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ADepT GIS: Alcohol and Drug Epidemiology and Treatment Geographic Information Service

Principal Investigator:
Joseph Kabel, PhD
President, Looking Glass Analytics, Inc.

Date: July 14, 2008 to July 13, 2011
Sponsor: Looking Glass Analytics ; National Institute on Drug Abuse ; Northwest Crime and Social Research, Inc. (HHSN271200800021C)
Categories: Epidemiology and Drug Abuse Trends

Other Investigators: Bill Luchansky, Looking Glass Analytics, Inc. (LGAN); Caleb Banta-Green, PhD, MPH, MSW (ADAI Research Scientist)


Description: [ADAI has a subcontract to support the work of Dr. Banta-Green on this project].

LGAN was awarded a Small Business Innovative Research (SBIR) Phase II contract from the National Institute on Drug Abuse to continue development of ADEpT GIS (Alcohol and Drug Epidemiology and Treatment Geographic Information Service), an internet-based software application that allows users to generate statistical analyses, maps, and reports on community-level measures of substance abuse. This web service augments the work of groups like the NIDA-sponsored Community Epidemiological Workgroups by providing a data repository and accessible analysis system for reporting and surveillance purposes. Phase I activities have demonstrated the technical feasibility of our approach through substantial development of a prototype online information system for reporting on drug epidemiology. During the two-year Phase II period, LGAN will add new data and new mapping and analysis tools to ADEpT GIS. These enhancements will broaden and deepen the understanding of the extent and impacts of substance abuse in King County, WA for public health professionals, treatment program administrators and law enforcement.

The PIs are Joseph Kabel and Bill Luchansky, of Looking Glass Analytics, Inc. Dr. Banta-Green is consulting on several content and methodological areas including the stability, accuracy and utility of various rates of substance abuse at small levels of geography derived from several different sources.

Related Web Sites:
Looking Glass Analytics, Inc.
NIH RePORTER record

Drug Abuse Epidemiology Reporting Project

Principal Investigator:
Caleb Banta-Green, PhD, MPH, MSW
Senior Research Scientist
Alcohol and Drug Abuse Institute
calebbg@u.washington.edu
http://bit.ly/adaistaff_bantagreen

Date: November, 2001 to Ongoing
Sponsor: Alcohol and Drug Abuse Institute
Categories: Epidemiology and Drug Abuse Trends

Other Investigators: Jason Williams, PhD


Description: This ongoing project involves the reporting of epidemiology and surveillance activities related to alcohol and other drug abuse trends in Washington state. Relevant data is compiled from a variety of sources for determining alcohol and other drug abuse trends in the state. Other aspects of the project include: development of a network of key informants and data sources in Washington counties; collect, collate and analyze data using both quantitative and qualitative methods; and produce written reports and oral presentations of the results. Data are used to produce the Community Epidemiology Work Group (CEWG) report for Seattle-King County. (funded by DASA in 1st year; subsequently funded by ADAI)

Related Web Sites:
Washington Drug Abuse Epidemiology

Impacts of Cannabis & Cannabis Legalization on Impaired Driving in WA State

Principal Investigator:
Caleb Banta-Green, PhD, MPH, MSW
Research Scientist
Alcohol and Drug Abuse Institute
calebbg@u.washington.edu
http://bit.ly/adaistaff_bantagreen

Date: July, 2014 to September, 2015
Sponsor: AAA Foundation
Categories: Marijuana | Epidemiology and Drug Abuse Trends

Other Investigators: Ali Rowhani-Rahbar, MD, MPH, PhD (Co-Principal Investigator), Assistant Professor of Epidemiology, UW School of Public Health; Beth E. Ebel, MD, MSc, MPH (Co-Investigator), Adjunct Associate Professor, Epidemiology & Health Services, UW School of Public Health, and Associate Professor, Pediatrics

External collaborators: Fiona Couper, PhD, State Toxicologist, Forensic Laboratory Services Bureau, Washington State Patrol; Staci Hoff, PhD Research Manager, Washington Traffic Safety Commission


Description: In conjunction with the Harborview Injury Prevention & Research Center, we will examine the relationship between changes in Washington State cannabis laws and policies and the incidence of cannabis-impaired driving, using linked toxicological, criminal justice, and crash databases. Secondarily we will examine the relationship between the presence and level of cannabis metabolites in driver blood samples and the severity of driving offense, rates, and police-reported crash severity.

In 2012, Washington passed Initiative 502 that licenses and regulates marijuana production, distribution, and possession for adults (age 21 and over); removes state-law criminal and civil penalties for specified activities; taxes and regulates marijuana sales; and earmarks marijuana-related revenues. The Initiative set a level of 5 ng/mL of tetrahydrocannabinol (THC) in whole blood as a per se level for driving under the influence (DUI).

This change in state law presents a unique opportunity to examine the potential impact of legislation on marijuana-impaired driving and crash risk. Our study team is uniquely positioned to conduct these analyses given our combined scientific expertise and our experience with the data sets, research methods, state agencies, and stakeholders.

Results: Cannabis Use among Drivers Suspected of Driving Under the Influence or Involved in Collisions: Analysis of Washington State Patrol Data. C Banta-Green, A Rowhani-Rahbar, B Ebel, LM Andris, and Q Qui. Report for the AAA Foundation, 6/2016. Report & related resources

Long-term Opioid Management of Chronic Pain: Trends and Risks

Principal Investigator:
Michael Von Korff, ScD
Senior Scientific Investigator
Center for Health Studies, Group Health Cooperative
vonkorff.m@ghc.org

Date: September 28, 2006 to April 30, 2010
Sponsor: National Institute on Drug Abuse
Categories: Clinical and Health Services | Epidemiology and Drug Abuse Trends

Other Investigators: Caleb Banta-Green, PhD, MSW, MPH (ADAI Research Scientist)


Description: Health services research and epidemiologic methods will be used to understand who receives long-term opioid therapy and to assess associated risks including onset of opioid abuse and mortality. This research will be conducted in two large, non-profit health plans serving over 1% of the U.S. population. Research goals - Our goals are to advance knowledge concerning determinants and risks of long-term opioid therapy among chronic pain patients. Aim 1-Examine trends: We will describe trends in use of long-term opioid therapy in the participating health plans from 1995-2006 and determine how patient characteristics indicating clinical complexity and prior substance abuse are related to trends in long-term opioid use. Aim 2-Assess risks of opioid abuse: We will assess risk factors for opioid abuse among persons receiving long-term opioid therapy. Aim 3-Assess mortality and other adverse event risks: We will assess whether mortality and other adverse event risks are increased by long-term opioid therapy. We will extend these analyses by studying the effects of long-term opioid therapy on other adverse events including: all-cause and opioid-related hospitalization; opioid overdose; and onset of recognized mood disorder.

This project is based at the Center for Health Studies, Group Health Cooperative. ADAI has a subcontract for the work of Dr. Banta-Green; his primary role will be in the development, implementation and analysis of the interview study used to address Aim 2, risk factors for opioid abuse.

Related Web Sites:
NIH RePORTER record

Methamphetamine: Where Does It Fit in the Bigger Picture of Drug Use of American Indian and Alaska Native Communities and Treatment Seekers?

Principal Investigator:
Dennis M. Donovan, PhD, Lisa Rey Thomas, PhD
Alcohol and Drug Abuse Institute
http://bit.ly/adaistaff_donovan

Date: 2008? to August 31, 2010
Sponsor: National Institute on Drug Abuse
Categories: American Indians / Alaska Natives | Epidemiology and Drug Abuse Trends | CTN (NIDA Clinical Trials Network)

Other Investigators: Sandra Radin, Lisa Rey Thomas, Caleb Banta-Green


Description: The first area of research emphasis in the NIDA Strategic Plan on Reducing Health Disparities (2004 Revision) is the epidemiology of drug abuse, health consequences and infectious diseases among minority populations. Because there are limited data available on methamphetamine use in American Indian communities, exploratory and pilot studies will be conducted as part of CTN protocol CTN-0033 to develop collaborations with tribes and Native American treatment programs and to explore the epidemiology of methamphetamine use and co-occurring problems and disorders in diverse Native American communities.

Protocol CTN-0033-Ot-3 will conduct exploratory and preliminary studies to develop collaborative working relationships with tribes and tribal treatment programs in the Western Washington and Southeast Alaska to assess the epidemiology of co-occurring health disorders among American Indians and Alaska Natives (AIANs) seeking treatment for methamphetamine and other substance use in reservation-based and urban treatment centers.

Related Web Sites:
Protocol record in CTN Library

Prescription Drug Overdose Prevention for States

Principal Investigator:
Caleb Banta-Green, PhD, MPH, MSW
Senior Research Scientist
Alcohol and Drug Abuse Institute
calebbg@u.washington.edu
http://bit.ly/adaistaff_bantagreen

Date: August 1, 2016 to August 31, 2017
Sponsor: Washington State Department of Health through a grant from the CDC
Categories: Epidemiology and Drug Abuse Trends | Prescription Drug Abuse | Overdose Prevention

Other Investigators: Ryan Hansen, PharmD, PhD, Lauren Whiteside, MD


Description: In response to Centers for Disease Control and Prevention (CDC) Priority Strategy 1 the UW will support and evaluate DOH efforts to expand and improve proactive Prescription Monitoring Program (PMP) reporting. This will include contributing to the design of new reports based on the research literature as well as analyses of existing WA State PMP data conducted by the UW. The impact of new proactive reports will be examined via longitudinal analyses of PMP data. The UW will be involved in guiding analyses to be conducted by DOH staff as well as the interpretation of statistical analyses and the writing of relevant evaluation findings. Drs. Banta- Green and Hansen will support this task.

In support of Priority Strategy 2, and a DOH nurse consultant who will be providing community and prescriber technical assistance to prevent overdoses, Dr. Banta-Green will work closely with DOH and the nurse consultant to inform and coordinate the activities with Dr. Banta-Green’s Center for Opioid Safety Education at the UW.

As part of Priority Strategy 3, Drs. Banta-Green, Whiteside and Hansen, will help design and oversee an evaluation of the connection between the PMP and the Emergency Department Information Exchange. Analyses at the ED, prescriber and patient levels will be conducted.

As another component in response to Priority Strategy 3, Drs. Banta-Green and Hansen will be involved in examining the impact of WA State’s Pain Rules and other longitudinal analyses of policy and practice changes.

As part of Priority Strategy 4, Rapid Response Projects, Dr. Banta-Green will lead the effort to utilize electronic Emergency Medical Systems (EMS), aka ambulance, electronic data to enhance the capacity to use these systems to conduct surveillance for opioid overdose occurrence and document community based interventions. This will include working with EMS systems across WA State, and their software vendors, to determine the capacity of existing systems and data fields to capture information for opioid overdose surveillance as well as the technical capacity to gather new information on bystander and law enforcement administered aid to overdose victims. In collaboration with DOH and CDC, a multi-year plan to improve data collection via data system enhancement and paramedic training will be developed and implemented. The utility of these data to support opioid overdose surveillance and document the occurrence and impact of community based interventions will be examined.

Prescription Opioid Misuse in a Large HMO

Principal Investigator:
Caleb Banta-Green, PhD, MPH, MSW
Research Scientist
http://bit.ly/adaistaff_bantagreen

Date: June 10, 2006 to May 31, 2008
Sponsor: National Institute on Drug Abuse (R21 DA018695)
Categories: Epidemiology and Drug Abuse Trends

Other Investigators: Don Calsyn, PhD (Professor, Psychiatry & Behavioral Sciences, Research Affiliate, Alcohol & Drug Abuse Institute; Dr. Calsyn was the original PI of this grant)


Description: Licit and illicit use of prescription opioids, as well as associated morbidity and mortality, have increased significantly in the past six years in Washington State and nationally. Prescription opioid misuse is a constellation of behaviors characterized by unstable or chaotic patterns of medication use and aberrant patterns of medical care seeking. The biopsychosocial model will be used to examine the transition from opioid use to opioid misuse in the context of chronic pain treatment with opioids from the perspectives of health systems and clinicians. The specific aims of this proposal are to: 1. Determine the prevalence of prescription opioid misuse, abuse and dependence among those prescribed chronic opioids for non-malignant pain, and to determine the correlation between opioid misuse and the commonly used diagnostic categories of opioid abuse and dependence. 2. Model the utility of automated medical record data in differentiating between opioid misusers and non-misusers and determine the screening properties of the derived model (e.g. sensitivity, specificity, positive and negative predictive values, likelihood ratio). 3. Assess the utility of the automated data model obtained in Aim #2, enhanced with brief interview items related to pain severity, substance abuse, and mental health symptoms to identify potential opioid misusers. To meet these aims, we propose a retrospective cohort study of moderate to long-term opioid users in a large HMO in Washington State. Eligible subjects include all HMO enrollees, including those receiving opioids from primary and specialty care physicians. This large (n=1,000) and diverse sample will allow for greater generalizability of the findings than most of the preliminary studies to date, which were often conducted in pain clinics or the V.A. with its primarily male clientele. Data on medication use, medical conditions, and other risk factors for misuse will be obtained from automated data files. A structured phone interview will be used to obtain the predictor variables for Aim 3, the outcome variables related to opioid misuse, and DSM IV diagnoses of opioid abuse and dependence. Models to identify predictors of opioid misuse will be developed with half of the sample and validated with the other half. De-identified data on non-respondents will be utilized to adjust analyses for any non-response bias.

Related Web Sites:
NIH RePORTER record

Quantitative Drug Surveillance System Development

Principal Investigator:
Caleb Banta-Green, PhD, MPH, MSW
Research Scientist
Alcohol and Drug Abuse Institute
calebbg@u.washington.edu
http://bit.ly/adaistaff_bantagreen

Date: April 1, 2008 to March 31, 2010
Sponsor: National Institute on Drug Abuse (1R21DA024800-01)
Categories: Epidemiology and Drug Abuse Trends

Other Investigators: Jennifer A. Field, PhD, Oregon State University


Description: Drug abuse continues to have major public health consequences. Yet, validated, quantitative drug abuse surveillance tools are limited. Several national drug abuse surveillance systems have ceased operating or been substantially curtailed in recent years. This proposal aims to address these limitations by developing the methodology and establishing the feasibility of a drug-surveillance system based on quantifying illicit drugs, other drug-use indicators including metabolites and synthesis precursors, and human biomarkers in raw influent entering municipal wastewater treatment plants (WWTP) that process human waste. WWTPs have known catchment areas with specific geographic boundaries, population estimates, and volumetric flows that allow for the analysis of trends in community drug discharge over time and between locations.

The primary substance of interest for this proposal is methamphetamine, which will be quantified along with several other drugs of abuse (illicit and pharmaceutical) along with selected metabolites and human population biomarkers. AIMS: 1) Develop and validate a sensitive and selective analytical method for quantifying the concentration of methamphetamine, other illicit and pharmaceutical drugs in 24 hr, flow-normalized composites of raw influent entering WWTPs; 2) Develop procedures for obtaining samples from a diverse set of WWTPs; 3) Determine the geographic and temporal (seasonal, day of week) variability of drug excretion on a per capita and community basis in order to describe use patterns and to develop sampling frames with optimal efficiency; and 4) Determine the correlation between measured drug discharge estimates and other drug use indicator data. To meet these aims, we propose to collect 24 hr, flow-normalized samples of raw influent from 20 WWTPs throughout Oregon and Washington for one year. A minimum of 52 samples will be obtained from each WWTP using a stratified, time-based sampling plan that will incorporate seasonal and interday variation. Methamphetamine and other drugs of abuse are readily detected and uniquely identifiable by liquid chromatography/tandem mass spectrometry. WWTPs provide coverage to more than 100 cities and towns in Oregon and Washington. Current drug surveillance data indicate substantial geographic heterogeneity in rates of drug use throughout the Pacific Northwest. Our proposal has the support of diverse, local stakeholders including public health, drug treatment, law enforcement, and WWTP managers.

The findings of this R21 can be used 1) to provide research tools to examine a range of questions regarding differences in drug use by linking WWTP influent data to other geocoded data, 2) to provide local planners with validated, quantitative findings that can be used to inform allocation decisions for prevention and intervention efforts and for outcome evaluations, 3) by environmental chemists to refine analytical methods for detecting licit and illicit drugs, 4) to evaluate other geographic areas, 5) for emergent outbreak investigations, and 6) to create baseline data for future longitudinal and geographic analyses. PUBLIC HEALTH RELEVANCE: This proposal directly addresses public health both in terms of its content and methods. Drug abuse has substantial public health consequences including morbidity and mortality due to the use and abuse of both licit and illicit substances. Methodologically this proposal develops a low-cost method for monitoring community level drug abuse trends as well as a means to conduct outbreak investigations.

Related Web Sites:
NIH RePORTER record

Toxicology Lab Data Epidemiology

Principal Investigator:
Caleb Banta-Green, PhD, MPH, MSW
Research Scientist
Alcohol and Drug Abuse Institute
calebbg@u.washington.edu
http://bit.ly/adaistaff_bantagreen

Date: January 18, 2006 to December 31, 2007
Sponsor: Washington State Patrol
Categories: Epidemiology and Drug Abuse Trends

Other Investigators: Sara Miller, MPH


Description: This project is funded by the Washington State Patrol's Toxicology Laboratory to investigate and analyze the epidemiology of street and prescription drug use in counties throughout Washington. Specific attention will be given to reviewing the cause and manner of deaths involving methamphetamine, and the significance of methamphetamine use in impaired driving populations. Multiple data sources will be utilized including mortality, DUI, and law enforcement drug seizure data. Analysis will examine temporal and geographic trends in drug use and the impacts of drug use.


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