News from the Nodes
Florida Node Alliance/CTN-0064 Update
The CTN-0064 (Linkage to Hepatitis C Virus (HCV) Care among HIV/HCV Co-infected Substance Users) main trial database was officially locked on May 9, 2018. Congratulations to all participating nodes and sites on reaching this study milestone!
A total of 422 participants were enrolled (Component 1) and 113 were randomized (Component 2). Sites achieved an outstanding retention rate of 95% at both the 6-month and 12-month follow-up time points.
Thank you to all site and node staff for your tireless dedication and commitment to CTN-0064 and the participants we strive to impact:
- Florida Node Alliance: Jackson Memorial Hospital, Emory University, Temple University, Harbor-UCLA, University of Pittsburgh Medical Center
- Greater New York Node: St. Luke’s
- New England Consortium Node: Boston Medical Center and Boston University
- Mid-Atlantic Node: Johns Hopkins University
- Ohio Valley Node: John H. Stroger, Jr. Hospital/CORE Center
- Texas Node: Parkland Health and Hospital System
- Southern Consortium Node: University of Alabama at Birmingham
Additionally, sites are fast approaching the ancillary study, CTN-0064-A-1 (Determination of Cause of Death Among HIV Infected Sub
On May 24, the Northeast Node welcomed Kinna Thakarar, DO, MPH, to present on "Opioid Use Disorder and Commonly Co-Occurring Conditions: An Infectious Disease Perspective" as part of the Node’s Science Series.
Dr. Thakarar is an infectious disease (ID) and addiction medicine physician with a special interest in health services research related to ID/addiction issues, as well as an Assistant Professor of Medicine at Maine Medical Center -- a partner of the Northeast Node.
In her presentation, Dr. Thakarar reviewed the epidemiology of injection drug use (IDU) and ID. These data demonstrate that people who have an opioid use disorder and inject drugs often have co-occurring infectious disease conditions such as HIV, hepatitis, and infective endocarditis. For example, physicians report a 25-50% increase in inpatient consultations for infections among people who inject drugs (PWID). The greatest increase in these infections is among young white people, paralleling the increase in opioid-related overdose fatalities in the US. IDU has also been found to be a main risk factor for acute Hepatitis C (HCV) which is a common co-infection with HIV and is becoming more rampant among younger age groups.
Given the recent inundation of patients admitted to hospitals for medical complications related to substance use, hospitals are being presented with a unique opportunity to intervene. Dr. Thakarar and her team at Maine Medical Center (MMC) have developed a clinical checklist for key health issues among PWID, focusing on harm reduction and infection prevention, such as talking with patients about safe injection techniques, PreP (Pre-Exposure Prophylaxis) for HIV prevention, screening for STIs and receiving relevant vaccines/boosters.
In a recent study conducted by Dr. Thakarar and colleagues at MMC, patients with IDU-associated infective endocarditis valve replacement surgery were discharged from MMC without medication-assisted treatment (MAT), and 38% were discharged with an opioid prescription. In response, MMC integrated a MAT program and addiction consult service, along with case management, of these surgical patients to provide needed assistance to improve recovery from valve replacement surgery.
You can view Dr. Thakarar’s presentation on the Northeast Node’s website.
The next session of the Northeast Node’s Science Series will take place on September 28, 2018 from 12-1pm EST: What’s the Point? Harm Reduction through Syringe Exchange in White River Junction and Springfield, VT by Laura Byrne.
Follow the Northeast Node on Twitter and Facebook.
New England Consortium Node
The McLean Hospital / Harvard Medical School Addictions in 2018 conference was held in Cambridge, Massachusetts on May 18th and 19th. This well-attended (420 participants) annual conference was developed for participants to: 1) summarize the high rates of opioid addiction in the United States; 2) implement appropriate treatment for opioid use disorder; 3) describe the relationship between stress and addiction; 4) learn about prescribing practices for medications to treat substance use disorders; 5) recognize and diagnose cocaine, methamphetamine, and club drug use disorders, and recommend appropriate treatment; 6) understand issues related to medical marijuana and marijuana use disorders; 7) develop strategies for working with patients on the issue of whether to cut down or abstain from substance use; 8) and recognize and treat co-occurring substance use, anxiety, and benzodiazepine use.
Dr. Roger Weiss and Dr. Shelly Greenfield were organizers of the course and many McLean Hospital/Harvard Medical School Faculty and CTN-affiliated investigators, current and past, delivered seminars at the conference, including Hilary S. Connery, MD, Ph.D. and R. Kathryn McHugh, PhD.
The Addictions in 2019 Conference is scheduled for May 3-4, 2019 at the Boston/Cambridge Marriott Hotel in Cambridge, Massachusetts.
Ohio Valley Node
Maryhaven site’s opioid treatment lauded by Senator Portman
A recent op-ed in the Washington Post by Ohio Senator Rob Portman gives praise to the treatment program at Maryhaven Inc., a community treatment program within the Ohio Valley Node and long-standing CTN participating study site.
In the article, Senator Portman discusses the role of the private sector in addressing the current opioid epidemic. He offers Maryhaven’s new Addiction Stabilization Center as an example of how private sector funding can combine with government funding to provide effective treatment strategies for opioid use disorder. Read the article here.
Prestera Center collaborating to develop new Quick Response Team for opioid overdose
Prestera Center (OVN; Huntington WV) has been working collaboratively with other community resources to develop Quick Response Teams in order to reach and respond more effectively to opioid overdose survivors.
The city of Huntington, WV has adopted the Colerain Township (OH) model, which was presented at the Annual CTN Scientific Meeting in March, with very impressive results so far. Since the teams have been responding in the community in early December 2017, 40% of the people they have had contact with have decided to enter a treatment or recovery program with one person being admitted within an hour of first contact. Comprehensive efforts to address the opioid epidemic in Huntington, including the Quick Response Teams, have resulted in a significant decrease in reported overdoses as well. Prestera Center is now working to develop a similar Quick Response Team in Charleston, WV. Once again, they are joining partners in that community to develop outreach to overdose survivors based on the Colerain Township model.
Pacific Northwest Node
On May 18, the University of Washington’s Alcohol & Drug Abuse Institute hosted its 3rd Symposium on Marijuana Research in Washington, this year in collaboration with colleagues from Washington State University.
The keynote speaker, Washington State Attorney General Bob Ferguson (pictured), spoke about issues of federal vs. state marijuana laws, and about Washington’s law protecting local jurisdictions’ right to exclude marijuana retail stores even if the product is legal in the state.
Scientists from the UW and WSU presented panels in three focus areas:
- Marijuana and Vulnerable Populations
- Cannabinoids: Therapeutic Potential
- Marijuana Use & Other Substances: Substitution, Combination, or Both?
The event drew approximately 200 researchers, state and local officials, and community partners.
The 2018 agenda, with video, slides, and speaker information, is available here: http://adai.uw.edu/mjsymposium/.
ADAI received funds from Washington’s Marijuana Dedicated Fund to support marijuana research and information dissemination, described in a report covering activities from July 2015-June 2017.
Western States Node
On March 12-13, the National Academies of Science convened a workshop on Integrating Infectious Disease Considerations with Response to the Opioid Epidemic. Dr. Korthuis served on the planning committee and as a moderator.
The workshop brought together stakeholders and policymakers to develop strategies to integrate treatment for opioid use disorder and HIV, hepatitis C, and hospitalizations for serious infections related to injection drug use.
The CTN-0067 protocol is up and running with all sites endorsed for enrolling participants. As of March 23, 2017, there have been a total of 16 people randomized. We are excited for participants to be induced on XR-NTX and commend all the sites for their efforts to date. As a reminder they protocol is looking for HIV-infected participants with untreated opioid use disorder and HIV RNA pcr with greater-or-equal-to 200 copies/ml.
On March 23, the OHSU-PSU School of Public Health held a retirement reception in honor of Dennis McCarty.
The event reminded us of the decades of contributions Dr. McCarty has given to the field of Addiction. We have all benefited from working with him and he will be missed greatly. (Pictured: Dennis & Sarah McCarty )