Grant will help UB scientists identify patients most at-risk for future opioid misuse

Researchers at UB’s Clinical and Research Institute on Addictions (CRIA) will work with the New York State Office of Alcoholism and Substance Abuse Services (OASAS) to assess what risks may occur for people with alcohol use disorder who use prescription painkillers.

“People who are dependent on alcohol or who have alcohol use disorder (AUD) are at greater risk for chronic pain for a variety of reasons,” says Kenneth Leonard, CRIA director. “For example, their alcohol use can lead to physical conditions that produce significant pain, or keep them from adhering to medical regimens for certain diseases, leading to increased pain.” In addition, people with AUD are more prone to accidents.

The amount of people with AUD who also have and receive treatment for chronic pain — often with opioid-type painkillers — raises the risk of overdose or death from opioids, especially if combined with excessive alcohol use.

The two-year grant from the National Institute on Alcohol Abuse and Alcoholism will help CRIA create an integrated database with information from OASAS and the New York State Medicaid office. Leonard is co-principal investigator of the grant along with Peter L. Elkin, professor and chair of the Department of Biomedical Informatics and professor of internal medicine, surgery, and pathology and anatomical sciences in the Jacobs School of Medicine and Biomedical Sciences.

“By cross-referencing these records, we should be able to determine the risk of painkiller use and misuse, such as opioids and benzodiazepine, for patients with alcohol use disorder, and look at the medical and treatment factors that increase risk in this population,” Leonard says. Elkin and Leonard will use machine learning to create predictive models to know which patients are at high risk for a withdrawal or overdose event. They will use these models to identify patients at risk for opioid overdoses and to link them to treatment before opioids become a problem.

 “These findings will have important clinical implications for the management of patients in primary care with an unrecognized history of an alcohol use disorder, as well as policy implications with respect to medical access to alcohol treatment records,” Elkin says.