Rebecca Ashare

PhD

Rebecca Ashare.

Rebecca Ashare

PhD

Rebecca Ashare

PhD

Research Interests

Substance use in medical (HIV, cancer) and psychiatric (depression, serious mental illness) comorbidities; cannabis use for symptom management; serious illness communication

Education

  • PhD, University at Buffalo, SUNY

About

My research takes an interdisciplinary approach to understanding substance use among individuals with medical and psychiatric comorbidities: (1) the mechanisms and outcomes of and treatments for tobacco use among people with HIV (PWH); (2) the intersection of cannabis and opioid use for symptom management. The impact of social determinants of health (SDoH) on health disparities crosscuts both domains.  

PWH smoke at higher rates than the general population and due to the widespread use of highly effective antiretroviral therapy, PWH actually lose more life years to tobacco use than to HIV. My research seeks to understand: (1) the mechanisms that underlie high smoking rates; (2) why existing treatments are less effective and relapse rates are higher among PWH; and (3) how HIV and smoking may act synergistically and ultimately lead to worse clinical outcomes including cancer and impaired immune function. 

More and more patients with cancer are using cannabis to help manage symptoms of cancer, its treatment, or both. Our work seeks to better understand how and why patients with cancer use cannabis for symptom management. Specifically, we are studying whether cannabis may help to reduce opioid use for managing pain among cancer patients. We are also studying how inequities in access to cannabis may alter the potential benefits and harms associated with cannabis use in the context of cancer.

Lastly, we are collaborating with Dee Johnson, Director of The Witness Project, a community-based organization, to understand and address mental health service barriers in Buffalo’s Black community. Through this community-based participatory research we hope to develop a novel health communication outreach program tailored to strategies for reaching, educating, and guiding the community to mental health services.

Selected Publications

  • Worster B, Meghani SH, Leader AE, Nugent SM, Jones KF, Yeager KA, Liou K, Ashare RL. Toward reducing racialized pain care disparities: Approaching cannabis research and access through the lens of equity and inclusion. Cancer. 2023 Nov 9. doi: 10.1002/cncr.35115. Epub ahead of print. PMID: 37941524
  • Ashare RL, Worster B, Nugent SM, Smith DM, Morasco BJ, Leader AE, Case AA, & Meghani SH. Cannabis and opioid perceptions, co-use, and substitution among patients across four NCI-designated cancer centers. JNCI Monographs, in press.
  • Medaglio D, Bilker WB, Han X, Merlin JS, Plankey M, Martin J, Crane HM, Hojat LS, Bamford L, Schnoll R, Tyndale RF, Gross R, Ashare RL. Nicotine Metabolite Ratio Decreases After Switching Off Efavirenz-Based Therapy in People With HIV Who Smoke. Clin Pharmacol Ther. 2023 Oct 3. doi: 10.1002/cpt.3068. Epub ahead of print. PMID: 37787039.
  • Greene B, Bernardo L, Thompson M, Loughead J, Ashare R. An Embedded Recruitment Trial of Behavioral Economic Strategies to Improve Enrollment Rates in Clinical Research. JMIR Formative Research, in press.
  • Ashare R, Turay E, Worster B, Wetherill R, Bidwell L, Doucette A, et al. Social Determinants of Health Associated with How Cannabis is Obtained and Used in Patients with Cancer Receiving Care a Cancer Treatment Center in Pennsylvania. Cannabis, Mar 2023, epub ahead of print
  • Arens Y, Bilker WB, Han X, Plankey M, Ware D, Friedman MR, D’Souza G, Stosor V, Shoptaw S, Schnoll RA, Tyndale RF, Gross R, Ashare RL. HIV Infection Does Not Explain Higher Nicotine Metabolism in People Living with HIV. JAIDS, 91(5): 497-501, Dec 2022
  • Ashare RL, Kelly E, Hajjar ER, Pant S, Meghani SH, Worster B. Characterizing Anxiety, Pain, Sleep, and Quality of Life among Patients in a State Medical Marijuana Program. Complementary Therapies in Clinical Practice, 48:101612, Aug 2022.
  • Bien-Gund CH, Bilker W, Schnoll RA, Tyndale RF, Ho JI, Bremner R, Gross R, Ashare RL: Nicotine metabolism ratio increases in HIV-positive smokers on effective antiretroviral therapy: a cohort study. JAIDS, 89(4): 428-432, Apr 2022.
  • Ashare RL, Brewer B, Patterson F, Hubbard A, Longacre ML: Psychological and Behavioral Moderators of Physical Health among Caregivers and Non-Caregivers. Geriatric Nursing, 43: 77-84, Jan-Feb 2022.
  • Meghani SH, Quinn R, Ashare R, Levoy K, Worster B, Naylor M, Chittams J, Cheatle M: Impact of cannabis use on least pain scores among African American and White patients with cancer pain: A moderation analysis. Journal of Pain Research 14: 3493-3502, Nov 2021.
  • Rosoff-Verbit Z, Logue-Chamberlain E, Fishman J, Audrain-McGovern J, Hawk L, Mahoney M, Mazur A, Ashare R: The Perceived Impact of COVID-19 among Treatment-Seeking Smokers: A Mixed Methods Approach. International Journal of Environmental Research and Public Health 18(2): 505, Jan 2021.
  • Ghura S, Gross R, Jordan-Sciutto K, Dubroff J, Schnoll R, Collman RG, Ashare RL: Bidirectional Associations among Nicotine and Tobacco Smoke, NeuroHIV, and Antiretroviral Therapy. Journal of Neuroimmune Pharmacology 15(4): 694-714, Dec 2020. PMCID: PMC7383218
  • Thompson, M. ,  Schnoll, R.,  Serrano, K.,  Leone, F.,  Gross, R.,  Collman, R. G.,  Ashare, R. L.: The effect of varenicline on mood and cognition in smokers with HIV. Psychopharmacology (Berl) 237(4): 1223-1231, Apr 2020. PMCID: PMC7125016
  • Ashare, R. L., Thompson, M., Serrano, K., Leone, F., Metzger, D. S., Frank, I., Gross, R., Hole, A., Mounzer, K., Weisbrot, J., Collman, R. G., Wileyto, E. P., Schnoll, R.: A Placebo-Controlled Randomized Clinical Trial Testing the Efficacy and Safety of Varenicline for Smokers with HIV. Drug and Alcohol Dependence 200: 26-33, July 2019.
  • Ashare RL, Thompson M, Leone F, Metzger D, Gross R, Mounzer K, Tyndale R, Lerman C, Mahoney MC, Cinciripini P, George TP, Collman R & Schnoll RA. : Differences in the rate of nicotine metabolism among smokers with and without HIV. AIDS 33(6): 1083-1088, May 2019.