Millennium Award Supports Research of Medication Monitoring, Drug Testing

Fellows who research medication monitoring and drug testing were recognized Saturday during the Annual Awards Luncheon and in a poster submission by the 2014 award winner.

Ahmed N. Hassan, MD, FRCPC, Dip. ABPN, is the 2015 ASAM-Millennium Research Institute Research Fellowship Award recipient. His research project, to be conducted this year, is “Effectiveness of Opioid Therapy on Adherence to Psychotropic Medications.”

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Sarah Bagley, MD

The 2014 award recipient, Sarah Bagley, MD, presented her research project, “Urine Drug Testing for Patients on Buprenorphine—Examining Self-Reported Cocaine Use,” as a poster.

The award was created to recognize and provide financial support for research by addiction medicine fellows and to encourage them to understand and research medication monitoring and drug testing in the early phases of their careers. The award winner receives $15,000 for salary support, and complimentary registration, hotel reservations, and airline travel to attend the ASAM Annual Conference.

Dr. Bagley, an Addiction Medicine Fellow at Boston University, designed a retrospective cohort study comparing the agreement of urine drug testing with patient self-reporting to monitor cocaine use in patients treated with buprenorphine for opioid use disorders.

“We looked at patients who had cocaine-positive urine and whether they disclosed cocaine use to a nurse in their visits,” Dr. Bagley said. “In 192 patients with 2,498 urine drug test samples that occurred during nursing visits, we found that only 5 percent tested positive for cocaine, which is not very high. We did find that, in the times when there was a positive urine cocaine drug test, 60 percent of the time cocaine use was not disclosed to the nurse.”

The next step is to determine what the results mean, she said. Questions include: Is a person who tests positive for cocaine doing worse in treatment? Are too many drug tests ordered?

“In an era of thinking about efficiency and why we are ordering tests, it is important that we understand if there is something in the patient profile that helps identify who is going to have a positive urine test because that would help direct our testing,” Dr. Bagley said. “That may help us be smarter about how we order urine drug tests.”

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Ahmed N. Hassan, MD, FRCPC, Dip. ABPN

Dr. Hassan, a Clinical Fellow in Psychiatry at the Center for Addiction and Mental Health at the University of Toronto, Toronto, Canada, is planning a retrospective study using data from the Millennium Research Institute.

The study will compare the adherence of patients using psychiatric medication before and after the use of opioid therapies, specifically methadone and buprenorphine. The study also will compare which drug is more effective in helping patients adhere to their psychotropic medications.

“To the best of our knowledge, this is the first study that will evaluate the influence of opioid treatment on psychotropic medication,” he said. “There has been research on the effect of opioid treatment on adherence to HIV medication, but it has never been done on psychotropic medication.

“This is important because a lot of physicians—specifically psychiatrists—prefer sequential treatment rather than integrated treatment, which might be a better option for some patients. Hopefully, this will provide evidence that integrating opioid treatment with mental illness treatment will reduce substance use and allow adherence to other medications. It is an important step to advocate the importance of integration treatment between both medications.”

To learn more about the Millennium Research Institute Research Fellowship Award, including eligibility and the application process, visit ASAM’s website.