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Substance Use and Addiction

Drugs and alcohol

Use of alcohol, tobacco, and other drugs has long been associated, both in the U.S. and internationally, with public health problems such as cancer, chronic lung and liver disease, as well as increased risk for sexually transmitted or blood-borne infections. More recently, the opioid crisis in the U.S. has claimed more lives annually than for motor vehicle accidents.

The availability of illicitly produced synthetic opioids has increased dramatically since 2013, further contributing to the public health crisis. Research includes epidemiological and geospatial analyses of opioid-involved fatalities in Connecticut and assessing the potential public health benefits of expanded access to naloxone and expedited referral to medication assisted treatment through harm reduction organizations and emergency departments.

Other studies have sought to understand:

  • Contextual factors that may contribute to risk of non-fatal opioid overdoses
  • The role of mental health, stigma, discrimination in substance abuse
  • How to integrate behavioral health care into primary care
  • Strategies for limiting the harms of substance abuse, and more foundational studies of the causes or impacts of inadequately treated substance abuse or mental illness.
  • The use of behavioral health economics to develop programs to promote risk reduction behaviors
  • Whether eHealth applications can be effective tools for treating tobacco and substance use disorders
  • The economics of substance abuse including lost productivity, cost-effectiveness of treatments, social costs and policy, and drivers behind key disparities
  • The role of substance abuse in co-morbidities such as cancer and HIV
  • Tobacco and e-cigarette control

Practice-based research and initiatives

From the development of the first syringe exchange van, Yale has worked with communities around the world promote risk reduction. Today, YSPH is in involved in the Connecticut Opioid Response (CORE), the State of Connecticut’s Medical Examiners’ Office and law enforcement to in response to the opioid epidemic in the region. Our work with community organizations and marginalized groups such as sex workers, MSM, intravenous drug users, and people who are displaced or incarcerated is global and seeks to address barriers to accessing treatment and to implement health promotion interventions in both traditional and non-traditional settings. For example, YSPH researchers are involved in treating Hep C viruses in conjunction with substance abuse treatment, removing barriers to treatment in health care systems such as the Veterans Administration outpatient clinics.

Tobacco and e-cigarette research includes the testing and evaluation of technology-based interventions for smoking cessation as well as feasibility of using the unique window of periods of hospitalization to access smoking cessation treatment.