"Many people have questions or concerns about alcohol and other drug use—and don’t know where to turn. Health systems have historically ignored alcohol and drug use; we are changing that.”

Katharine A. Bradley, MD, MPH
Senior Investigator, Kaiser Permanente Washington Health Research Institute
Physician, Washington Permanente Medical Group, Internal Medicine

Research overview

Kaiser Permanente Washington researchers are exploring how to improve prevention and treatment of health issues due to alcohol and other drug use. The addictions research group conducts innovative research to help patients and their providers prevent and treat problems caused by tobacco, alcohol, cannabis, opioids, and other drugs in health settings.

A major focus of the addictions research group is how to integrate patient-centered care for alcohol and other drug use into medical settings. Over the past three decades, their work has focused on the need for health systems to routinely measure and address alcohol and other drug use as part of whole-person health, in nonjudgmental, patient-centered ways.

"Our alcohol-related research has built tools—such as a brief video, handout, and a patient decision aid—that help overcome stigma so that patients and families can find the help they want and need," says Katharine A. Bradley, MD, MPH, a senior investigator at Kaiser Permanente Washington Health Research Institute (KPWHRI) and internal medicine physician with Washington Permanente Medical Group.

The addictions research group is conducting a variety of studies. "We are working to find ways to easily document the extent of cannabis exposure for both medical and nonmedical use in electronic health records," says Gwen Lapham, PhD, MSW, a KPWHRI assistant investigator. "We are also testing how to get proven online treatments for addiction into the hands of patients who could benefit," says Joseph E. Glass, PhD, MSW, a KPWHRI associate investigator. These are among the group’s current studies:

  • PRimary Care Opioid Use Disorders (PROUD) is an implementation trial testing collaborative care for opioid use disorders.
  • Digital Treatments for Substance Use Disorder (DIGITS) is a trial of strategies to implement online substance use disorder treatments into primary care.
  • The Medical Cannabis study uses electronic health record (EHR) and survey data to study patterns of medical cannabis use among primary care patients.
  • Medication Use, Safety, and Evidence (MUSE) is a multisite observational study on the incidence of and risk factors for opioid misuse, abuse, and addiction.
  • Dr. Glass has an early-career award to study the effectiveness of treatments for alcohol use disorders in primary care.
  • As a K12 CATALyST Learning Health Systems scholar, Dr. Lapham is partnering with Kaiser Permanente Washington Mental Health and Wellness leaders to integrate evidence-based care for substance use into adolescent primary care.
  • Dr. Bradley’s mid-career award supports research innovation and mentoring early-career addictions researchers.

"We partnered with mental health and primary care leaders at Kaiser Permanente Washington to implement a program that addresses addictions and other common mental health concerns as part of routine primary care," says Amy K. Lee, MPH, a KPWHRI research associate. These are among the studies that the addictions research group has completed:

  • In collaboration with Emily Williams, PhD, MPH, a KPWHRI affiliate investigator at Veterans Affairs Puget Sound Health Care System, they found that patients with unhealthy alcohol use who had HIV were less likely to receive evidence-based alcohol-related care than those without HIV.
  • The Choosing Healthier Drinking Options in Primary Care (CHOICE) trial found that, with nurse care management, collaborative care for patients with high-risk drinking raised their engagement in alcohol-related care—but did not decrease heavy drinking or related problems. But usual care may have had benefits for patients without high-risk drinking.
  • The Options study developed a patient-centered decision aid for thinking about drinking and learning about options for making changes in drinking.
  • Integrated Mental Health was implemented and evaluated in Kaiser Permanente Washington.
  • The Sustained Patient-centered Alcohol-related Care (SPARC) trial found that implementing integrated mental health in primary care improved sustained implementation of evidence-based alcohol-related care.
  • The impact of poverty on alcohol use was stronger among black people—men and women alike—than in people in other racial/ethnic groups.

Recent Publications on Addictions

Firemark AJ, Schneider JL, Kuntz JL, Papajorgji-Taylor D, Dickerson JF, Thorsness LA, Reese KR, Sullivan MD, Debar LL, Smith DH. "We need to taper" interviews with clinicians and pharmacists about use of a pharmacy-led opioid tapering program. Pain Med. 2021 May 21;22(5):1213-1222. doi: 10.1093/pm/pnaa442. PubMed

Tsui JI, Akosile MA, Lapham GT, Boudreau DM, Johnson EA, Bobb JF, Binswanger IA, Yarborough BJH, Glass JE, Rossom RC, Murphy MT, Cunningham CO, Arnsten JH, Thakral M, Saxon AJ, Merrill JO, Samet JH, Bart GB, Campbell CI, Loree AM, Silva A, Stotts AL, Ahmedani B, Braciszewski JM, Hechter RC, Northrup TF, Horigian VE, Bradley KA. Prevalence and medication treatment of opioid use disorder among primary care patients with hepatitis C and HIV. J Gen Intern Med. 2021 Feb 10. doi: 10.1007/s11606-020-06389-7. [Epub ahead of print]. PubMed

Gray SL, Elsisi Z, Phelan EA, Hanlon JT. Interventions to reduce fall-risk-increasing drug use to prevent falls: a narrative review of randomized trials. Drugs Aging. 2021 Feb 5. doi: 10.1007/s40266-021-00835-9. [Epub ahead of print]. PubMed

Campbell CI, Saxon AJ, Boudreau DM, Wartko PD, Bobb JF, Lee AK, Matthews AG, McCormack J, Liu DS, Addis M, Altschuler A, Samet JH, LaBelle CT, Arnsten J, Caldeiro RM, Borst DT, Stotts AL, Braciszewski JM, Szapocznik J, Bart G, Schwartz RP, McNeely J, Liebschutz JM, Tsui JI, Merrill JO, Glass JE, Lapham GT, Murphy SM, Weinstein ZM, Yarborough BJH, Bradley KA. PRimary Care Opioid Use Disorders treatment (PROUD) trial protocol: a pragmatic, cluster-randomized implementation trial in primary care for opioid use disorder treatment. Addict Sci Clin Pract. 2021;16(1):9. doi: 10.1186/s13722-021-00218-w. PubMed

Williams EC, Frost MC, Rubinsky AD, Glass JE, Wheat CL, Edmonds AT, Chen JA, Matson TE, Fletcher OV, Lehavot K, Blosnich JR. Patterns of alcohol use among transgender patients receiving care at the Veterans Health Administration: overall and relative to nontransgender patients. J Stud Alcohol Drugs. 2021;82(1):132-141. PubMed

Researchers in Addictions

Jennifer F. Bobb, PhD

Associate Investigator
206-287-2190
Jennifer.F.Bobb@kp.org

Curriculum vitae (CV)

Katharine A. Bradley, MD, MPH

Senior Investigator
206-287-2151
Katharine.A.Bradley@kp.org

Curriculum vitae (CV)

David S. Carrell, PhD

Associate Investigator
206-287-2705
David.S.Carrell@kp.org

Curriculum vitae (CV)

Lynn DeBar, PhD

Senior Investigator
(206) 287-2942
Lynn.Debar@kp.org

Curriculum vitae (CV)

Joseph E. Glass, PhD, MSW

Associate Investigator
206-287-4266
Joseph.E.Glass@kp.org

Curriculum vitae (CV)

Clarissa Hsu, PhD

Assistant Investigator
206-287-4276
Clarissa.W.Hsu@kp.org

Curriculum vitae (CV)

Gwen Lapham, PhD, MPH, MSW

Assistant Investigator
206-287-2021
Gwen.T.Lapham@kp.org

Curriculum vitae (CV)

Amy K. Lee, MPH

Research Associate
206-287-2827
Amy.K.Lee@kp.org

Curriculum vitae (CV)

Jennifer B. McClure, PhD

Director of Research, Faculty, & Development; Senior Investigator
206-287-2737
Jennifer.B.Mcclure@kp.org

Curriculum vitae (CV)

Julie E. Richards, PhD, MPH

Research Associate II
206-287-2100
Julie.E.Richards@kp.org

Curriculum vitae (CV)

Paige D. Wartko, PhD, MPH

Research Associate
206-442-5230
Paige.D.Wartko@kp.org

Curriculum vitae (CV)

Kai Yeung, PharmD, PhD

Assistant Investigator
206-287-2063
Kai.Yeung@kp.org

Curriculum vitae (CV)

Yu-Ru Su, PhD

Assistant Investigator
206-287-2948
yuru.su@kp.org

Curriculum vitae (CV)

Leah K. Hamilton, PhD

Research Associate II
206-287-2515
Leah.K.Hamilton@kp.org

Curriculum vitae (CV)

 

Affiliate researcher in addictions 

Emily Williams, PhD, MPH
Investigator
Health Services Research & Development
VA Puget Sound Health Care System