Facilitated by Linda Cottler
lbcottler@ufl.edu

1. What is the SAR-B2C Group? SAR-B2C is a group of investigators and students at UF with a focus on translational science regarding T0 to T4 substance use and addiction research. The group meets monthly to share ideas that focus on collaborative research initiatives. Given the national opioid epidemic, and other drug use on the rise, there is an explicit need for translational research, and training the next generation of scientists, in this important area.
   • Florida is 3^rd most populous state in the US; 20% of the population is 65 years of age and older, Florida is unique in that medical examiners, Department of Health (DOH), Department of Children and Families (DCF), the Sheriff’s Office, Fire and Rescue, Safety Net agencies, are well-integrated and well-coordinated.
   • Given the national opioid epidemic, in particular, there is an explicit need to train public health oriented scientists and clinicians from the bench to community who can collaborate on effective strategies for treatment and prevention.
   • Contribution to science
     • Numerous publications both past and recent in the areas of the epidemiology of opioid use, misuse, dependence, ED (emergency department) utilization for opioid use, pain and opioids, drug development, Prescription Drug Monitoring Program (PDMP), prevention of opioid use among the community, Neonatalabstinence syndrome (NAS), disposal of opioid pills, harm reduction research, forensics, policy evaluation, medical examiner data, and comorbidities.
     • History of significant—the National Institute on Drug Abuse (NIDA) funding (past and current) from all divisions of NIDA indicating breadth and depth of research funding.
     • Significant leadership with NIDA, National Institute on Alcohol Abuse and Alcoholism (NIAAA), Office of National Drug Control Policy (ONDCP), College on Problems of Drug Dependence (CPDD), Food and Drug Administration (FDA), Drug Enforcement Administration (DEA), Centers for Disease Control and Prevention Centers for Disease Control and Prevention (CDC), DOH, World Health Organization (WHO), Diagnostic and Statistical Manual of Mental Disorders (DSM), International Classification of Diseases (ICD), Behavior, Biology and Chemistry (BBC).
     • Current Clinical and Translational Science Award (CTSA) KL2 scholar, Dr. Henry Young is an ED physician (former NIDA T32 post doc) and is developing program of research for UF EDs.
     • Team of individuals from professors to NIDA fellows from 6 UF Colleges spanning T0 to T4 translational areas.
   • Sources of data for primary and secondary analyses of opioid use
     • • Site for the national Opioid Post-Marketing Requirement (PMR) Consortium (OPC) Longitudinal and Cross-Sectional Medication Use Safety Evidence Study (MUSE)
       • Ongoing community cohort of 11,000 members from 51 Florida counties (14% past-30-day prescription pain pill users and >50% lifetime prescription pain pill use with permission to recontact)
       • 650 retired NFL players screened for opioid use, with permission to recontact
       • 11,048 youth 10-18 years of age (secondary database)
       • OneFlorida Clinical Consortium (ongoing claims data and HER with 15M lives)
       • Florida Prescription Drug Monitoring Program (PDMP)
       • Pharmacogenetics data
       • FROST data – come from medical examiners looking at overdoses by drug from 2005-2016, and continuously updating going forward
         • Including epidemiologic indicators
         • Data on an interactive map that anyone can analyze
       • Claims data
         • Medicaid – 13 years, 100 million people, 29 states
         • Privately insured – 11 years, 80 million people
       • ABCD (Adolescent Brain Cognitive Development study) data

     https://com-phhp-epi.sites.medinfo.ufl.edu/wordpress/wp-admin/profile.php

     • NIDA smokescreen chip data
2. What opportunities exist to participate in addressing the specific research areas?
   • Access to patients throughout Florida
   • Access to community members
     • Florida has been impacted by opioids significantly more than most other states in the nation
     • HealthStreet – unique community engagement program
   • ABCD study site
   • MUSE national study site
   • Access to NFL players who have been assessed previously
   • Access to ER/LA (extended release/long acting) users (MUSE study)
   • Members of Alachua County Opiate Task Force with Sheriff’s Office, DOH, Fire Rescue, UF
   • OD (Overdose) surveillance
   • Access to 5,000 Deterra Deactivation Pouches to distribute to the community
   • International expert in toxicology/forensics/medico-legal death investigation
   • Pain Research and Intervention Center of Excellence (PRICE)
   • NIDA funded Substance Abuse Module assessment for DSM 5 substance use disorders
   • OD study in West Virginia (CDC-funded)
   • Members of Opiate Task Force for Alachua County
   • 54k students at UF
   • Rural areas surrounding UF (9 counties)
   • Experienced basic, clinical, epidemiological and policy-focused investigators
   • Consent2Share (UF Health patients are asked to participate in research)
     • 407k in Gainesville and 290k in Jacksonville who have had an opioid prescription
   • Text messaging protocols
   • FDA adverse events expertise
   • Geo-spatial expertise
   • Trained and certified Community Health Workers (CHWs)
   • Site for NCATS CTSA
   • Pharmacoepidemiologists
   • UF Health Cancer Center
   • Center for Addiction Research & Education (CARE)
   • Clinical Research Internship Study Program (CRISP)
   • Southern HIV & Alcohol Research Consortium (SHARC)
   • Resource Centers for Minority Aging Research (RCMAR)
   • Pepper Center
   • Institute on Aging
   • McKnight Brain Institute
   • Genetics Institute
   • Study of Teen Opioid Misuse and Prevention (STOMP) Lab
   • Addiction Treatment Program and Florida Recovery Center
   • Well-established community engagement program with CHWs, volunteers, and staff
   • Very strong NIDA-funded basic science initiatives
   • Home of a NIDA T32 focused on prevention and public health consequences of substance abuse (Director LB Cottler) and an NIA T32 focused on aging and pain (Director R Fillingim)
   • Host site for “Our Community, Our Health”: a monthly national town hall meeting to disseminate research findings
   • Lake Nona –Center for Pharmacometrics and Systems Pharmacology
   • CTSA Translational Drug Development Core
   • Family Medicine Department pain management training program (may be the only one in the US)
3. What are action oriented next steps your pod or other CTSA Program groups could take to move participation in the NIH Opioid Research Initiative forward?
   • R13 conference meeting
     • Focus on T0-T4 studies related to opioid use, prevention, epidemiology, back translational studies, drug discovery for alternatives to opioids, and medicinal chemistry
     • Hosting meetings with other CTSAs to discuss our ideas and plans for future grant submission
   • CTSA symposium with site members at CPDD, BBC, or Society for Prevention Research
4. What can the CTSA Program Consortium do to train the next generation of researchers?
   • Get NIDA/other NIH T32 directors together who are also CTSA members
   • Have NIDA sponsor a national meeting with fellows and NIDA/other NIH T32 directors
     • Fellows will be exposed to collaborative research
   • Online seminar hosted by NIDA to disseminate on a regular basis the latest research
   • Funding new investigators, fellows, graduate students, and post-docs
     • A certain percentage of CTSI pilot grants could be set aside for opioid research conducted by new investigators
   • Fund more junior faculty
   • More K awards
   • Translational workforce development
     • Develop and train more clinician researchers

The SARB2C Group consists of the following people along with their 2018-19 publications related to opioids:

• Team Lead: Linda B. Cottler, PhD, MPH, FACE – Dean’s Professor, Epidemiology (COM/PHHP) and Associate Dean for Research (PHHP) – psychiatric epidemiologist with research interests in classification, assessment development, risk; factors/prevention of opioid misuse/dependence in young and older adults. NIDA T32 Director.
  • Sex differences in patterns of prescription opioid non-medical use among 10–18 year olds in the US
  • Power of the Peer and Parent: Gender Differences, Norms, and Nonmedical Prescription Opioid Use Among Adolescents in South Central Kentucky
  • Reasons for Prescription Opioid Use While Playing in the National Football League as Risk Factors for Current Use and Misuse Among Former Players
  • Prevalence of Concurrent Prescription Opioid and Hazardous Alcohol Use Among Older Women: Results from a Cross-Sectional Study of Community Members
  • A latent class analysis of the past-30-day substance use patterns among lifetime cocaine users: Findings from a community sample in North Central Florida
  • Re: Doctor-Patient Trust Among Chronic Pain Patients on Chronic Opioid Therapy after Opioid Risk Reduction Initiatives: A Survey
  • The importance of considering polysubstance use: lessons from cocaine research
  • The Association Between Religiosity and Substance Use Patterns Among Women Involved in the Criminal Justice System
• Kelly Gurka, MPH, PhD – Assistant Professor, Epidemiology – injury epidemiology – conducts research on prescription misuse and abuse and outcomes, particularly ODs related to opioids in West Virginia (ground zero for the opioid epidemic)
  • Prevalence of Concurrent Prescription Opioid and Hazardous Alcohol Use Among Older Women: Results from a Cross-Sectional Study of Community Members
• Hui Hu, PhD – Assistant Professor, Epidemiology – environmental epidemiologist who studies geo-spatial relationships (opioids in Florida and neighborhood deprivation)
• Krishna Vaddiparti, PhD, MPE, MSW – Assistant Professor, Epidemiology – psychiatric epidemiologist with training in community based epidemiological research and interests in cross-cultural research
  • Prevalence of Concurrent Prescription Opioid and Hazardous Alcohol Use Among Older Women: Results from a Cross-Sectional Study of Community Members
  • Associations of Adolescent Exposure to Severe Violence with Substance Use From Adolescence into Adulthood: Direct Versus Indirect Exposures
• Deepthi Varma, PhD, MPhil, MSW – Assistant Professor, Epidemiology – psychiatric epidemiologist with interests in community engagement and trust in community-academic research partnerships
• Catherine Striley, PhD, MSW, ACSW, MPE – Associate Professor, Epidemiology – psychiatric epidemiologist looking at consequences of drug use and access to care
  • Sex differences in patterns of prescription opioid non-medical use among 10–18 year olds in the US
  • Reasons for Prescription Opioid Use While Playing in the National Football League as Risk Factors for Current Use and Misuse Among Former Players
  • Prevalence of Concurrent Prescription Opioid and Hazardous Alcohol Use Among Older Women: Results from a Cross-Sectional Study of Community Members
  • The Association Between Religiosity and Substance Use Patterns Among Women Involved in the Criminal Justice System
• Henry Young, MD – Emergency Department physician and former NIDA T32 post-doc – studying alternatives to opioids and opioid risk in the ED;  current CTSA KL2 Scholar; RCMAR Fellow
• Roger Fillingim, PhD – Professor, Department of Community Dentistry and Behavioral Science – research interests include the biological, social, and psychological factors that may influence the experience of pain, Director, NIA T32 and Director PRICE
  • Association of OPRM1, OPRK1 and COMT genes with opioid response is opioid and pain modality specific (N4.001)
  • Power of the Peer and Parent: Gender Differences, Norms, and Nonmedical Prescription Opioid Use Among Adolescents in South Central Kentucky
  • International Stakeholder Community of Pain Experts and Leaders Call for an Urgent Action on Forced Opioid Tapering
  • CYP2D6-guided opioid therapy improves pain control in CYP2D6 intermediate and poor metabolizers: a pragmatic clinical trial
  • Opioid prescribing and risk mitigation implementation in the management of acute pain: Results from The National Dental Practice-Based Research Network
  • Training experiences regarding pain management, addiction, and drug diversion of dentists enrolled in the National Dental Practice-Based Research Network

• Bruce Goldberger, PhD, FABFT – Director, UF Health Forensic Medicine, Department of Pathology, Immunology, and Laboratory Medicine – forensic toxicologist, studies the measurement of therapeutic, abused, and emerging drugs in biological tissues; developer of FROST
  • The Fentanyl Epidemic and Evolution of Fentanyl Analogs in the United States and the European Union
  • Analysis of Acetyl Fentanyl in Postmortem Specimens by Gas Chromatography-Mass Spectrometry (GC–MS): Method Validation and Case Report
  • The Opioid Epidemic: Moving Toward an Integrated, Holistic Analytical Response
  • Opportunities to Prevent Overdose Deaths Involving Prescription and Illicit Opioids, 11 States, July 2016–June 2017
• Chris McCurdy, PhD, BSPh, FAAPS – Professor, Medicinal Chemistry and Director, UF Translational Drug Development Core – research focuses on the design, synthesis, and development of pharmacotherapy for drug abuse/addiction and pain
  • Investigating the antinociceptive effects of N-docosahexaenoyl ethanolamine and novel kappa opioid receptor agonists
• Almut Winterstein, RPh, PhD, FISPE – Professor and Chair, Pharmaceutical Outcomes and Policy – research interests in pharmacoepidemiology, drug safety and effectiveness, and the evaluation and prevention of inappropriate medication use
  • Performance of the Centers for Medicare & Medicaid Services’ Opioid Overutilization Criteria for Classifying Opioid Use Disorder or Overdose
  • Prevalence of and Factors Associated With Long-term Concurrent Use of Stimulants and Opioids Among Adults With Attention-Deficit/Hyperactivity Disorder
  • Sex differences in patterns of prescription opioid non-medical use among 10–18 year olds in the US
  • Clinical utility and perils of prescription drug monitoring program–based alert systems
• Michael Gutter, PhD – Associate Dean for Extension and State Program Leader for 4H Youth Development, Families and Communities, IFAS
• Jalie Tucker, PhD, MPH – Professor and Chair of Health, Education and Behavior, College of Health and Human Performance
• Patrick Tighe, MD, COM, Anesthesiology
  • Chronic opioid use in patients undergoing treatment for oropharyngeal cancer
• Jeff Boissoneault, PhD, COM
  • Discrepancies in sleep diary and actigraphy assessments in adults with fibromyalgia: Associations with opioid dose and age
  • Pain intensity as a moderator of the association between opioid use and insomnia symptoms among adults with chronic pain
  • Alcohol and Opioid Use, Co‐Use, and Chronic Pain in the Context of the Opioid Epidemic: A Critical Review
• Sara Jo Nixon, PhD, COM, Professor, Psychiatry, Co-Director NIDA T32, Director of CARE
• Robert Leeman, PhD, Department of Health Education & Behavior, Professor
  • A latent class analysis of the past-30-day substance use patterns among lifetime cocaine users: Findings from a community sample in North Central Florida
• Maureen Keller-Wood, PhD, COP
• Lance McMahon, Jr. PhD. COP
• Diana Wilkie, PhD, CON, Professor, Palliative Care
  • Learning optimal opioid prescribing and monitoring: a simulation study of medical residents 
  • Opioid doses and acute care utilization outcomes for adults with sickle cell disease: ED versus acute care unit
• Catalina Lopez-Quintero, MD, PHHP/COM, Epidemiology
  • Young, American Indian or Alaskan Native, and born in the USA: at excess risk of starting extra-medical prescription pain reliever use?
• Eric Porges, PhD, PHHP
• Rene Przkora, MD, Director of Pain Management, UF Health, Fellowship Director
• Julia Graber, PhD, CLAS, Psychology
• Barry Setlow, PhD, COM, Psychiatry
  • The importance of considering polysubstance use: lessons from cocaine research
• Robert Cook, MD, PHHP/COM, alcohol and cannabis, HIV/AIDS, Director NIAAA T32
  • The prevalence and patterns of substance use by birth cohort among HIV-positive adults in Florida
• Michael Robinson, PhD, PHHP, Director for Pain Research & Behavioral Health
  • Discrepancies in sleep diary and actigraphy assessments in adults with fibromyalgia: Associations with opioid dose and age
  • Pain intensity as a moderator of the association between opioid use and insomnia symptoms among adults with chronic pain
  • International Stakeholder Community of Pain Experts and Leaders Call for an Urgent Action on Forced Opioid Tapering
  • Draft Opioid-Prescribing Guidelines for Uncomplicated Normal Spontaneous Vaginal Birth
  • Initial Opioid Prescriptions among U.S. Commercially Insured Patients, 2012–2017
  • Evaluation of State-Mandated Reporting of Neonatal Abstinence Syndrome — Six States, 2013–2017
• Yenisel Cruz-Almeida, MD, COM, Assistant Professor, Aging, interested in opioids and pain
• Amie Goodin, PhD, Assistant Professor, COP, interested in opioid use disorder, claims data and trajectories
  • Rural and Appalachian Disparities in Neonatal Abstinence Syndrome Incidence and Access to Opioid Abuse Treatment
  • Rapid Expansion of the Opioid Ecosystem: National Implications for Prescriber–Pharmacist Communication
  • We Cannot Treat the Dead
  • Perinatal Navigator Approach to Smoking Cessation for Women With Prevalent Opioid Dependence
  • Pharmacists’ role in harm reduction: a survey assessment of Kentucky community pharmacists’ willingness to participate in syringe/needle exchange
  • Neonatal Abstinence Syndrome and Maternal Access to Treatment for Opioid Use Disorder in California Counties
• Lori Knackstedt, PhD, Assistant Professor, CLAS, Psychology; cocaine and polysubstance use
  • The importance of considering polysubstance use: lessons from cocaine research
• Joy Gabrielli, PhD, Assistant Professor, PHHP
• Richard Segal, PhD – Associate Dean for Faculty Affairs, College of Pharmacy
  • Association Between Recombinant Human Bone Morphogenetic Proteins and Postoperative Opioid Use in Lumbar Fusion Procedure Patients: A Propensity Score-Matched Analysis
  • Efficacy and safety of a monthly buprenorphine depot injection for opioid use disorder: a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial

• Micah Johnson, PhD – NIDA T32 post-doc – criminologist/sociologist; Director of STOMP Lab (30 minority undergrads who Study of Teen Opioid Misuse and Prevention
  • Family structure and past-30 day opioid misuse among justice-involved children
• Amy Elliott, MS – NIDA T32 and Epidemiology pre-doc studying addiction in juvenile justice system
  • A latent class analysis of the past-30-day substance use patterns among lifetime cocaine users: Findings from a community sample in North Central Florida
• Shawnta Lloyd – NIDA T32 and Epidemiology pre-doc studying addiction in older adults
• Nathan Smith – NIDA T32 and Epidemiology pre-doc studying addiction (gambling, prescription drugs)
• Mirsada Serdarevic – Epidemiology pre-doc and former NIDA T32 pre-doc – studying sex influences on prescription opioid use
  • Prevalence of Concurrent Prescription Opioid and Hazardous Alcohol Use Among Older Women: Results from a Cross-Sectional Study of Community Members
  • A latent class analysis of the past-30-day substance use patterns among lifetime cocaine users: Findings from a community sample in North Central Florida
• Yiyang Liu – Epidemiology pre-doc studying polysubstance use
  • A latent class analysis of the past-30-day substance use patterns among lifetime cocaine users: Findings from a community sample in North Central Florida
  • The importance of considering polysubstance use: lessons from cocaine research
• Laura Gonzalez Paz – NIDA T32 and Epidemiology pre-doc studying opioid use among pregnant women
• Deji Otufowora – Epidemiology pre-doc, studying diversion of opioids in community, comorbid psychiatric disorders
  • Re: Doctor-Patient Trust Among Chronic Pain Patients on Chronic Opioid Therapy after Opioid Risk Reduction Initiatives: A Survey