Arthur Robin Williams

 

POSITION TITLE: NIDA T32 Fellow, Division on Substance Abuse, Columbia University Medical Center, New York State Psychiatric Institute

 

 

 Contributions to Science

 

1. Treatment of Opioid Use Disorder.  My work has consistently demonstrated that our substance abuse treatment system continues to struggle to connect practice with science. Patients experience inferior outcomes as a result, although patients effectively retained on MAT have improved trajectories. My studies on buprenorphine clinic patients at Bellevue Hospital Center following Hurricane Sandy, in which I conducted retrospective patient surveys, demonstrated the flexibility of this treatment modality in the face of service disruption, especially for patients with psychiatric comorbidity. More recent work analyzing state policies, Medicaid redesign, and the integration of substance abuse treatment into the general healthcare system has investigated the delivery of MAT more broadly. Pilot data (currently under submission) on community-based xr-naltrexone patients demonstrates challenges of retaining patients in care evolve over the course of treatment. Through retrospective telephone surveys with prior xr-naltrexone clinical trial participants who were referred out to continue injections through community providers, I determined that barriers to continuation in care typically evolve from external barriers to internal beliefs that treatment is no longer necessary or “feeling cured.” Rather than continue with retrospective phone surveys, my K23 research plan will pivot toward large multi-site clinical providers’ EHR records in combination with insurance claims data. Initially, analyses will assess patient characteristics associated with success along the OUD treatment cascade that can inform future qualitative studies (such as surveys of patients’ experiences along the Cascade) and quality improvement projects.

 

C.        Contributions to Science

 

1. Treatment of Opioid Use Disorder.  My work has consistently demonstrated that our substance abuse treatment system continues to struggle to connect practice with science. Patients experience inferior outcomes as a result, although patients effectively retained on MAT have improved trajectories. My studies on buprenorphine clinic patients at Bellevue Hospital Center following Hurricane Sandy, in which I conducted retrospective patient surveys, demonstrated the flexibility of this treatment modality in the face of service disruption, especially for patients with psychiatric comorbidity. More recent work analyzing state policies, Medicaid redesign, and the integration of substance abuse treatment into the general healthcare system has investigated the delivery of MAT more broadly. Pilot data (currently under submission) on community-based xr-naltrexone patients demonstrates challenges of retaining patients in care evolve over the course of treatment. Through retrospective telephone surveys with prior xr-naltrexone clinical trial participants who were referred out to continue injections through community providers, I determined that barriers to continuation in care typically evolve from external barriers to internal beliefs that treatment is no longer necessary or “feeling cured.” Rather than continue with retrospective phone surveys, my K23 research plan will pivot toward large multi-site clinical providers’ EHR records in combination with insurance claims data. Initially, analyses will assess patient characteristics associated with success along the OUD treatment cascade that can inform future qualitative studies (such as surveys of patients’ experiences along the Cascade) and quality improvement projects.

 

C.        Contributions to Science

 

1. Treatment of Opioid Use Disorder.  My work has consistently demonstrated that our substance abuse treatment system continues to struggle to connect practice with science. Patients experience inferior outcomes as a result, although patients effectively retained on MAT have improved trajectories. My studies on buprenorphine clinic patients at Bellevue Hospital Center following Hurricane Sandy, in which I conducted retrospective patient surveys, demonstrated the flexibility of this treatment modality in the face of service disruption, especially for patients with psychiatric comorbidity. More recent work analyzing state policies, Medicaid redesign, and the integration of substance abuse treatment into the general healthcare system has investigated the delivery of MAT more broadly. Pilot data (currently under submission) on community-based xr-naltrexone patients demonstrates challenges of retaining patients in care evolve over the course of treatment. Through retrospective telephone surveys with prior xr-naltrexone clinical trial participants who were referred out to continue injections through community providers, I determined that barriers to continuation in care typically evolve from external barriers to internal beliefs that treatment is no longer necessary or “feeling cured.” Rather than continue with retrospective phone surveys, my K23 research plan will pivot toward large multi-site clinical providers’ EHR records in combination with insurance claims data. Initially, analyses will assess patient characteristics associated with success along the OUD treatment cascade that can inform future qualitative studies (such as surveys of patients’ experiences along the Cascade) and quality improvement projects.