Alexander Y Walley
Dados Biográficos
| ID | 5542469 |
|---|---|
| NOME | Alexander Y Walley |
| PRENOMES | Alexander Y |
| SOBRENOME | Walley |
| ASSINATURA | WALLEY A Y |
| AFILIAÇÕES | Boston University |
| ORCID | 0000-0002-8158-4882 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 44 |
| TOTAL DE CITAÇÕES | 27 |
| TOTAL COMO AUTOR | 44 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2007 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 4 |
A descriptive study of drug overdose epidemics, overdose prevention efforts, and opioid settlement fund distribution across six states
The Optimus International Consensus Guidance for Monitoring User-Reported Outcomes of Opioid Maintenance Treatment
Opioid use disorder is a major cause of drug-related harm and mortality. These can be reduced by expanded access to evidence-based and highly effective opioid agonist maintenance treatment or therapy (OMT). There is a lack of consensus on how to assess opioid use disorder treatment outcomes, and key health outcomes are often omitted. We report the results of a Delphi study to produce service user- and public health–centred international consensus…
Building connection
To better engage survivors, overdose response processes should prioritize survivors' physical and emotional comfort and seek to build trust by utilizing person-centered, trauma-informed, and non-stigmatizing approaches
Effect of the Communities That Heal Intervention on Overdose Education and Naloxone Distribution
Objectives. To determine whether the Communities That HEAL (CTH) intervention is effective in increasing naloxone distribution compared with usual care. Methods. The HEALing (Helping to End Addiction Long-Term) Communities Study (HCS) is a cluster-randomized, parallel-arm, wait-list controlled implementation science trial testing the impact of the CTH intervention on increasing the use of evidence-based practices to lower opioid-related overdose …
Self-medication of pain and discomfort with alcohol and other substances by people with HIV infection and substance use disorder
There is a limited literature regarding factors associated with self-medication of pain and discomfort using alcohol, non-prescription substances or overuse of prescription medications among people living with Human Immunodeficiency Virus (HIV). This cross-sectional analysis used data from the Boston ARCH Cohort among participants with HIV infection and a history of alcohol or other substance use. Among 248 participants, 37% were female, 50% Blac…
A call for compassionate opioid overdose response
High dose and long-acting opioid overdose reversal drugs can precipitate withdrawal in people who are opioid dependent. Products recently brought to market for community use in the United States (US) have drawn international concern because of their increased risk of withdrawal. At the March 18-19, 2024, Compassionate Overdose Response Summit & Naloxone Dosing Meeting, a panel of harm reduction experts issued the following call to action: 1) peop…
Privacy and confidentiality in Massachusetts' post-overdose outreach programs
Cannabis use frequency and pain interference among people with HIV
Cannabis is often used by people with HIV (PWH) for pain, yet study results are inconsistent regarding whether and how it affects pain. This study examines whether greater cannabis use frequency is associated with lower pain interference and whether cannabis use modifies the association of pain severity and pain interference among 134 PWH with substance dependence or a lifetime history of injection drug use. Multi-variable linear regression model…
Opioid Agonist Maintenance Treatment Outcomes—The Optimus International Consensus Towards Evidence-Based and Patient-Centred Care, an Interim Report
Non-medical opioid use is a major public health concern causing high mortality. While opioid agonist maintenance treatment (OMT) is a key life-saving intervention, there is (a) no international consensus on opioid treatment outcomes and (b) few opioid treatment outcome studies include key (public) health outcomes, such as overdose or HIV/hepatitis C. We report the rationale and study protocol for, and preliminary results of, an ongoing internatio…
Characteristics of post-overdose outreach programs and municipal-level opioid overdose in Massachusetts
Association of sex work and social-structural factors with non-fatal overdose among women who use drugs in Vancouver, Canada
Civil commitment perspectives and experiences among friends and family of people who use illicit opioids in Massachusetts, USA
The police paradox
Perspectives and recommendations of opioid overdose survivors experiencing unsheltered homelessness on housing, overdose, and substance use treatment in Boston, MA
If we build it, will they come? Perspectives on pharmacy-based naloxone among family and friends of people who use opioids
Despite high levels of pharmacy naloxone access in Massachusetts, few bystanders in our study had attempted to obtain naloxone under the NSO. Low perceived risk of overdose, misinformation, stigma, and confidentiality were important barriers to pharmacy naloxone uptake, all of which are amenable to intervention. Support groups provided a setting for addressing stigma and misinformation and provided a discreet and comfortable setting for naloxone …
Functional Impairment and Cognitive Symptoms Among People with HIV Infection on Chronic Opioid Therapy for Pain
Warrant checking practices by post-overdose outreach programs in Massachusetts
Variation in Initiation, Engagement, and Retention on Medications for Opioid Use Disorder Based on Health Insurance Plan Design
BACKGROUND: The association between cost-sharing and receipt of medication for opioid use disorder (MOUD) is unknown. METHODS: We constructed a cohort of 10,513 commercially insured individuals with a new diagnosis of opioid use disorder and information on insurance cost-sharing in a large national deidentified claims database. We examined 4 cost-sharing measures: (1) pharmacy deductible; (2) medical service deductible; (3) pharmacy medication co…
Predictors of pain-related functional impairment among people living with HIV on long-term opioid therapy
People living with HIV (PLWH) have high levels of functional impairment due to pain, also called pain interference. Long-term opioid therapy (LTOT) is commonly prescribed for chronic pain among PLWH. We sought to better understand the predictors of pain interference, measured with the Brief Pain Inventory Interference subscale (BPI-I), among PLWH with chronic pain on LTOT. Using a prospective cohort of PLWH on LTOT we developed a model to identif…
Outcomes of Ottawa, Canada's Managed Opioid Program (MOP) where supervised injectable hydromorphone was paired with assisted housing
Targeting community-based naloxone distribution using opioid overdose death rates
Opening the door to somebody who has a chance.” – The experiences and perceptions of public safety personnel towards a public restroom overdose prevention alarm system
Overdose response in public restrooms has been incorporated into the daily duties of public safety personnel at an academic medical center. Anti-motion alarm systems are an innovation with potential to improve overdose response and safety, though the technology warrants ongoing development and unintended consequences should be assessed. To optimize restroom safety in the midst of fentanyl use, more research is needed among first responders, peopl…
Medication for addiction treatment and acute care utilization in HIV-positive adults with substance use disorders
Medication for addiction treatment (MAT) could reduce acute care utilization in HIV-positive individuals with substance use disorders. The study objective was to determine if HIV-positive people with substance use disorders treated with MAT report less acute care utilization than those not receiving MAT. We assessed the association between MAT and acute care utilization among HIV-positive individuals with alcohol or opioid use disorder. Acute car…
Rurality and differences in pharmacy characteristics and community factors associated with provision of naloxone in the pharmacy
Laws Mandating Coprescription of Naloxone and Their Impact on Naloxone Prescription in Five US States, 2014–2018
Objectives. To examine early impacts of laws that require naloxone to be prescribed to patients at increased overdose risk. Methods. Using data from 2014 to 2018 from a large pharmacy chain, CVS Pharmacy, we examined the effects of naloxone-prescribing mandates 90 days before and after they took effect in Arizona, Florida, Rhode Island, Vermont, and Virginia. We compared the number of naloxone doses initiated directly by prescribers and by pharma…
Saved by the Nose
Administering naloxone hydrochloride (naloxone) during an opioid overdose reverses the overdose and can prevent death. Although typically delivered via intramuscular or intravenous injection, naloxone may be delivered via intranasal spray device. In August 2006, the Boston Public Health Commission passed a public health regulation that authorized an opioid overdose prevention program that included intranasal naloxone education and distribution of…
Estimated Prevalence of Opioid Use Disorder in Massachusetts, 2011–2015
Objectives. To estimate the annual prevalence of opioid use disorder (OUD) in Massachusetts from 2011 to 2015. Methods. We performed a multisample stratified capture–recapture analysis to estimate OUD prevalence in Massachusetts. Individuals identified from 6 administrative databases for 2011 to 2012 and 7 databases for 2013 to 2015 were linked at the individual level and included in the analysis. Individuals were stratified by age group, sex, an…
Expanded Access to Naloxone Among Firefighters, Police Officers, and Emergency Medical Technicians in Massachusetts
Naloxone is a medication that reverses respiratory depression from opioid overdose if given in time. Paramedics routinely administer naloxone to opioid overdose victims in the prehospital setting, and many states are moving to increase access to the medication. Several jurisdictions have expanded naloxone administration authority to nonparamedic first responders, and others are considering that step. We report here on policy change in Massachuset…
Laws Mandating Coprescription of Naloxone and Their Impact on Naloxone Prescription in Five US States, 2014–2018
Objectives. To examine early impacts of laws that require naloxone to be prescribed to patients at increased overdose risk. Methods. Using data from 2014 to 2018 from a large pharmacy chain, CVS Pharmacy, we examined the effects of naloxone-prescribing mandates 90 days before and after they took effect in Arizona, Florida, Rhode Island, Vermont, and Virginia. We compared the number of naloxone doses initiated directly by prescribers and by pharma…
Implications of Cannabis Use and Heavy Alcohol Use on HIV Drug Risk Behaviors in Russian Heroin Users
Cannabis and heavy alcohol use potentially increase HIV transmission by increasing risky drug behaviors. We studied 404 subjects entering treatment for heroin dependence, in St. Petersburg, Russia. We used the HIV Risk Assessment Battery (RAB) drug subscale to measure risky drug behavior. Although all heavy alcohol users had risky drug behaviors, their drug RAB scores did not differ from non-heavy alcohol users in unadjusted or adjusted analyses.…
Saved by the Nose
Administering naloxone hydrochloride (naloxone) during an opioid overdose reverses the overdose and can prevent death. Although typically delivered via intramuscular or intravenous injection, naloxone may be delivered via intranasal spray device. In August 2006, the Boston Public Health Commission passed a public health regulation that authorized an opioid overdose prevention program that included intranasal naloxone education and distribution of…
Nondisclosure of HIV Infection to Sex Partners and Alcohol’s Role
Opioid overdose rates and implementation of overdose education and nasal naloxone distribution in Massachusetts
OBJECTIVE: To evaluate the impact of state supported overdose education and nasal naloxone distribution (OEND) programs on rates of opioid related death from overdose and acute care utilization in Massachusetts. DESIGN: Interrupted time series analysis of opioid related overdose death and acute care utilization rates from 2002 to 2009 comparing community-year strata with high and low rates of OEND implementation to those with no implementation. S…
Risk factors for recent nonfatal overdose among HIV-infected Russians who inject drugs
Overdoses and HIV infection are common among Russians who inject drugs, yet risk factors have not been studied. We analyzed baseline data of 294 participants with 30-day injection drug use from an HIV secondary prevention trial for persons reporting "heavy" alcohol use (National Institute on Alcohol Abuse and Alcoholism [NIAAA] risky drinking definition) and risky sex in the past 6 months. The outcome was any self-reported overdose in the previou…
Overdose rescues by trained and untrained participants and change in opioid use among substance-using participants in overdose education and naloxone distribution programs
Among 4926 substance users who participated in OEND, 373(7.6%) reported administering naloxone during an overdose rescue. We found few differences in behavior between trained and untrained overdose rescuers. Prospective studies will be needed to determine the optimal level of training and whether naloxone rescue kits can meet an over-the-counter standard. With no clear evidence of increased heroin use, this concern should not impede expansion of …
Heroin Use and HIV Disease Progression
Expanded Access to Naloxone Among Firefighters, Police Officers, and Emergency Medical Technicians in Massachusetts
Naloxone is a medication that reverses respiratory depression from opioid overdose if given in time. Paramedics routinely administer naloxone to opioid overdose victims in the prehospital setting, and many states are moving to increase access to the medication. Several jurisdictions have expanded naloxone administration authority to nonparamedic first responders, and others are considering that step. We report here on policy change in Massachuset…
HIV-infected individuals who use alcohol and other drugs, and virologic suppression
People living with HIV (PLWH) on antiretroviral therapy (ART) who use substances were examined to (a) describe those with virologic control and (b) determine which substance use-factors are associated with lack of virologic control. Participants were adult PLWH taking ART with either past 12-month DSM-IV substance dependence or past 30-day alcohol or illicit drug use. Substance use factors included number of DSM-IV alcohol or drug dependence crit…
HIV Stigma and Substance Use Among HIV-Positive Russians with Risky Drinking
Fatal and non-fatal overdose after narcology hospital discharge among Russians living with HIV/Aids who inject drugs
Naloxone for heroin, prescription opioid, and illicitly made fentanyl overdoses
Medication for Opioid Use Disorder After Nonfatal Opioid Overdose and Association With Mortality
Background: Opioid overdose survivors have an increased risk for death. Whether use of medications for opioid use disorder (MOUD) after overdose is associated with mortality is not known. Objective: To identify MOUD use after opioid overdose and its association with all-cause and opioid-related mortality. Design: Retrospective cohort study. Setting: 7 individually linked data sets from Massachusetts government agencies. Participants: 17 568 Massa…
Polypharmacy and risk of falls and fractures for patients with HIV infection and substance dependence
Although people with HIV infection (PLWH) are at higher risk of polypharmacy and substance use, there is limited knowledge about potential harms associated with polypharmacy such as falls and fractures in this population. The study objective was to determine whether polypharmacy, as measured by the number and type of medication, is associated with falls and fractures among PLWH and DSM-IV substance dependence in the past year or ever injection dr…
Post opioid overdose outreach by public health and public safety agencies
Estimated Prevalence of Opioid Use Disorder in Massachusetts, 2011–2015
Objectives. To estimate the annual prevalence of opioid use disorder (OUD) in Massachusetts from 2011 to 2015. Methods. We performed a multisample stratified capture–recapture analysis to estimate OUD prevalence in Massachusetts. Individuals identified from 6 administrative databases for 2011 to 2012 and 7 databases for 2013 to 2015 were linked at the individual level and included in the analysis. Individuals were stratified by age group, sex, an…
Provider opioid prescribing practices and the belief that opioids keep people living with HIV engaged in care
We describe HIV providers' opioid prescribing practices and assess whether belief that chronic opioid therapy (COT) keeps people living with HIV (PLWH) engaged in care is associated with differences in these practices among providers from two HIV clinics. We conducted logistic regression to evaluate the association between the belief that COT keeps PLWH engaged in care and at least one component of guideline-recommended care (i.e., urine drug tes…
Opioid overdose deaths and potentially inappropriate opioid prescribing practices (PIP)
Overdose and PIP hotspots were identified, as well as regions where the two overlapped, and where they diverged. Results indicate that PIP clustering alone does not explain overdose clustering patterns. Our findings can inform public health policy decisions at the local level, which include a focus on PIP and misuse of heroin and fentanyl that aim to curb opioid overdoses
Beliefs Associated with Pharmacy-Based Naloxone
Medication for addiction treatment and acute care utilization in HIV-positive adults with substance use disorders
Medication for addiction treatment (MAT) could reduce acute care utilization in HIV-positive individuals with substance use disorders. The study objective was to determine if HIV-positive people with substance use disorders treated with MAT report less acute care utilization than those not receiving MAT. We assessed the association between MAT and acute care utilization among HIV-positive individuals with alcohol or opioid use disorder. Acute car…
Rurality and differences in pharmacy characteristics and community factors associated with provision of naloxone in the pharmacy
Laws Mandating Coprescription of Naloxone and Their Impact on Naloxone Prescription in Five US States, 2014–2018
Objectives. To examine early impacts of laws that require naloxone to be prescribed to patients at increased overdose risk. Methods. Using data from 2014 to 2018 from a large pharmacy chain, CVS Pharmacy, we examined the effects of naloxone-prescribing mandates 90 days before and after they took effect in Arizona, Florida, Rhode Island, Vermont, and Virginia. We compared the number of naloxone doses initiated directly by prescribers and by pharma…
Predictors of pain-related functional impairment among people living with HIV on long-term opioid therapy
People living with HIV (PLWH) have high levels of functional impairment due to pain, also called pain interference. Long-term opioid therapy (LTOT) is commonly prescribed for chronic pain among PLWH. We sought to better understand the predictors of pain interference, measured with the Brief Pain Inventory Interference subscale (BPI-I), among PLWH with chronic pain on LTOT. Using a prospective cohort of PLWH on LTOT we developed a model to identif…
Outcomes of Ottawa, Canada's Managed Opioid Program (MOP) where supervised injectable hydromorphone was paired with assisted housing
Targeting community-based naloxone distribution using opioid overdose death rates
Medicine (42 obras) · Opioid Use Disorder Treatment (30 obras) · Opioid (26 obras) · HIV, Drug Use, Sexual Risk (21 obras) · Internal Medicine (21 obras) · Psychiatry (20 obras) · Poison control (18 obras) · Psychology (17 obras) · Opioid overdose (16 obras) · Public health (16 obras)