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. Most recently, this work has focused on three areas: (1) the mechanisms and outcomes of tobacco use among people with HIV (PWH); (2) digital interventions for smoking cessation among individuals with serious mental illness; and (3) the intersection of cannabis and opioid use for symptom management.
My work in tobacco use and HIV evaluates the mechanisms and outcomes of tobacco use among PWH, a population with disproportionately high smoking rates. Coupled with the widespread use of antiretroviral therapy, PWH actually lose more life years to tobacco use than to HIV. I have three current research projects that address this problem from three perspectives to better 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. These translational studies incorporate biological (e.g., nicotine metabolism, inflammation), behavioral, and cognitive assessments address these questions.
I am also collaborating with investigators at Duke University on a multi-site clinical trial to evaluate the effectiveness of a mobile health application (i.e., smartphone app) for smoking cessation among individuals with serious mental illness. We are collaborating with outpatient psychiatry clinics at ECMC on this trial.
Other research interests include several aspects of cannabis use in the context of comorbid medical conditions. Specifically, these projects focus on: (1) whether cannabis may help to reduce opioid use for managing pain among cancer patients; (2) evaluating perceptions and patterns of cannabis use among cancer patients; and (3) clinician attitudes and knowledge about medical cannabis.