In addition to expert evaluation and care for adolescents with substance use problems and disorders, the Division of Addiction Medicine is home to a thriving research program that aims to find ways to prevent or decrease substance use and associated problems. Our goal is to improve support for adolescents, families, and the providers that care for them.
Currently funded research projects
Adolescent outcomes of Post-operative opioid EXposure (APEX)
The aim of this observational study is to develop and validate screening algorithms designed to detect “early warning signs” of opioid use disorder risk factors and to develop and validate a time-series prediction model designed to predict a clinical trajectory and the likelihood of development of risks of opioid use disorder in adolescents undergoing painful orthopedic surgeries. The study will recruit 10,000 adolescents receiving opioids for orthopedic surgeries and their parents across multiple sites in the US.
Project Lead Investigators: Dr. Sharon Levy, MD, MPH and Dr. Joe Cravero, MD
Project Investigators: Dr. Vidya Chidambaran, MD, MS, MM; Dr. Gabriel Brat, MD; Dr. Elissa Weitzman, ScD, MSc; Griffin Weber, MD, PhD; Denis Agniel, PhD, MS
Funder: NIH/NIDA-CTN
Status: Recruiting
'Evaluation of Adolescent Substance Use Screening Tools'
The goal of this study is to test the performance (sensitivity and specificity) of three instruments (BSTAD, S2BI, TAPS) against a criterion standard of DSM-5 substance use disorder diagnoses in a population of adolescents presenting for routine primary care. Two brief screening tools (BSTAD, S2BI) that use past-year frequency of use questions to determine risk level have been developed for use with adolescents, and each has been validated in a single trial. The third tool (TAPS), which includes both screen and brief assessment, has been studied more extensively in adult primary care patients, though validity with adolescents is not known.
Publications:
Levy, S., Brogna, M., Minegishi, M., et al. Screens for Identifying Substance Use Disorders in Adolescents: Results of the Adolescent Screening To Help Eliminate Misuse Trial. JAMA Netw Open. Accepted. 2023
'Evaluation of SBIRT in primary care for adolescents and young adults'
This project aims to collect evidence about the effects of screening, brief intervention, and referral to treatment (SBIRT) integrated care by measuring and comparing substance use, mental health, and health service use outcomes for adolescents and young adults (AYA) receiving primary care in practices with and without integrated SBIRT services.
'Modeling adjuvant responses in human blood in vitro to inform opioid vaccine development'
The primary goal of this project is to develop an optimally adjuvanted fentanyl (FEN) vaccine. In order to develop an effective fentanyl vaccine, we are trying to understand the differences in immune response between a) people who have previously used opioids and people who have not used opioids, and b) people of deferring age groups than dose traditionally studied as part of pre-clinical vaccine development, such as adolescents and young adults. A second goal of this project is to conduct key informant interviews with patients, family members, and doctors in order to determine perspectives on the safety, efficacy, and likely benefits of an opioid vaccine.
Publications
Weitzman ER, Kossowsky J, Blakemore LM, et al. Acceptability of a Fentanyl Vaccine to Prevent Opioid Overdose and Need for Personalized Decision-Making. Clin Infect Dis. 2022;75(Suppl 1):S98-S109. doi:10.1093/cid/ciac344
The overarching goal of this project is to create new access to a full range of high-quality screening, brief intervention, and referral to treatment (SBIRT) services, including medication treatment for addiction, in a statewide network of pediatric primary care practices. The Adolescent Substance Use and Addiction Program (ASAP) and the Pediatric Physicians Organization of Children’s (PPOC), which are both programs within the Boston Children’s Hospital integrated care organization, have partnered to re-envision SBIRT in pediatric primary care. Over the next five years, we will aim to provide high-quality SBIRT services to more than 33,000 adolescents and young adults (AYA), including brief treatment for more than 3,100 and medication treatment for opioid use disorder for more than 100 AYA annually within five years by scaling the program of integrated LICSWs into 25 pediatric practices. Each integrated practice will be staffed with an LICSW who will provide 20 hours of SBIRT clinical services per week, and supported clinically by the team of Pediatric Addiction Medicine specialists in ASAP.
The primary goal of this project is to evaluate a state policy which mandates Massachusetts schools to deliver screening, brief intervention, and referral to treatment (SBIRT) to middle and high school students. Data collection will occur through anonymous student surveys administered in all participating schools and grades pre- and post-screening intervention. The project aims to evaluate the impact of school SBIRT on health and behavioral outcomes among adolescents through case-control comparison of schools. We will also conduct a brief phone interview with the school leader(s) of the SBIRT program, pre- and post-implementation, to outline and evaluate the implementation model.
Publications
Levy S, Wisk LE, Minegishi M, et al. Association of Screening and Brief Intervention With Substance Use in Massachusetts Middle and High Schools. JAMA Netw Open. 2022;5(8):e2226886. doi:10.1001/jamanetworkopen.2022.26886
Chadi N, Levy S, Wisk LE, Weitzman ER. Student Experience of School Screening, Brief Intervention, and Referral to Treatment. J Sch Health. 2020;90(6):431-438. doi:10.1111/josh.12890
The goals of this project are to validate a set of measures to support the study of brief interventions in primary care, and to develop a prototype brief intervention to prevent alcohol and cannabis use in adolescents with type 1 diabetes, rheumatic diseases, and inflammatory bowel disease.
Publications
Oliver A, Kossowsky J, Minegishi M, Levy S, Weitzman E. Association of vaping and social/emotional health and attitudes towards COVID-19 mitigation measures in adolescent and young adult cohorts during the COVID-19 pandemic. Journal of Sub Abuse. Accepted. 2023.
Ross JA, Malone PK, Levy S. The Impact of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Pandemic on Substance Use in the United States. Clin Infect Dis. 2022;75(Suppl 1):S81-S85. doi:10.1093/cid/ciac311
Levy S, Wisk LE, Chadi N, Lunstead J, Shrier LA, Weitzman ER. Validation of a single question for the assessment of past three-month alcohol consumption among adolescents. Drug Alcohol Depend. 2021;228:109026. doi:10.1016/j.drugalcdep.2021.109026
Weitzman ER, Wisk LE, Minegishi M, et al. Effects of a Patient-Centered Intervention to Reduce Alcohol Use Among Youth With Chronic Medical Conditions. J Adolesc Health. 2022;71(4S):S24-S33. doi:10.1016/j.jadohealth.2021.10.017
Levy S, Wisk LE, Minegishi M, Lunstead J, Weitzman ER. Pediatric Subspecialist Alcohol Screening Rates and Concerns About Alcohol and Cannabis Use Among Their Adolescent Patients. J Adolesc Health. 2022;71(4S):S34-S40. doi:10.1016/j.jadohealth.2022.03.001
Weitzman ER, Salimian PK, Rabinow L, Levy S. Perspectives on substance use among youth with chronic medical conditions and implications for clinical guidance and prevention: A qualitative study. PLoS One. 2019;14(1):e0209963. Published 2019 Jan 23. doi:10.1371/journal.pone.0209963
Lunstead J, Weitzman ER, Harstad E, et al. Screening and Counseling for Alcohol Use in Adolescents With Chronic Medical Conditions in the Ambulatory Setting. J Adolesc Heal. 2019;64(6):804-806. doi:10.1016/j.jadohealth.2019.02.011
