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Substance Use and Addiction

Use of alcohol, tobacco, and other drugs has long been associated with public health problems such as cancer, chronic lung and liver disease, and an increased risk for sexually transmitted or blood-borne infections. More recently, the opioid crisis in the U.S. has claimed more lives annually than motor vehicle accidents.

The availability of illicitly produced synthetic opioids has increased dramatically since 2013, further contributing to the public health crisis. Research conducted by YSPH includes epidemiological and geospatial analyses of opioid-involved fatalities in Connecticut, and assessing the potential public health benefits of expanded access to naloxone. Additionally, research is being conducted assessing the impact of expedited referral to medication-assisted treatment through harm-reduction organizations and emergency departments on recovery.

Other studies have sought to understand:

  • Contextual factors that may contribute to risk of non-fatal opioid overdoses

  • The role of mental health, stigma and discrimination in substance use

  • How to integrate behavioral health care into primary care

  • Strategies for limiting the harms of substance use, and more foundational studies of the causes or impacts of inadequately treated substance use or mental illness

  • The use of behavioral health economics to develop programs to promote risk-reduction behaviors

  • Whether eHealth applications can be effective tools for treating tobacco- and substance-use disorders

  • The economics of substance abuse, including lost productivity, cost-effectiveness of treatments, social costs and policy, and drivers behind key disparities

  • The role of substance use in co-morbidities such as cancer and HIV

  • Tobacco and e-cigarette control

Practice- and community-based research and initiatives

  • From the development of the first syringe-exchange van, Yale has worked with communities around the world to promote risk reduction. Today, the Yale School of Public Health is involved in the Connecticut Opioid Response (CORE), the State of Connecticut’s Medical Examiner’s Office and law enforcement in response to the opioid epidemic in the region. Our work with community organizations and marginalized groups such as sex workers, MSM, intravenous drug users and people who are displaced or incarcerated seeks to address barriers to accessing treatment and to implement health promotion interventions in both traditional and non-traditional settings domestically and globally. For example, YSPH researchers are involved in treating Hepatitis C viruses in conjunction with substance abuse treatment, removing barriers to treatment in health care systems such as the Veterans Administration outpatient clinics.
  • Tobacco and e-cigarette research includes the testing and evaluation of technology-based interventions for smoking cessation, as well as the feasibility of using the unique window of periods of hospitalization to access smoking-cessation treatment.
  • Research and consultancy is being provided for a pain-management phone application targeting patients with neurofibromatoses.
  • The Community Alliance for Research and Engagement’s (CARE) Renew Study collaborates with several treatment centers and incorporates substance-use counseling students from Gateway Community College in an internship partnership to provide further connections and dissemination to the community.
  • YSPH researchers are collaborating with the VA to decrease suicide risk in veterans through the engagement of their significant others, as well as minimizing access to means of lethal suicide. This work can aid in ending the increasing numbers of suicides in veterans, and lead to practice changes to implement the interventions. In addition, the research includes a model for collaboration with and engagement of civilian treatment services.
  • Research in humanitarian settings looks at the role of substance use and abuse and risk factors for a range of conditions, including sexually transmitted infections, cancer and more.