2018 Annual Meeting

Applying Epidemiology Across the Lifespan to Improve Health Care,
Inform Health Policy and Enhance Population Health




Monday Afternoon Plenary

Location: University of Cincinnati, Medical Sciences Building (MSB), Kresge Auditorium

The Epidemiology of Addiction and the Opioid Use Epidemic

Co-Chairs: Maurizio Macaluso, MD, DrPH, FACE, Professor of Pediatrics, University of Cincinnati College of Medicine, Director, Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center and Russell Kirby, PhD, MS, FACE, Distinguished University Professor and Merrell Endowed Chair, Department of Community and Family Health, College of Public Health, University of South Florida

Description: This plenary session places the opioid use epidemic in the broader context of the epidemiology of addiction, and discusses in depth opioid use during pregnancy and barriers to treatment among HIV-infected injection drug users.

Abstract: The opioid abuse epidemic is undoubtedly one of the most disturbing social and public health problems that the U.S. faces today.  As the number of individuals who misuse prescription opioids is in the millions, and the number of deaths due to overdose continues to grow, it is important to understand the epidemiology of addiction and its health consequences.  This session places the opioid use epidemic in the broader context of the epidemiology of addictive behaviors, addresses the increased use of opioids during pregnancy and the resulting epidemic of neonatal abstinence syndrome, and discusses the difficulties of promoting medication assisted treatment as well as antiretroviral treatment among injection drug users.

Brief Biographies:

Maurizio Macaluso, MD, DrPH, FACE, is Professor of Pediatrics at the University of Cincinnati (UC) College of Medicine, Director of the Division of Biostatistics and Epidemiology at Cincinnati Children’s Hospital and Associate Director of the Center for Clinical and Translational Science and Training of UC.  He has over 35 years of research experience in methods; cancer; occupational health and safety; reproductive health; infectious diseases; surveillance systems; and has authored over 200 publications. He is a Fellow of the American College of Epidemiology and serves on the Board of Directors of ACE and as Associate Editor of the Annals of Epidemiology. He is the Program Chair and Local Host of the 2018 meeting.

Dr. Russell Kirby, PhD, MS, FACE, is perinatal and pediatric epidemiologist trained both in epidemiology and human geography. His work focuses on population-based research concerning adverse pregnancy outcomes, birth defects, and developmental disabilities, data integration, and spatial methods applied to epidemiologic studies. Dr. Kirby became a member of ACE in 1993, and has been a Fellow since 1996. He will serve as president of ACE for 2018-19.



Steve Sussman, PhD, FAAHB, FAPA, Professor of Preventive Medicine, Psychology, and Social Work, Institute for Health Promotion and Disease Prevention Research, University of Southern California, “Addiction as a Dysregulation of Appetitive Motivation"

Description: I argue that understanding the definition and breadth of addiction leads one to consider any number of substances and behaviors that can become dysregulated. I also discuss what may lead to one addiction but not another (addiction specificity), the notion of an “addiction class”, and suggest implications for health policy.  

Abstract: Addiction often is described without being well-defined. In this presentation, the definition of addiction is presented, which involves engaging in behaviors, including imbibing of substances that achieve a subjective appetitive effect, then lead to preoccupation and loss of control, and to undesired consequences. In this presentation I suggest that up to 48% of the adult population suffers from one or more of 11 focal addictions (nicotine, alcohol, other drugs, food, gambling, electronic media, love, sex, shopping, exercise, and work). Based on Latent Class Analysis data I suggest that, considering these focal addictions, there exists an “addiction class” of persons, and a non-addiction class, and that both classes are quite stable over a year’s period. Within the addiction class the specific addiction harnessed is not stable and may fluctuate based on pragmatics, attraction of the behavior, communication expertise regarding the behavior, and meeting expectations (PACE). Lifestyle (including social pushes and pulls), associative learning, along with neurobiological vulnerability impact the tendency to develop an addictive pattern. Health policy should consider the need to grapple with the addiction process to halt the development of negative substitute addictions, while maintain realistic coverage of persons.   

Brief Biography:

Steve Sussman, Ph.D., FAAHB, FAPA, received his doctorate in social-clinical psychology from the University of Illinois at Chicago in 1984. He is a professor of preventive medicine, psychology, and social work at the University of Southern California (USC), and he has been at USC for 34 years. He studies etiology, prevention, and cessation within the addictions arena, broadly defined, as well as translation research and program development. He has over 500 publications. His programs include Project Towards No Tobacco Use (young teen tobacco use prevention), Project Towards No Drug Abuse (older teen drug abuse prevention), and Project EX (older teen tobacco use prevention/cessation), which are considered evidence-based programs at numerous agencies (i.e., CDC, NIDA, NCI, OJJDP, SAMSHA, CSAP, Colorado and Maryland Blueprints, Health Canada, U.S. DOE and various State Departments of Education). He received the honor of Research Laureate for the American Academy of Health Behavior in 2005, and he was President there (2007-2008). Also, as of 2007, he received the honor of Fellow of the American Psychological Association (Division 50, Addictions). He is the current Editor of Evaluation & the Health Professions (SAGE Publications). His newest text is: Substance and Behavioral Addictions: Concepts, Causes, and Cures (Cambridge, 2017).


Stephen Patrick, MD, MPH, MS, Vanderbilt University, “The Impact of the Opioid Epidemic on Pregnant Women and Infants”

Description: This talk will focus on the rise of opioid use in in the US, how it has affected pregnant women and infants and how public health systems have responded.

Abstract: Over the past two decades, there has been substantial growth in opioid consumption in pregnancy, diagnoses of opioid use disorder among pregnant women, and neonatal complications from in utero opioid exposure. By 2014, one infant was born on average every 15 minutes in the United States having signs of drug withdrawal after birth, also known as neonatal abstinence syndrome (NAS). The rapid rise of opioid use in pregnancy caught hospitals and public health systems off guard. This talk will describe the rise of opioid use in pregnancy and NAS and will focus on their implications for public health systems as well as state and federal policy.  

Brief Biography:

Stephen W. Patrick, MD, MPH, MS, is the Director of the Vanderbilt Center for Child Health Policy, an Assistant Professor of Pediatrics and Health Policy at Vanderbilt University School of Medicine and an attending neonatologist at Monroe Carell Jr. Children’s Hospital at Vanderbilt. He is a graduate of the University of Florida, Florida State University College of Medicine and Harvard School of Public Health. Dr. Patrick completed his training in pediatrics, neonatology and health services research as a Robert Wood Johnson Foundation Clinical Scholar at the University of Michigan. Dr. Patrick’s National Institute on Drug Abuse-funded research focuses on improving outcomes for opioid-exposed infants and women with substance-use disorder and evaluating state and federal drug control policies. He previously served as Senior Science Policy Advisor to the White House Office of National Drug Control Policy. Dr. Patrick is a member of the American Academy of Pediatrics Committee on Substance Use and Prevention and has been a voting member on several US Food and Drug Administration Advisory Boards focused on opioid use in children. He has testified about the impact of the opioid epidemic on pregnant women and infants before committees in both the US House of Representatives and the US Senate. Dr. Patrick’s awards include the American Medical Association Foundation Excellence in Medicine Leadership Award, the Academic Pediatric Association Fellow Research Award Tennessee Chapter of the American Academy of Pediatrics Early Career Physician of the Year and the Nemours Child Health Services Research Award. His research has been published in leading scientific journals including the New England Journal of Medicine, JAMA, Pediatrics and Health Affairs.


William C. Miller, MD, PhD, MPH, Chair and Professor of Epidemiology, Center of Excellence in Regulatory Tobacco Science, The Ohio State University, “Opioids and HIV: From Global to Local”

Description: In some parts of the world, the HIV epidemic continues among people who inject drugs (PWID), a marginalized population with limited access to HIV or substance use care. As the opioid crisis expands in the United States, what can we learn from our global work to have an impact here locally?

Abstract:The HIV epidemic continues unabated among people who inject drugs (PWID) in many parts of the world. HIV, and hepatitis C virus (HCV), transmission is facilitated by the sharing of injection paraphernalia. Several evidence-based interventions are known to reduce HIV risk, including substance use treatment and access to syringe service programs. In a recent study, we used systems navigation and psychosocial counseling to help HIV-infected people engage in HIV care. Through this intervention, ART use was markedly increased, as was viral suppression and medication-assisted treatment. Mortality was also reduced.  This study has substantial implications for PWID worldwide, and many of the lessons learned are directly applicable to PWID in the United States. Remarkably, however, the barriers to addressing the opioid crisis in the United States, such as stigma surrounding not only substance use, but also substance use treatment, may limit the impact of this integrated intervention.

Brief Biography:

William C. Miller, MD, PhD, MPH, is Professor and Chair in the Division of Epidemiology, College of Public Health at OSU. Bill is an infectious diseases epidemiologist with primary expertise in sexually transmitted diseases and HIV infection. His work has addressed STD and HIV epidemiology broadly, including partner services, surveillance, spatial analyses, and diagnostic test evaluation. Currently, he is the PI for a study in Malawi examining approaches to partner services (contact tracing), incorporating network and phylogenetic analyses. He is the protocol chair for HIV Prevention Trials Network (HPTN) 074, a study examining approaches to engaging people who inject drugs in HIV care to prevent transmission to uninfected injection partners. He is also the PI of a NIDA-funded UG3 award to address the opioid crisis in Ohio and a CDC-funded U01 to examine the syphilis epidemic among MSM. Bill is the editor-in-chief for the journal, Sexually Transmitted Diseases, and associate editor for Epidemiology.

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