guydish J, Junge B. Syringe Use and Reuse: Effects of Syringe Exchange Programs in Four Cities. JAIDS Journal Of Acquired Immune Deficiency Syndromes 1998, 18: s37-s44. PMID: 9663622, DOI: 10.1097/00042560-199802001-00008.Peer-Reviewed Original Research
1995
HIV Incidence Among New Haven Needle Exchange Participants
Kaplan E, Heimer R. HIV Incidence Among New Haven Needle Exchange Participants. JAIDS Journal Of Acquired Immune Deficiency Syndromes 1995, 10: 175-176. PMID: 7552482, DOI: 10.1097/00042560-199510020-00010.Peer-Reviewed Original Research
1994
A circulation theory of needle exchange
Kaplan E, Heimer R. A circulation theory of needle exchange. AIDS 1994, 8: 567-574. PMID: 8060540, DOI: 10.1097/00002030-199405000-00001.Peer-Reviewed Original ResearchHIV incidence among needle exchange participants: estimates from syringe tracking and testing data.
Kaplan E, Heimer R. HIV incidence among needle exchange participants: estimates from syringe tracking and testing data. JAIDS Journal Of Acquired Immune Deficiency Syndromes 1994, 7: 182-9. PMID: 8301530.Peer-Reviewed Original Research
1993
Needle exchange decreases the prevalence of HIV-1 proviral DNA in returned syringes in New Haven, Connecticut
Heimer R, Kaplan E, Khoshnood K, Jariwala B, Cadman E. Needle exchange decreases the prevalence of HIV-1 proviral DNA in returned syringes in New Haven, Connecticut. The American Journal Of Medicine 1993, 95: 214-220. PMID: 8356986, DOI: 10.1016/0002-9343(93)90263-o.Peer-Reviewed Original ResearchConceptsHIV-1 proviral DNANeedle exchange programsProviral DNANew Haven's needle exchange programNeedle exchangeHIV-1 prevalenceIntravenous drug usersNeedle exchange clientsDrug treatment programsPercentage of syringesDrug use habitsSyringe trackingDNA prevalenceNew HavenPolymerase chain reactionDrug treatmentDrug usersTreatment programPrevalenceChain reactionExchange programsSyringesMonthsProgram participantsFunded evaluation
1992
Prevalence of HIV-Infected Syringes during a Syringe-Exchange Program
Heimer R, Kaplan E, Cadman E. Prevalence of HIV-Infected Syringes during a Syringe-Exchange Program. New England Journal Of Medicine 1992, 327: 1883-1884. PMID: 1448131, DOI: 10.1056/nejm199212243272613.Peer-Reviewed Original ResearchHIV prevalence among intravenous drug users: model-based estimates from New Haven's legal needle exchange.
Kaplan E, Heimer R. HIV prevalence among intravenous drug users: model-based estimates from New Haven's legal needle exchange. JAIDS Journal Of Acquired Immune Deficiency Syndromes 1992, 5: 163-9. PMID: 1732509.Peer-Reviewed Original Research