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CENTER FOR SUBSTANCE USE & INFECTIOUS DISEASE CARE INTEGRATION

Overview

The Center for Substance Use & Infectious Disease Care Integration is dedicated to promoting healthy outcomes for people who use substances, with a focus on prevention and treatment of infectious disease and other unintended consequences of substance use.

Mission

We seek to advance scientific knowledge, engage and partner with people and communities affected by substance use, and educate and train scholars. Together, we will develop and implement innovative strategies to promote health outcomes for people with substance use.

Vision

Universally accessible care to prevent and treat infectious disease and other harms of substance use.

Approach

Implementation science: Identifying ways to promote the integration of evidence-based practices into regular medical care to improve health outcomes.

Center Director

Oluwaseun O. Falade-Nwulia, MBBS, MPH

Dr. Falade-Nwulia is an Associate Professor at the Johns Hopkins University School of Medicine in Baltimore, MD. She previously served as Medical Director of the Baltimore City Health Department (BCHD) Ryan White funded HIV Early Intervention Initiative program, designed and implemented the BCHD hepatitis C virus (HCV) testing, linkage to care, and treatment programs. Her research has focused on understanding the distribution and impact of treatments for hepatitis and HIV infections on clinical outcomes and improving access to HCV/HIV and drug use treatment for people who use drugs. Her work has been funded by the National Institutes of Health, the Centers for Disease Control and the Substance Abuse and Mental Health Services administration and has centered on strategies to improve uptake of integrated infectious disease and substance use care. She is an active provider of HIV, hepatitis C and substance use care.

Center Programs Manager

Tracy Agee

Tracy Agee is a Senior Nurse Practitioner at The Johns Hopkins University SOM, Division of Infectious Disease. She has provided care to people with HIV, viral hepatitis C, substance use, and mental health disorders for over 20 years. In addition to ongoing patient care, she is committed to research and program development designed to reduce barriers to care for people with HIV and those who use drugs.

Programs

Provision of and support for low-barrier access to substance use and alcohol use disorder treatment and recovery support services (RSS) at the John G. Bartlett Infectious Diseases Practice at Johns Hopkins Hospital.

RESTORE delivers low threshold SUD medical treatment (including buprenorphine) and RSS in a primary care infectious disease setting. RESTORE’s success in linking, engaging and retaining psychosocially and medically complex patients with severe SUDs lies in intensive peer-delivered RSS, leveraging addictions psychiatry services existing in the Bartlett clinic, dedicated clinician champions for support of Bartlett clinicians and staff in providing evidence-based, non-stigmatizing, low-threshold access to office based opioid and alcohol use disorder treatment.

RESTORE was developed and implemented in response to rising rates of opioid use disorder, overdose deaths, and concomitant increase in viral hepatitis infections and disparate health outcomes for people living with HIV and ongoing substance use. Initially funded by the Substance Abuse and Mental Health Services Administration, it has been sustained and is an ongoing service of the Johns Hopkins Bartlett Specialty Practice.

Funding (originally): Substance Abuse and Mental Health Service Administration
Status: ongoing

Interested in quick information about this program and how to find out if you are eligible? Please click here.

Escalation in opioid use in rural Maryland has led to marked increases in overdose morbidity, mortality, and hepatitis C infection. Key barriers to effective HIV/HCV and OUD response in rural Maryland include limited transportation options in rural regions of our state, a limited number of infectious disease and substance use care providers, and scant integration of addiction and infectious disease treatment and services.

Working in collaboration with the Maryland Department of Health Center for Harm Reduction services and local health department/Syringe Service Programs, providers from the Johns Hopkins Infectious Disease Division provide expert care for hepatitis C and opioid use disorder care via telemedicine to patients at these local health departments or syringe service programs.

Appointments for care can be scheduled by calling 443-812-8148.

Funding: Maryland Department of Health ACCESS Telehealth

Research

This project aims to further the National Ending the HIV Epidemic goals via peer-supported collaborative care for substance use and mental health disorder and HIV care integration.

Despite effectiveness of antiretrovirals for HIV treatment, people living with HIV who also have mental health or substance use disorders suffer disparities in rates of HIV suppression and retention in HIV care. Collaborative care is a well-established, evidence-based model for integrating mental health disorder care into primary care settings.

PROSPER is a Hybrid Type 1 implementation-effectiveness trial of an adapted collaborative care model with peer coaches as care managers. The program aims to increase integration of screening and treatment for mental health and substance use disorder care into HIV care settings. In PROSPER, peer coaches receive rigorous training and supervision in a structured, flexible intervention. Those who agree to participate and are randomized to intervention engage with a peer coach who is part of a collaborative care team including a consulting psychiatrist and the patient’s own HIV primary care provider. Those randomized to usual care have access to existing Bartlett Clinic resources, including therapists, psychiatrists and in-clinic low-barrier SUD treatment and support.  Mixed methods will be used to characterize the implementation process and outcomes.

Funding: NIH: NIH/ NIDA R01DA052297
ClinicalTrials.gov: NCT04601064
Status: Ongoing

Interested in quick information about this study and how to find out if you are eligible? Please click here.

A multicenter, open-label, phase IV randomized controlled trial, led by Johns Hopkins and implemented in Baltimore, Toronto (University of Toronto), San Francisco (UCSF), and Alabama (UAB) evaluating an approach to delivering hepatitis C (HCV) treatment in accredited opioid treatment programs (OTPs).

People who receive opioid agonist treatment in OTPs, such as methadone or buprenorphine, have disproportionately high rates of HCV. Oral direct-acting antivirals can cure >= 95% of HCV, but do not reach all who are infected.

RAPID HCV a hybrid implementation-effectiveness trial evaluating the effectiveness of immediate access to on-site HCV evaluation and treatment, enhanced by peer mentor support at the OTP, compared to standard of care of referral for off-site HCV treatment. Mixed methods will be used to characterize the implementation process and outcomes

Funding: Investigator initiated trial funded by AbbVie
ClinicalTrial.gov:
NCT04677153
Status: Enrollment complete

Past Grants & Projects