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CDA 09-204 – HSR&D Study

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CDA 09-204
Prescription Opiates in Overdoses Among VHA Patients
Amy S Bohnert PhD MHS BA
VA Ann Arbor Healthcare System, Ann Arbor, MI
Ann Arbor, MI
Funding Period: April 2010 - March 2015

BACKGROUND/RATIONALE:
Opioid overdose is a critical public health problem in the United States. Many Veterans have injuries, pain, mental health, and substance abuse conditions. Consequently, it is important to understand opioid overdose and implement interventions to reduce overdose risk for VHA patients.

OBJECTIVE(S):
The objectives are to: (1) analyze VHA pharmacy data to examine opioid prescribing patterns; (2) analyze clinical and mortality data to assess opioid overdose trends; and (3) apply epidemiologic methods to understand risk factors for opioid overdose in the VHA.

METHODS:
This study used existing datasets. VHA patients who experience a fatal overdose were identified using National Death Index data. Prescribing was measured with VHA pharmacy benefits management records. National Patient Care Database Records provided additional data about patient and treatment characteristics. Data analyses included descriptive statistics, overdose rates by year, Poisson regression for temporal trends, and Cox proportional hazards models to test the association of specific factors with overdose risk.

FINDINGS/RESULTS:
Not yet available.

IMPACT:
VHA patients have higher rates of persistent pain than the general population, and are also at greater risk for fatal overdose. This study has had important implications for pain treatment, particularly around opioid therapy, for VHA patients. The information provided from this study has provided VHA clinicians and patients with important information about the risks of opioid use that will assist them in weighing treatment opioids.

Recently updated opioid prescribing guidelines have recommended more cautious opioid prescribing practices, in line with the findings from this study. Additionally, the VHA's Opioid Safety Initiative seeks to reduce high dosage opioids prescribing and concurrent opioid and benzodiazepine prescribing. The results of the study aided the identification of a number of risk factors for overdose, which informed the development of several brief motivational interventions to reduce overdose risk that are now being tested in clinical trials in and outside of VHA.

PUBLICATIONS:

Journal Articles

  1. Bohnert ASB, Lin LA. It is time to recognize that synthetic opioids are not going away. Addiction (Abingdon, England). 2021 Jan 11.
  2. Ilgen MA, Coughlin LN, Bohnert ASB, Chermack S, Price A, Kim HM, Jannausch M, Blow FC. Efficacy of a Psychosocial Pain Management Intervention for Men and Women With Substance Use Disorders and Chronic Pain: A Randomized Clinical Trial. JAMA psychiatry. 2020 Dec 1; 77(12):1225-1234.
  3. Lagisetty P, Bohnert A, Goesling J, Hu HM, Travis B, Lagisetty K, Brummett CM, Englesbe MJ, Waljee J. Care Coordination for Patients on Chronic Opioid Therapy Following Surgery: A Cohort Study. Annals of surgery. 2020 Aug 1; 272(2):304-310.
  4. Gicquelais RE, Bohnert ASB, Fernandez AC. Opportunities to boost naloxone awareness among people who misuse opioid analgesics who have not used illegal opioids. Substance Abuse. 2020 Jul 21; 1-5.
  5. Lin LA, Bohnert ASB, Blow FC, Gordon AJ, Ignacio RV, Kim HM, Ilgen MA. Polysubstance use and association with opioid use disorder treatment in the US Veterans Health Administration. Addiction (Abingdon, England). 2021 Jan 1; 116(1):96-104.
  6. Dora-Laskey AD, Goldstick JE, Arterberry BJ, Roberts SJ, Haffajee RL, Bohnert ASB, Cunningham RM, Carter PM. Prevalence and Predictors of Driving after Prescription Opioid Use in an Adult ED Sample. The western journal of emergency medicine. 2020 Jun 19; 21(4):831-840.
  7. Gicquelais RE, Jannausch M, Bohnert ASB, Thomas L, Sen S, Fernandez AC. Links between suicidal intent, polysubstance use, and medical treatment after non-fatal opioid overdose. Drug and Alcohol Dependence. 2020 Jul 1; 212:108041.
  8. Bonar EE, Schneeberger DM, Bourque C, Bauermeister JA, Young SD, Blow FC, Cunningham RM, Bohnert AS, Zimmerman MA, Walton MA. Social Media Interventions for Risky Drinking Among Adolescents and Emerging Adults: Protocol for a Randomized Controlled Trial. JMIR research protocols. 2020 May 13; 9(5):e16688.
  9. Lagisetty P, Zhang K, Haffajee RL, Lin LA, Goldstick J, Brownlee R, Bohnert A, Larochelle MR. Opioid prescribing history prior to heroin overdose among commercially insured adults. Drug and Alcohol Dependence. 2020 Jul 1; 212:108061.
  10. Lagisetty P, Smith A, Antoku D, Winter S, Smith M, Jannausch M, Mi Choe H, Bohnert ASB, Heisler M. A physician-pharmacist collaborative care model to prevent opioid misuse. American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists. 2020 May 7; 77(10):771-780.
  11. Maust DT, Lin LA, Goldstick JE, Haffajee RL, Brownlee R, Bohnert ASB. Association of Medicare Part D Benzodiazepine Coverage Expansion With Changes in Fall-Related Injuries and Overdoses Among Medicare Advantage Beneficiaries. JAMA Network Open. 2020 Apr 1; 3(4):e202051.
  12. Lin LA, Brummett CM, Waljee JF, Englesbe MJ, Gunaseelan V, Bohnert ASB. Association of Opioid Overdose Risk Factors and Naloxone Prescribing in US Adults. Journal of general internal medicine. 2020 Feb 1; 35(2):420-427.
  13. Fernandez AC, Gicquelais RE, Jannausch M, Bohnert ASB. The Role of Drugs in Alcohol Poisoning and Blackout Events: A Latent Class Analysis of a Residential Treatment Sample. Alcoholism, clinical and experimental research. 2019 Nov 1; 43(11):2431-2437.
  14. Lagisetty PA, Lin LA, Ganoczy D, Haffajee RL, Iwashyna TJ, Bohnert ASB. Opioid Prescribing After Opioid-related Inpatient Hospitalizations by Diagnosis: A Cohort Study. Medical care. 2019 Oct 1; 57(10):815-821.
  15. Lagisetty PA, Ross R, Bohnert A, Clay M, Maust DT. Buprenorphine Treatment Divide by Race/Ethnicity and Payment. JAMA psychiatry. 2019 Sep 1; 76(9):979-981.
  16. Giannitrapani KF, Fereydooni S, Azarfar A, Silveira MJ, Glassman PA, Midboe AM, Bohnert ABS, Zenoni MA, Kerns RD, Pearlman RA, Asch SM, Becker WC, Lorenz KA. Signature Informed Consent for Long-Term Opioid Therapy in Patients With Cancer: Perspectives of Patients and Providers. Journal of pain and symptom management. 2020 Jan 1; 59(1):49-57.
  17. Gicquelais RE, Mezuk B, Foxman B, Thomas L, Bohnert ASB. Justice involvement patterns, overdose experiences, and naloxone knowledge among men and women in criminal justice diversion addiction treatment. Harm reduction journal. 2019 Jul 16; 16(1):46.
  18. Lagisetty PA, Healy N, Garpestad C, Jannausch M, Tipirneni R, Bohnert ASB. Access to Primary Care Clinics for Patients With Chronic Pain Receiving Opioids. JAMA Network Open. 2019 Jul 3; 2(7):e196928.
  19. Distel LML, Egbert AH, Bohnert AM, Santiago CD. Chronic Stress and Food Insecurity: Examining Key Environmental Family Factors Related to Body Mass Index Among Low-Income Mexican-Origin Youth. Family & Community Health. 2019 Jul 1; 42(3):213-220.
  20. Larochelle MR, Bohnert ASB. Opportunities to Address First Opioid Prescriptions to Reduce Incident Long-Term Opioid Use. Annals of internal medicine. 2019 Jul 16; 171(2):129-130.
  21. Haffajee RL, Lin LA, Bohnert ASB, Goldstick JE. Characteristics of US Counties With High Opioid Overdose Mortality and Low Capacity to Deliver Medications for Opioid Use Disorder. JAMA Network Open. 2019 Jun 5; 2(6):e196373.
  22. Lin LA, Peltzman T, McCarthy JF, Oliva EM, Trafton JA, Bohnert ASB. Changing Trends in Opioid Overdose Deaths and Prescription Opioid Receipt Among Veterans. American journal of preventive medicine. 2019 Jul 1; 57(1):106-110.
  23. Bates CR, Bohnert AM, Buscemi J, Vandell DL, Lee KTH, Bryant FB. Family entropy: understanding the organization of the family home environment and impact on child health behaviors and weight. Translational behavioral medicine. 2019 May 16; 9(3):413-421.
  24. Chua KP, Brummett CM, Conti RM, Haffajee RL, Prosser LA, Bohnert ASB. Assessment of Prescriber and Pharmacy Shopping Among the Family Members of Patients Prescribed Opioids. JAMA Network Open. 2019 May 3; 2(5):e193673.
  25. Egbert AH, Creber C, Loren DM, Bohnert AM. Executive function and dietary intake in youth: A systematic review of the literature. Appetite. 2019 Aug 1; 139:197-212.
  26. Strickler GK, Zhang K, Halpin JF, Bohnert ASB, Baldwin GT, Kreiner PW. Effects of mandatory prescription drug monitoring program (PDMP) use laws on prescriber registration and use and on risky prescribing. Drug and Alcohol Dependence. 2019 Jun 1; 199:1-9.
  27. Bohnert ASB, Ilgen MA. Understanding Links among Opioid Use, Overdose, and Suicide. The New England journal of medicine. 2019 Jan 3; 380(1):71-79.
  28. Bohnert ASB, Larochelle MR. Are Temporal Trends Important Measures of Opioid-prescribing Risk?. Journal of addiction medicine. 2019 Jan 1; 13(1):5-6.
  29. Fernandez AC, Bush C, Bonar EE, Blow FC, Walton MA, Bohnert ASB. Alcohol and Drug Overdose and the Influence of Pain Conditions in an Addiction Treatment Sample. Journal of addiction medicine. 2019 Jan 1; 13(1):61-68.
  30. Bohnert ASB, Guy GP, Losby JL. Opioid Prescribing in the United States Before and After the Centers for Disease Control and Prevention's 2016 Opioid Guideline. Annals of internal medicine. 2018 Sep 18; 169(6):367-375.
  31. Whiteside LK, Goldstick J, Dora-Laskey A, Thomas L, Walton M, Cunningham R, Bohnert ASB. Patient Preference for Pain Medication in the Emergency Department Is Associated with Non-fatal Overdose History. The western journal of emergency medicine. 2018 Jul 1; 19(4):722-730.
  32. Bonar EE, Matusiewicz AK, Bohnert ASB, Ilgen MA, Sanborn ML, Chermack ST. Coping and violence perpetration in a residential substance use disorder treatment sample. Journal of addictive diseases. 2018 Jun 1; 1-11.
  33. Haffajee RL, Bohnert ASB, Lagisetty PA. Policy Pathways to Address Provider Workforce Barriers to Buprenorphine Treatment. American journal of preventive medicine. 2018 Jun 1; 54(6 Suppl 3):S230-S242.
  34. Bonar EE, Walton MA, Barry KL, Bohnert ASB, Chermack ST, Cunningham RM, Massey LS, Ignacio RV, Blow FC. Sexual HIV risk behavior outcomes of brief interventions for drug use in an inner-city emergency department: Secondary outcomes from a randomized controlled trial. Drug and Alcohol Dependence. 2018 Feb 1; 183:217-224.
  35. Bohnert ASB, Walton MA, Cunningham RM, Ilgen MA, Barry K, Chermack ST, Blow FC. Overdose and adverse drug event experiences among adult patients in the emergency department. Addictive Behaviors. 2018 Nov 1; 86:66-72.
  36. Lagisetty P, Klasa K, Bush C, Heisler M, Chopra V, Bohnert A. Primary care models for treating opioid use disorders: What actually works? A systematic review. PLoS ONE. 2017 Oct 17; 12(10):e0186315.
  37. Lin LA, Bohnert ASB, Jannausch M, Goesling J, Ilgen MA. Use of non-pharmacological strategies for pain relief in addiction treatment patients with chronic pain. The American journal on addictions. 2017 Sep 1; 26(6):564-567.
  38. Lagisetty P, Bohnert A. Web Exclusives. Annals for Hospitalists Inpatient Notes - The Opioid Epidemic-What's a Hospitalist to Do?. Annals of internal medicine. 2017 Jul 18; 167(2):HO2-HO3.
  39. Chatters LM, Taylor RJ, Woodward AT, Bohnert ASB, Peterson TL, Perron BE. Differences between African Americans and Non-Hispanic Whites Utilization of Clergy for Counseling with Serious Personal Problems. Race and social problems. 2017 Jun 1; 9(2):139-149.
  40. Blow FC, Walton MA, Bohnert ASB, Ignacio RV, Chermack S, Cunningham RM, Booth BM, Ilgen M, Barry KL. A randomized controlled trial of brief interventions to reduce drug use among adults in a low-income urban emergency department: the HealthiER You study. Addiction (Abingdon, England). 2017 Aug 1; 112(8):1395-1405.
  41. Lagisetty PA, Maust D, Heisler M, Bohnert A. Physical and Mental Health Comorbidities Associated With Primary Care Visits For Substance Use Disorders. Journal of addiction medicine. 2017 Mar 1; 11(2):161-162.
  42. Ward A, Arola N, Bohnert A, Lieb R. Social-emotional adjustment and pet ownership among adolescents with autism spectrum disorder. Journal of communication disorders. 2017 Jan 25; 65:35-42.
  43. Logan J, Bohnert A, Spies E, Jannausch M. Suicidal ideation among young Afghanistan/Iraq War Veterans and civilians: Individual, social, and environmental risk factors and perception of unmet mental healthcare needs, United States, 2013. Psychiatry Research. 2016 Nov 30; 245:398-405.
  44. Lin LA, Hosanagar A, Park TW, Bohnert AS. Opioid Overdose: Risk Assessment and Mitigation in Outpatient Treatment. Journal of addiction medicine. 2016 Nov 1; 10(6):382-386.
  45. McLeod DL, Buscemi J, Bohnert AM. Becoming American, becoming obese? A systematic review of acculturation and weight among Latino youth. Obesity Reviews : An Official Journal of The International Association For The Study of Obesity. 2016 Nov 1; 17(11):1040-1049.
  46. Lagisetty P, Heisler M, Bohnert A. Re-purposing anticoagulation clinics: expanding access to opioid agonist therapy in primary care settings. Addiction (Abingdon, England). 2017 Mar 1; 112(3):384-385.
  47. Bohnert AS, Bonar EE, Cunningham R, Greenwald MK, Thomas L, Chermack S, Blow FC, Walton M. A pilot randomized clinical trial of an intervention to reduce overdose risk behaviors among emergency department patients at risk for prescription opioid overdose. Drug and Alcohol Dependence. 2016 Jun 1; 163:40-7.
  48. Bonar EE, Bohnert AS. Perceived Severity of and Susceptibility to Overdose Among Injection Drug Users: Relationships With Overdose History. Substance use & misuse. 2016 Aug 23; 51(10):1379-83.
  49. Bohnert AS, Logan JE, Ganoczy D, Dowell D. A Detailed Exploration Into the Association of Prescribed Opioid Dosage and Overdose Deaths Among Patients With Chronic Pain. Medical care. 2016 May 1; 54(5):435-41.
  50. Ilgen MA, Bohnert AS, Ganoczy D, Bair MJ, McCarthy JF, Blow FC. Opioid dose and risk of suicide. Pain. 2016 May 1; 157(5):1079-84.
  51. Jakubczyk A, Ilgen MA, Kopera M, Krasowska A, Klimkiewicz A, Bohnert A, Blow FC, Brower KJ, Wojnar M. Reductions in physical pain predict lower risk of relapse following alcohol treatment. Drug and Alcohol Dependence. 2016 Jan 1; 158:167-71.
  52. Lin LA, Bohnert AS, Price AM, Jannausch M, Bonar EE, Ilgen MA. Pain acceptance and opiate use disorders in addiction treatment patients with comorbid pain. Drug and Alcohol Dependence. 2015 Dec 1; 157:136-42.
  53. Lin LA, Bohnert AS, Ilgen MA, Pfeiffer PN, Ganoczy D, Blow FC. Outpatient Provider Contact Prior to Unintentional Opioid Overdose Among VHA Service Users. Psychiatric services (Washington, D.C.). 2015 Nov 1; 66(11):1149-54.
  54. Peciña M, Bohnert AS, Sikora M, Avery ET, Langenecker SA, Mickey BJ, Zubieta JK. Association Between Placebo-Activated Neural Systems and Antidepressant Responses: Neurochemistry of Placebo Effects in Major Depression. JAMA psychiatry (Chicago, Ill.). 2015 Nov 1; 72(11):1087-94.
  55. Sripada RK, Bohnert AS, Teo AR, Levine DS, Pfeiffer PN, Bowersox NW, Mizruchi MS, Chermack ST, Ganoczy D, Walters H, Valenstein M. Social networks, mental health problems, and mental health service utilization in OEF/OIF National Guard veterans. Social psychiatry and psychiatric epidemiology. 2015 Sep 1; 50(9):1367-78.
  56. Ashrafioun L, Bohnert AS, Jannausch M, Ilgen MA. Evaluation of the current opioid misuse measure among substance use disorder treatment patients. Journal of substance abuse treatment. 2015 Aug 1; 55:15-20.
  57. Larney S, Bohnert AS, Ganoczy D, Ilgen MA, Hickman M, Blow FC, Degenhardt L. Mortality among older adults with opioid use disorders in the Veteran's Health Administration, 2000-2011. Drug and Alcohol Dependence. 2015 Feb 1; 147:32-7.
  58. Becker WC, Ganoczy D, Fiellin DA, Bohnert AS. Buprenorphine/Naloxone dose and pain intensity among individuals initiating treatment for opioid use disorder. Journal of substance abuse treatment. 2015 Jan 1; 48(1):128-31.
  59. Czyz EK, Bohnert AS, King CA, Price AM, Kleinberg F, Ilgen MA. Self-efficacy to avoid suicidal action: factor structure and convergent validity among adults in substance use disorder treatment. Suicide & Life-Threatening Behavior. 2014 Dec 1; 44(6):698-709.
  60. Bohnert AS, Ilgen MA, Trafton JA, Kerns RD, Eisenberg A, Ganoczy D, Blow FC. Trends and regional variation in opioid overdose mortality among Veterans Health Administration patients, fiscal year 2001 to 2009. The Clinical Journal of Pain. 2014 Jul 1; 30(7):605-12.
  61. Bonar EE, Ilgen MA, Walton M, Bohnert AS. Associations among pain, non-medical prescription opioid use, and drug overdose history. The American journal on addictions. 2014 Jan 1; 23(1):41-7.
  62. Bonar EE, Walton MA, Cunningham RM, Chermack ST, Bohnert AS, Barry KL, Booth BM, Blow FC. Computer-enhanced interventions for drug use and HIV risk in the emergency room: preliminary results on psychological precursors of behavior change. Journal of substance abuse treatment. 2014 Jan 1; 46(1):5-14.
  63. Park TW, Bohnert AS, Austin KL, Saitz R, Pizer SD. Datapoints: regional variation in benzodiazepine prescribing for patients on opioid agonist therapy. Psychiatric services (Washington, D.C.). 2014 Jan 1; 65(1):4.
  64. Klimkiewicz A, Jakubczyk A, Wnorowska A, Klimkiewicz J, Bohnert A, Ilgen MA, Brower KJ, Wojnar M. Violent Behavior and Driving under the Influence of Alcohol: Prevalence and Association with Impulsivity among Individuals in Treatment for Alcohol Dependence in Poland. European Addiction Research. 2013 Dec 14; 20(3):151-8.
  65. Bohnert AS, McCarthy JF, Ignacio RV, Ilgen MA, Eisenberg A, Blow FC. Misclassification of suicide deaths: examining the psychiatric history of overdose decedents. Injury Prevention : Journal of The International Society For Child and Adolescent Injury Prevention. 2013 Oct 1; 19(5):326-30.
  66. Bowersox NW, Bohnert AS, Ganoczy D, Pfeiffer PN. Inpatient psychiatric care experience and its relationship to posthospitalization treatment participation. Psychiatric services (Washington, D.C.). 2013 Jun 1; 64(6):554-62.
  67. Zivin K, Pfeiffer PN, Bohnert AS, Ganoczy D, Blow FC, Nallamothu BK, Kales HC. Evaluation of the FDA warning against prescribing citalopram at doses exceeding 40 mg. The American journal of psychiatry. 2013 Jun 1; 170(6):642-50.
  68. Conner KR, Bohnert AS, McCarthy JF, Valenstein M, Bossarte R, Ignacio R, Lu N, Ilgen MA. Mental disorder comorbidity and suicide among 2.96 million men receiving care in the Veterans Health Administration health system. Journal of abnormal psychology. 2013 Feb 1; 122(1):256-63.
  69. Bonar EE, Bohnert AS, Ilgen MA, Sanborn ML, Chermack ST. Physical assault victimization and coping among adults in residential substance use disorder treatment. Violence and victims. 2013 Jan 1; 28(5):849-64.
  70. Kim HM, Smith EG, Ganoczy D, Walters H, Stano CM, Ilgen MA, Bohnert AS, Valenstein M. Predictors of suicide in patient charts among patients with depression in the Veterans Health Administration health system: importance of prescription drug and alcohol abuse. The Journal of clinical psychiatry. 2012 Oct 1; 73(10):e1269-75.
  71. Klimkiewicz A, Ilgen MA, Bohnert AS, Jakubczyk A, Wojnar M, Brower KJ. Suicide attempts during heavy drinking episodes among individuals entering alcohol treatment in Warsaw, Poland. Alcohol and Alcoholism. 2012 Sep 1; 47(5):571-6.
  72. Klimkiewicz A, Bohnert AS, Jakubczyk A, Ilgen MA, Wojnar M, Brower K. The association between insomnia and suicidal thoughts in adults treated for alcohol dependence in Poland. Drug and Alcohol Dependence. 2012 Apr 1; 122(1-2):160-3.
  73. Bohnert AS, Ilgen MA, Bossarte RM, Britton PC, Chermack ST, Blow FC. Veteran status and alcohol use in men in the United States. Military medicine. 2012 Feb 1; 177(2):198-203.
  74. Bohnert AS, Ilgen MA, Ignacio RV, McCarthy JF, Valenstein M, Blow FC. Risk of death from accidental overdose associated with psychiatric and substance use disorders. The American journal of psychiatry. 2012 Jan 1; 169(1):64-70.
  75. Bohnert AS, Tracy M, Galea S. Characteristics of drug users who witness many overdoses: implications for overdose prevention. Drug and Alcohol Dependence. 2012 Jan 1; 120(1-3):168-73.
  76. Britton PC, Bohnert AS, Wines JD, Conner KR. A procedure that differentiates unintentional from intentional overdose in opioid abusers. Addictive Behaviors. 2012 Jan 1; 37(1):127-30.
  77. Chermack ST, Bohnert AS, Price AM, Austin K, Ilgen MA. Substance use disorders and homicide death in veterans. Journal of studies on alcohol and drugs. 2012 Jan 1; 73(1):10-4.
  78. Bohnert AS, Roeder KM, Ilgen MA. Suicide attempts and overdoses among adults entering addictions treatment: comparing correlates in a U.S. National Study. Drug and Alcohol Dependence. 2011 Dec 1; 119(1-2):106-12.
  79. Kuramoto SJ, Bohnert AS, Latkin CA. Understanding subtypes of inner-city drug users with a latent class approach. Drug and Alcohol Dependence. 2011 Nov 1; 118(2-3):237-43.
  80. Burnett-Zeigler I, Zivin K, Ilgen MA, Islam K, Bohnert AS. Perceptions of quality of health care among veterans with psychiatric disorders. Psychiatric services (Washington, D.C.). 2011 Sep 1; 62(9):1054-9.
  81. Perron BE, Bohnert AS, Monsell SE, Vaughn MG, Epperson M, Howard MO. Patterns and correlates of drug-related ED visits: results from a national survey. The American journal of emergency medicine. 2011 Sep 1.
  82. Price AM, Ilgen MA, Bohnert AS. Prevalence and correlates of nonmedical use of prescription opioids in patients seen in a residential drug and alcohol treatment program. Journal of substance abuse treatment. 2011 Sep 1; 41(2):208-14.
  83. Mezuk B, Bohnert AS, Ratliff S, Zivin K. Job strain, depressive symptoms, and drinking behavior among older adults: results from the health and retirement study. The journals of gerontology. Series B, Psychological sciences and social sciences. 2011 Jul 1; 66(4):426-34.
  84. Ilgen MA, Roeder KM, Webster L, Mowbray OP, Perron BE, Chermack ST, Bohnert AS. Measuring pain medication expectancies in adults treated for substance use disorders. Drug and Alcohol Dependence. 2011 May 1; 115(1-2):51-6.
  85. Bohnert AS, Valenstein M, Bair MJ, Ganoczy D, McCarthy JF, Ilgen MA, Blow FC. Association between opioid prescribing patterns and opioid overdose-related deaths. JAMA. 2011 Apr 6; 305(13):1315-21.
  86. Bohnert AS, Ilgen MA, Galea S, McCarthy JF, Blow FC. Accidental poisoning mortality among patients in the Department of Veterans Affairs Health System. Medical care. 2011 Apr 1; 49(4):393-6.
  87. Bohnert AS, Zivin K, Welsh DE, Kilbourne AM. Ratings of patient-provider communication among veterans: serious mental illnesses, substance use disorders, and the moderating role of trust. Health communication. 2011 Apr 1; 26(3):267-74.
  88. Ilgen MA, Price AM, Burnett-Zeigler I, Perron B, Islam K, Bohnert AS, Zivin K. Longitudinal predictors of addictions treatment utilization in treatment-naïve adults with alcohol use disorders. Drug and Alcohol Dependence. 2011 Jan 15; 113(2-3):215-21.
  89. Bohnert AS, Nandi A, Tracy M, Cerdá M, Tardiff KJ, Vlahov D, Galea S. Policing and risk of overdose mortality in urban neighborhoods. Drug and Alcohol Dependence. 2011 Jan 1; 113(1):62-8.
  90. Zivin K, Bohnert AS, Mezuk B, Ilgen MA, Welsh D, Ratliff S, Miller EM, Valenstein M, Kilbourne AM. Employment status of patients in the VA health system: implications for mental health services. Psychiatric services (Washington, D.C.). 2011 Jan 1; 62(1):35-8.
  91. Ilgen MA, Zivin K, Austin KL, Bohnert AS, Czyz EK, Valenstein M, Kilbourne AM. Severe pain predicts greater likelihood of subsequent suicide. Suicide & Life-Threatening Behavior. 2010 Dec 1; 40(6):597-608.
  92. Perron BE, Bohnert AS, Vaughn MG, Bauer MS, Kilbourne AM. Profiles of disability among adults with bipolar spectrum disorders. Social psychiatry and psychiatric epidemiology. 2010 Dec 1; 45(12):1125-34.
  93. Ilgen MA, Bohnert AS, Ignacio RV, McCarthy JF, Valenstein MM, Kim HM, Blow FC. Psychiatric diagnoses and risk of suicide in veterans. Archives of general psychiatry. 2010 Nov 1; 67(11):1152-8.
  94. Mowbray O, Perron BE, Bohnert AS, Krentzman AR, Vaughn MG. Service use and barriers to care among heroin users: results from a national survey. The American journal of drug and alcohol abuse. 2010 Nov 1; 36(6):305-10.
  95. Bohnert AS, Miech RA. Changes in the association of drug use with depressive disorders in recent decades: the case of cocaine. Substance use & misuse. 2010 Aug 1; 45(10):1452-62.
  96. Bohnert AS, Roeder K, Ilgen MA. Unintentional overdose and suicide among substance users: a review of overlap and risk factors. Drug and Alcohol Dependence. 2010 Aug 1; 110(3):183-92.
  97. Bohnert AS, Fudalej S, Ilgen MA. Increasing poisoning mortality rates in the United States, 1999-2006. Public health reports (Washington, D.C. : 1974). 2010 Jul 1; 125(4):542-7.
  98. Bohnert AS, Perron BE, Jarman CN, Vaughn MG, Chatters LM, Taylor RJ. Use of clergy services among individuals seeking treatment for alcohol use problems. The American journal on addictions / American Academy of Psychiatrists in Alcoholism and Addictions. 2010 Jul 1; 19(4):345-51.
  99. Knowlton AR, Arnsten JH, Eldred LJ, Wilkinson JD, Shade SB, Bohnert AS, Yang C, Wissow LS, Purcell DW. Antiretroviral use among active injection-drug users: the role of patient-provider engagement and structural factors. AIDS Patient Care and Stds. 2010 Jul 1; 24(7):421-8.
  100. Vaughn MG, Fu Q, Perron BE, Bohnert AS, Howard MO. Is crack cocaine use associated with greater violence than powdered cocaine use? Results from a national sample. The American journal of drug and alcohol abuse. 2010 Jul 1; 36(4):181-6.
  101. Bohnert AS, Prescott MR, Vlahov D, Tardiff KJ, Galea S. Ambient temperature and risk of death from accidental drug overdose in New York City, 1990-2006. Addiction. 2010 Jun 1; 105(6):1049-54.
  102. Bohnert AS, German D, Knowlton AR, Latkin CA. Friendship networks of inner-city adults: a latent class analysis and multi-level regression of supporter types and the association of supporter latent class membership with supporter and recipient drug use. Drug and Alcohol Dependence. 2010 Mar 1; 107(2-3):134-40.
  103. Bohnert AS, Tracy M, Galea S. Circumstances and witness characteristics associated with overdose fatality. Annals of Emergency Medicine. 2009 Oct 1; 54(4):618-24.
Journal Other

  1. Lagisetty P, Slat S, Thomas J, Macleod C, Golmirzaie G, Bohnert AS. Access to Multimodal Pain Management for Patients with Chronic Pain: an Audit Study. [Letter to the Editor]. Journal of general internal medicine. 2021 Mar 1; 36(3):818-820.
  2. Lagisetty PA, Bohnert A. Role of an Accurate Treatment Locator and Cash-Only Practices in Access to Buprenorphine for Opioid Use Disorders. [Editorial]. Annals of internal medicine. 2019 Jul 2; 171(1):58-59.
  3. Bohnert ASB, Ilgen MA. Understanding Links among Opioid Use, Overdose, and Suicide. Reply. [Letter to the Editor]. The New England journal of medicine. 2019 Apr 4; 380(14):1380.
  4. Bair MJ, Bohnert AS. Overdoses in Patients on Opioids: Risks Associated with Mental Health Conditions and Their Treatment. [Editorial]. Journal of general internal medicine. 2015 Aug 1; 30(8):1051-3.
  5. Zivin K, Pfeiffer PN, Bohnert AS, Ganoczy D, Blow FC, Nallamothu BK, Kales HC. Safety of high-dosage citalopram. The American journal of psychiatry. 2014 Jan 1; 171(1):20-2.
Conference Presentations

  1. Bohnert AS, Levine DA, Ganoczy D, Blow FC. Factors associated with opioid overdose death among VHA patients age 50 and older prescribed opioids. Poster session presented at: VA HSR&D / QUERI National Meeting; 2015 Jul 9; Philadelphia, PA.
  2. Bohnert AS, Blow FC, Cunningham R, Thomas L, Greenwald MK, Chermack S, Bonar EE, Walton M. A randomized clinical trial of a behavioral intervention to reduce opioid overdose risk behavior. Paper presented at: College on Problems of Drug Dependence Annual Meeting; 2015 Jun 15; Phoenix, AZ.
  3. Bohnert AS. Prescription drug abuse, overdose, and responsible opioid prescribing. Paper presented at: Oakland County Health Division, Prescription Drug Abuse and Overdose Prevention Collaborative Meeting; 2015 Mar 20; Pontiac, MI.
  4. Bohnert AS, Pfeiffer PN, Ganoczy D, Ilgen MA, Valenstein MT, Eisenberg AM, Blow FC. The Association of Length of Opioid Therapy and Days Since Last Opioid Fill with Opioid Overdose Death. Paper presented at: VA HSR&D / QUERI National Meeting; 2012 Jul 17; National Harbor, MD.
  5. Bohnert AS, Blow FC. The association between opioid prescribing patterns and opioid overdose-related deaths. Paper presented at: College on Problems of Drug Dependence Annual Meeting; 2012 Jun 12; Palm Springs, CA.
  6. Bohnert AS. Recent non-medical prescription opioid use among adult patients at an inner-city emergency department. Paper presented at: College on Problems of Drug Dependence Annual Meeting; 2012 Jun 11; Palm Springs, CA.
  7. Ilgen MA, Bohnert AS, Blow FC. Substance use histories of adults seeking a medical marijuana card. Paper presented at: College on Problems of Drug Dependence Annual Meeting; 2012 Jun 4; Palm Springs, CA.
  8. Bohnert AS. Treatment Prior to Opioid Overdose Death. Paper presented at: VA Mental Health Annual Conference; 2011 Aug 24; Baltimore, MD.
  9. Ilgen MA, Bohnert AS, Blow FC. Personality Disorders and Suicide Mortality in Department of Veteran Affairs Patients. Poster session presented at: American Psychological Association Annual Convention; 2011 Aug 6; Washington, DC.
  10. Bohnert AS, Tracy M, Galea S. Characteristics of drug users who witness many overdoses: Implications for overdose prevention. Poster session presented at: College on Problems of Drug Dependence Annual Meeting; 2011 Jun 21; Hollywood, FL.
  11. Ilgen MA, Edwards P, Bohnert AS, Blow FC. Rates of substance use in dental clinic patients. Paper presented at: College on Problems of Drug Dependence Annual Meeting; 2011 Jun 20; Hollywood, FL.
  12. Kleinberg F, Ilgen MA, Bohnert AS. Pain acceptance and substance use severity in addictions treatment patients with pain. Poster session presented at: College on Problems of Drug Dependence Annual Meeting; 2011 Jun 20; Hollywood, FL.
  13. Klimkiewicz A, Bohnert AS, Brower K, Wojnar M, Conner K, Ilgen MA, Blow FC. Sleep problems and suicide attempts in adults seeking alcohol use disorder treatment in Poland. Poster session presented at: College on Problems of Drug Dependence Annual Meeting; 2011 Jun 20; Hollywood, FL.
  14. Bohnert AS, Ilgen MA, Ganoczy D, Valenstein MT, McCarthy JF, Blow FC. Opioid Prescribing and Fatal Opioid Overdose Trends in the VHA, 2000-2007. Paper presented at: VA HSR&D National Meeting; 2011 Feb 18; National Harbor, MD.
  15. Bohnert AS. The impact of psychiatric disorders on the risk of fatal accidental and suicidal overdoses among Veterans. Paper presented at: VA Implementing a Public Health Model for Meeting the Mental Health Needs of Veterans Annual Mental Health Conference; 2010 Jul 28; Baltimore, MD.
  16. Bohnert AS, Fudalej S, Austin KL, Barry KL, Blow FC, Ilgen MA. The association of alcohol use disorders with injury and non-injury mortality among Veterans: relative and attributable risks. Poster session presented at: Research Society on Alcoholism Annual Scientific Meeting; 2010 Jun 30; San Antonio, TX.
  17. Ilgen MA, Burnett-Ziegler IE, Price AM, Islam K, Bohnert AS. Longitudinal predictors of addictions treatment utilization in treatment-naive adults with alcohol use disorders. Poster session presented at: Research Society on Alcoholism Annual Scientific Meeting; 2010 Jun 30; San Antonio, TX.
  18. Bohnert AS. The impact of psychiatric and substance use disorders on the risk of fatal accidental overdose among Veterans. Paper presented at: College on Problems of Drug Dependence Annual Meeting; 2010 Jun 14; Scottsdale, AZ.
  19. Bohnert AS, Fudalej S, Austin KL, Barry KL, Blow FC, Ilgen MA. The association of alcohol use disorders with injury and non-injury mortality among veterans: relative and attributable risks. Poster session presented at: Albert J. Silverman Research Annual Conference; 2010 May 12; Ann Arbor, MI.
  20. Bohnert AS. Prescription and Illicit Drug Overdose. Paper presented at: Michigan State University Department of Epidemiology Visiting Professor; 2010 Apr 22; East Lansing, MI.
  21. Ilgen MA, Bohnert AS, Price AM. The association between specific pain conditions and suicide in Veterans. Poster session presented at: American Association of Suicidology Annual Conference; 2010 Apr 21; Orlando, FL.
  22. Islam MK, Bohnert AS, Mezuk B, Ilgen MA, Kilbourne AM, Valenstein MT, Zivin K. Mental disorders and employment status in VA patients. Paper presented at: Health Policy Statistics Annual International Conference; 2010 Jan 20; Washington, DC.
  23. Mezuk B, Bohnert AS, Ratliff S, Lim KA, Zivin KZ. Influence of occupational stress and satisfaction on risk of depression among older workers: Evidence from the Health and Retirement Study. Poster session presented at: American Public Health Association Annual Meeting and Exposition; 2009 Nov 7; Philadelphia, PA.


DRA: Substance Abuse and Addiction, Health Systems, Mental, Cognitive and Behavioral Disorders
DRE: Treatment - Observational, Prevention
Keywords: Addictive behaviors, Pain, Pharmaceuticals
MeSH Terms: none

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