Patients with substance use disorders are disproportionately affected by infectious diseases, particularly HCV and HIV. It is challenging to bridge the gap between the disparate disciplines of substance abuse and infectious diseases. I have fortunately and deliberately achieved considerable success in managing each of these conditions clinically. Through clinical activities, directed mentorship, participation in research and contribution to the medical literature at the interface of infectious diseases and substance abuse, I am now in a position to redirect my training to develop into an independent, patient-oriented researcher. In order to make this transition from clinician to researcher, I have identified three major career goals: 1) To gain expertise in the pharmacological treatment of substance abuse and the implementation of therapeutic research in the substance abuse treatment setting;2) To develop expertise in research methods necessary to design, implement, and evaluate effective and integrated interventions in community settings resulting in improved health outcomes for drug users with substance abuse disorders and HCV and/or HIV;and 3) To enhance my professional development toward an independent research career path in patient-oriented research at the challenging intersection of substance abuse and infectious diseases. I will accomplish these goals through didactic coursework and seminars, directed and multidisciplinary mentorship and participation in two feasible and related research projects. As part of my didactic coursework, I will obtain a Masters in Science in Epidemiology. My first research project will be to conduct an analysis of the treatment outcomes of HCV treatment among prisoners using a retrospective analytic approach. The second research project will occur in two phases and will seek to develop and evaluate novel strategies for the treatment of HCV infection among opioid-dependent patients within a drug treatment program. Intervention development will occur with both methadone (MMT) and buprenorphine (BMT) maintenance treatment. Among these, the adherence to therapy intervention will compare onsite or co-location of HCV services with HCV services provided off-site from the drug treatment program. Data used from the two phases of this study will provide an effect estimate that will be used for a R01 submission to conduct a randomized controlled trial.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23DA022143-05
Application #
7924577
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Khalsa, Jagjitsingh H
Project Start
2006-08-01
Project End
2011-06-30
Budget Start
2010-07-01
Budget End
2011-06-30
Support Year
5
Fiscal Year
2010
Total Cost
$181,332
Indirect Cost
Name
Yale University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
043207562
City
New Haven
State
CT
Country
United States
Zip Code
06520
Bruce, R Douglas; Moody, David E; Altice, Frederick L et al. (2013) A review of pharmacological interactions between HIV or hepatitis C virus medications and opioid agonist therapy: implications and management for clinical practice. Expert Rev Clin Pharmacol 6:249-69
Morano, Jamie P; Walton, Mary R; Zelenev, Alexei et al. (2013) Latent tuberculosis infection: screening and treatment in an urban setting. J Community Health 38:941-50
Bruce, R Douglas; Eiserman, Julie; Acosta, Angela et al. (2012) Developing a modified directly observed therapy intervention for hepatitis C treatment in a methadone maintenance program: implications for program replication. Am J Drug Alcohol Abuse 38:206-12
Schwarz, Ryan; Zelenev, Alexei; Bruce, R Douglas et al. (2012) Retention on buprenorphine treatment reduces emergency department utilization, but not hospitalization, among treatment-seeking patients with opioid dependence. J Subst Abuse Treat 43:451-7
Altice, Frederick L; Bruce, R Douglas; Lucas, Gregory M et al. (2011) HIV treatment outcomes among HIV-infected, opioid-dependent patients receiving buprenorphine/naloxone treatment within HIV clinical care settings: results from a multisite study. J Acquir Immune Defic Syndr 56 Suppl 1:S22-32
Copenhaver, Michael M; Lee, I-Ching; Margolin, Arthur et al. (2011) Testing an optimized community-based human immunodeficiency virus (HIV) risk reduction and antiretroviral adherence intervention for HIV-infected injection drug users. Subst Abus 32:16-26
Bruce, Robert Douglas; Altice, Frederick L; Moody, David E et al. (2010) Pharmacokinetic interactions between buprenorphine/naloxone and once-daily lopinavir/ritonavir. J Acquir Immune Defic Syndr 54:511-4
Bruce, R Douglas; Kresina, Thomas F; McCance-Katz, Elinore F (2010) Medication-assisted treatment and HIV/AIDS: aspects in treating HIV-infected drug users. AIDS 24:331-40
Bruce, R Douglas (2010) Methadone as HIV prevention: high volume methadone sites to decrease HIV incidence rates in resource limited settings. Int J Drug Policy 21:122-4
Kresina, Thomas F; Bruce, R Douglas; McCance-Katz, Elinore F (2009) Medication assisted treatment in the treatment of drug abuse and dependence in HIV/AIDS infected drug users. Curr HIV Res 7:354-64

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