The University at Buffalo will receive a major, $7 million award to address a casualty of the national opioid epidemic: the spread of hepatitis C virus (HCV) among drug users who share needles. The funding award is from the Patient-Centered Outcomes Research Institute (PCORI), which Congress authorized in 2010 to conduct evidence-based research to identify the most effective health care approaches.
[Photo: Dr. Marianthi Markatou]
“The opioid epidemic creates secondary health, economic and social repercussions that pose their own challenges and require serious attention,” said Congressman Brian Higgins, a member of the Congressional Bipartisan Task Force to Combat the Heroin Epidemic. “Research happening right here at the University at Buffalo is once again developing innovative treatment options and this significant award demonstrates the confidence in UB’s work to help to address a national and growing problem.”
The purpose of the five-year award to UB is to find an effective way to treat drug users with HCV, a population that has traditionally been difficult to treat in conventional health care settings. Even when receiving regular treatment for substance use at methadone clinics, these patients often don’t seek treatment for HCV, despite the fact that roughly half of them or more are likely chronically infected. In 2014, HCV killed a record 20,000 Americans, according to the Centers for Disease Control and Prevention and liver related deaths are projected to increase exponentially over the next decade.
“The conventional method of treatment delivery -referral to an offsite location- has discouraged many individuals from initiating or completing treatment,” said Dr. Andrew H. Talal, professor of medicine at UB. He noted that these individuals may have low literacy and multiple medical conditions, including depression and anxiety, which often discourage them from seeking treatment for HCV. They are more likely to be affected by poverty and a lack of social support.
To overcome these issues, integrating substance abuse treatment and HCV treatment has been widely advocated, but physical integration has been difficult to achieve since such services often aren’t available in the same clinic. In the new project, researchers will use telemedicine, two-way live videoconferencing, between a physician and a patient in separate geographic locations, as a treatment delivery strategy. “Telemedicine permits virtual integration,” Talal added. “This strategy enables HCV treatment to be delivered in the familiar environment of the opiate treatment program,” he explained, “allowing the HCV provider and the addiction medicine team to work together to evaluate and treat patients.”
In addition to Talal, other UB investigators on this project are Dr. Marianthi Markatou, professor and associate chair for research in the department of biostatistics in the UB School of Public Health and Health Professions and Dr. Richard Blondell, professor and vice chair of addiction medicine in the department of family medicine. Other investigators are Dr. Lawrence Brown, chief executive officer of START Treatment & Recovery Centers; Dr. Jonathan Tobin, president of Clinical Directors Network, and Dr. Don Des Jarlais, director of research, Baron Edmond de Rothschild Chemical Dependency Institute at Mount Sinai Beth Israel Medical Center.