MRI Fellowship Awarded for Toxicology Screening Research

Sarah Bagley, M.D., is this year’s ASAM Millennium Research Institute (MRI) Fellowship Award winner. Dr. Bagley, who also is the recipient of a 2014 Ruth Fox Award, is a Fellow in Addiction Medicine in the Section of General Internal Medicine at Boston University Medical Center.

Dr. Bagley’s research submission on urine toxicology screening (UTS) in clinical practice earned her the MRI honor. The study examines discrepancies between self-reported patient drug use and UTS results in patients being treated for opioid use disorder with buprenorphine in an urban primary-care based program. In some countries, these patients only have UTS at the start of treatment, but in the United States patients are often monitored using UTS.

Researchers hypothesize that there is a subset of patients who do not disclose use but are found to have illicit substances in their urinalysis results. This study will identify and describe those patients, which is critical as they may require enhanced substance abuse treatment, Dr. Bagley said.

“The evidence base for the value of UTS in clinical practice is surprisingly limited,” she said. “For example, scant evidence exists about the consistency between patient self-reporting of drug use and urine toxicology results in patients maintained on buprenorphine, or how well urine toxicology results predict treatment outcomes.”

The award, which will be presented at the ASAM Awards Luncheon from noon to 2 pm Saturday, encourages Fellows to understand and research medication monitoring and drug testing in the early phases of their addiction medicine careers. The winning Fellow receives one year of research financial support. The Millennium database includes drug testing results identified in patient specimens from pain, primary care, and addiction practice settings tested at Millennium Laboratories. To conduct this research, fellowship applicants can access the database of medication monitoring test results available through MRI and/or collaborating with MRI researchers to draft the research topic. Many of the specimens have both immunoassay results and LC-MS/MS results. Winners must be in a two-year addiction medicine fellowship program with the recommendation and agreement of his/her training program director and institution.

“To have the financial support of the MRI Fellowship Award is critically important to the success of the research,” Dr. Bagley said. “It goes beyond just having a good idea. As researchers, we must have the infrastructure to do the work.

“The clinical significance of an unacknowledged urine toxicology result—when urine toxicology is discrepant from self-report—is not clear. Patients who have unexpected UTS results early in treatment may have a worse prognosis. If differences exist between treatment outcomes, based on the acknowledgment of UTS results, this may in fact inform future clinical care, such as the need for enhancing clinical services.”

Dr. Bagley said she is honored that her proposed research was selected from all award submissions and is fortunate to have the backing of Boston University Medical Center.

“I come from a program with great support and mentorship—one that is nationally recognized,” Dr. Bagley said. “There are still a lot of unanswered questions in addiction medicine, so the MRI Fellowship Award contributes to the future of the field.”

Ticket prices for the Annual ASAM Awards Luncheon are $75 per person. The event provides professionals with an opportunity to network with colleagues, draw inspiration from outstanding accomplishments, and welcome new Fellows.