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