From the Chair
Montefiore Einstein’s exceptional effort to meet the needs of its large and diverse community has placed us at the forefront of national healthcare reform. One of our Department’s many examples of this unique bond to the Bronx community comes from our Division of General Internal Medicine.
Drug abuse has become an overwhelming epidemic: the Centers for Disease Control and Prevention report that 2014 was a record-breaking year for deaths from drug overdose, with over 60% involving opioids. Heroin use is rising, with 75% of users reporting previous abuse of prescription opioids.
Led by Dr. Julia Arnsten, General Internal Medicine Division Chief and Director of the Montefiore Einstein Center for Comparative Effectiveness Research, these outstanding, highly committed faculty members are conducting innovative investigations to address the burgeoning rates of substance abuse in our community and the nation.
Yaron Tomer, MD, FACP
Anita and Jack Saltz Chair in Diabetes Research
Professor and University Chair, Department of Medicine
Albert Einstein College of Medicine
Montefiore Medical Center
Resident & Medical Student Training
Clinical Addiction Research and Education (CARE) Program
Julia Arnsten, MD, MPHDespite the high prevalence of substance abuse among medical in- and outpatients, training in substance abuse disorders for resident physicians and medical students remains limited.
The Montefiore Einstein Clinical Addiction Research and Education (CARE) Program, a post-doctoral fellowship that began in 2002, trains physicians for careers in drug abuse research and clinical practice. Led by Dr. Julia Arnsten, Chief of the Division of General Internal Medicine and Director of the Center for Comparative Effectiveness Research, the program provides clinical research training strategically designed to prepare physicians for independent careers as HIV and substance abuse researchers. more>>
Research
General Internal Medicine faculty are examining the broader issues that surround addiction.
Addiction Treatment
Outcomes
Neurocognitive Effects of Opiate Agonist Treatment in HIV-Infected Drug Users
Julia Arnsten, MD, MPH
NIH: $520,108
Dr. Arnsten's study tests the hypothesis that treatment with buprenorphine is associated with significant improvement in neurocognitive function in opioid-dependent, HIV-infected and uninfected drug users, compared to methadone.
Project FIRST
Chinazo O. Cunningham, MD, MS
NIH: $458,462
Dr. Cunningham's study examines whether financial incentives for abstinence from illicit drugs lead to improved HIV outcomes.
Risk
Opioid misuse and addiction in people taking opioid analgesics
Joanna Starrels, MD, MS
NIH: $83,399
Studies in opioid misuse and addiction in people taking opioid analgesics examine the risk of developing opioid misuse and addiction among patients with chronic pain based on the type of opioids prescribed and the duration of opioid use. Dr. Starrels is also examining state policies for health care providers who prescribe opioid medications for individuals with chronic pain.
Access
Addiction Treatment in the Affordable Care Act
Marcus Bachhuber, MD
Dr. Bachhuber's study examines how gains in insurance coverage after the 2014 Medicaid expansion affect persons with addiction, and how access to addiction treatment by in-network providers in Marketplace plans is changing.
Increasing primary care access to buprenorphine treatment for opioid addiction
Chinazo O. Cunningham, MD, MS
Lifestyle Support
Incarceration and Reentry
Buprenorphine-Facilitated Access and Supportive Treatment in Former Inmates (BUP-FAST)
Aaron Fox, MD
NIH: $152,165
Dr. Fox is examining why people relapse to opioids when they come home from prison, and what can be done to help them engage in substance abuse and primary medical treatment. In this study, he evaluates peer mentorship to assist individuals with opioid use disorders entering addiction treatment after jail/prison release.
Smoking Cessation
Smoking Cessation Treatment for Methadone Maintenance Patients
Shadi Nahvi, MD
NIH: $88,380
Tobacco use and tobacco-related disease is markedly prevalent among methadone maintenance patients. Dr. Nahvi seeks to help methadone-maintained smokers quit smoking by developing and evaluating an effective intervention to optimize smoking cessation medication use.
Drug Abuse and Chronic Disease
Risky sexual behavior and needle sharing have inextricably linked drug abuse and addiction to diseases such as HIV/AIDS and hepatitis C (HCV).
Patient-Centered Models of HCV Care for People Who Inject Drugs
NIH: $268,402
PCORI: $14,000,000
Dr. Litwin's multi-center study aims to determine whether directly observed treatment (DOT), in which HCV medication is taken under a staff member’s observation, or patient navigation (PN), a more autonomous method involving peer education and support, produces the best results and is preferred by patients.
Intensive Models of HCV Care for Injection Drug Users
Dr. Litwin seeks to maximize treatment outcomes by piloting DOT and concurrent group therapy (CGT) within a multidisciplinary model of HCV care that integrates on-site primary care (including HIV care), substance abuse treatment, psychiatric care, and HCV-related care within opiate agonist treatment clinics.
HCV Group Evaluation and Treatment Uptake (HCV GET-UP)
Brianna Norton, MD
NIH: $184,002
Dr. Norton is testing the ability of a group HCV evaluation and primary care clinic-based intervention to improve HCV treatment uptake among HCV-positive and HIV/HCV-positive intravenous drug users.
Published April 6, 2016
