Simeon D. Kimmel's research while affiliated with Boston University and other places

Publications (36)

Article
Full-text available
Background Police action can increase risky substance use patterns by people who use drugs (PWUD), but it is not known how increased police presence affects utilization of low-barrier substance use disorder bridge clinics. Increased police presence may increase or decrease treatment-seeking behavior. We examined the association between Operation Cl...
Article
Full-text available
Gabapentin is associated with dizziness, falls, and somnolence yet commonly prescribed to people with HIV (PWH) treated with chronic opioid therapy (COT). Physical function and cognition are understudied when prescribed together. Among PWH on COT, we evaluated whether co-prescribed gabapentin is associated with (a) functional impairment; (b) troubl...
Article
Background Pulmonary valve infective endocarditis (PVIE) represents a rare subset of right-sided IE. This study aimed to evaluate the population-level surgical outcomes of PVIE in the United States. Methods We performed a retrospective observational study using the 2002–2017 National Inpatient Sample database. We included hospitalizations with bot...
Article
Since the start of the COVID-19 pandemic, nursing home residents have accounted for roughly one of every six COVID-19 deaths in the United States. Nursing homes have also been very dangerous places for workers, with more than one million nursing home workers testing positive for COVID-19 as of April 2022. Labor unions may play an important role in...
Article
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Background Community-based harm reduction programs reduce morbidity and mortality associated with drug use. While hospital-based inpatient addiction consult services can also improve outcomes for patients using drugs, inpatient clinical care is often focused on acute withdrawal and the medical management of substance use disorders. There has been l...
Article
Referrals of hospitalized patients with opioid use disorder (OUD) to postacute medical care facilities are commonly rejected. We linked all electronic referrals from a Boston safety-net hospital in 2018 to clinical data and used multivariable logistic regression to examine the association between OUD diagnosis and rejection from postacute medical c...
Preprint
Background: Police action can increase risky substance use patterns by people who use drugs (PWUD), but it is not known how increased police presence affects utilization of low-barrier substance use disorder bridge clinics. Increased police presence may increase or decrease treatment-seeking behavior. We examined whether Operation Clean Sweep (OCS)...
Article
Background: Hospitalizations for people who inject drugs (PWID) are opportunities to address substance use. However, little is known about hospitalized PWIDs' motivation to stop substance use or improve skin and needle hygiene, common means for reducing injection sequelae. Methods: We used baseline data from a randomized controlled trial of a behav...
Article
Importance: Emerging evidence supports the use of outpatient parenteral antimicrobial therapy (OPAT) and, in many cases, partial oral antibiotic therapy for the treatment of injection drug use-associated infective endocarditis (IDU-IE); however, long-term outcomes and cost-effectiveness remain unknown. Objective: To compare the added value of in...
Article
Background Hospitalizations for drug-use associated endocarditis (DUA-IE) have led to increasing surgical consultation for valve replacement. Cardiothoracic surgeons’ perspectives about the process of decision-making around surgery for people with DUA-IE are largely unknown. Methods This multi-site semi-qualitative study sought to gather the persp...
Article
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Background Drug use-associated infective endocarditis (DUA-IE) is typically treated with 4-6 weeks of in hospital intravenous antibiotics (IVA). Outpatient parenteral antimicrobial therapy (OPAT) and partial oral antibiotics (PO) may be as effective as IVA, though long-term outcomes and costs remain unknown. We evaluated the clinical outcomes and c...
Article
During the COVID-19 pandemic, safely reopening schools has been one of the most pressing public health challenges in the United States. At the beginning of the 2020-21 school year, the Centers for Disease Control and Prevention strongly encouraged schools to require mask wearing. Although teachers unions frequently supported such policies, the adop...
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Importance Methadone access may be uniquely vulnerable to disruption during COVID-19, and even short delays in access are associated with decreased medication initiation and increased illicit opioid use and overdose death. Relative to Canada, US methadone provision is more restricted and limited to specialized opioid treatment programs. Objective...
Article
Objectives: Widespread use and misuse of prescription and illicit opioids have exposed millions to health risks including serious infectious complications. Little is known, however, about the association between opioid use and sepsis. Design: Retrospective cohort study. Setting: About 373 U.S. hospitals. Patients: Adults hospitalized between...
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Massachusetts is one of the epicenters of the opioid epidemic and has been severely impacted by injection-related viral and bacterial infections. A recent increase in newly diagnosed human immunodeficiency virus (HIV) infections among persons who inject drugs in the state highlights the urgent need to address and bridge the overlapping epidemics of...
Article
This cross-sectional study describes naloxone rescue kit receipt among people with HIV (PWH) on chronic opioid therapy (COT) and HIV clinician opioid overdose prevention care in two clinics between 2015 and 2017. Naloxone rescue kit receipt was uncommon. History of overdose was associated with receiving naloxone but having a clinician who reported...
Article
In summarizing the proceedings of a longitudinal meeting of experts on substance use disorders among adolescents and young adults, we review 2 principles of care related to harm reduction for young adults with substance use disorders. The first is that harm reduction services are critical to keeping young adults alive and healthy and can offer oppo...
Article
: The Grayken Center for Addiction at Boston Medical Center includes programs across the care continuum for people with substance use disorders (SUDs), serving both inpatients and outpatients. These programs had to innovate quickly during the COVID-19 outbreak to maintain access to care. Federal and state regulatory flexibility allowed these progra...
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Full-text available
Importance Although hospitalizations for injection drug use–associated infective endocarditis (IDU-IE) have increased during the opioid crisis, utilization of and mortality associated with receipt of medication for opioid use disorder (MOUD) after discharge from the hospital among patients with IDU-IE are unknown. Objective To assess the proportio...
Article
More than 40% of all reported coronavirus disease 2019 (COVID-19) deaths in the United States have occurred in nursing homes. As a result, health care worker access to personal protective equipment (PPE) and infection control policies in nursing homes have received increased attention. However, it is not known if the presence of health care worker...
Article
Increased infections from injection drug use harm patients and are costly to the health care system. The impact on clinical microbiology laboratories is less recognized. Microbiology laboratories face increased test volume and test complexity from the spectrum and burden of pathogens associated with injection drug use, which lead to diagnostic chal...
Article
Full-text available
Background Patients with opioid use disorder (OUD) who are hospitalized for serious infections requiring prolonged intravenous antibiotics may face barriers to discharge, which could prolong hospital length of stay (LOS) and increase financial burden. We investigated differences in LOS, discharge disposition, and charges between hospitalizations fo...
Article
Background: Among those with injection drug use-associated infective endocarditis (IDU-IE), against medical advice (AMA) discharge is common and linked to adverse outcomes. Understanding trends, risk factors and timing is needed to reduce IDU-IE AMA discharges. Methods: We identified individuals ages 18-64 with International Classification of Di...
Article
In response to the novel coronavirus 2019 (Covid-19) pandemic, many people experiencing homelessness and substance use disorders entered respite and recuperation facilities for care and to isolate and prevent subsequent SARS-CoV-2 transmission. However, because drug use was officially prohibited in these facilities, we observed people who use subst...
Article
Objectives: To determine how commonly medical inpatients with opioid use disorder (OUD) referred for postacute medical care were rejected due to substance use or treatment with opioid agonist therapy (OAT). Additionally, to assess for changes in rejection rates following the United States Attorney's May 2018 settlement with a Massachusetts nursing...
Article
Objectives: The global pandemic of coronavirus disease 2019 (Covid-19) may disproportionately affect persons in congregate settings, including those in residential substance use treatment facilities. To limit the spread of SARS-CoV-2 through congregate settings, universal testing may be necessary. We aimed to determine the point prevalence of SARS...
Article
Amidst the opioid overdose crisis, there are increased efforts to expand access to medications for opioid use disorder (MOUD). Hospitalization for the complications of substance use in the United States (US) provides an opportunity to initiate methadone, buprenorphine, and extended release naltrexone and link high-risk, not otherwise engaged, patie...
Article
Background Within the United States, there is a shortage of opioid treatment programs (OTPs), facilities which dispense methadone for opioid use disorder. It is unknown how pharmacy-based methadone dispensing, as available internationally, could affect methadone access. We aimed to compare drive times to the nearest OTP with drive times to the near...
Article
Background: Injection drug use-associated infective endocarditis (IDU-IE) is rising and valve surgery is frequently indicated. The effect of initiating public outcomes reporting for aortic valve surgery on rates of valve surgery and in-hospital mortality for endocarditis is not known. Methods: For an interrupted time series analysis, we used dat...
Article
Infective endocarditis (IE) is a systemic disease with many potential neurologic manifestations including ischemic and hemorrhagic strokes, cerebral microbleeding, infectious intracranial aneurysms, meningitis, brain abscesses, and encephalopathy. The majority of left-sided (heart) IE patients have brain lesions that may alter management decisions,...
Article
Full-text available
Opioid overdose deaths in the U.S. rose dramatically after 1999, but also exhibited substantial geographic variation. This has largely been explained by differential availability of prescription and non-prescription opioids, including heroin and fentanyl. Recent studies explore the underlying role of socioeconomic factors, but overlook the influenc...
Article
In the midst of an opioid epidemic, mortality related to opioid overdose continues to rise in the US. Medications to treat opioid use disorder, including methadone and buprenorphine, are highly effective in reducing the morbidity and mortality related to illicit opioid use. Despite the efficacy of these life-saving medications, the majority of peop...

Citations

... 6,7 Research also suggests that labor unions play an important role in improving workplace safety, with potential benefits for nursing home workers and residents. [8][9][10][11] Unionized workers in essential industries have better access to paid sick leave, SARS-CoV-2 testing, and personal protective equipment, and they may also be less likely to work multiple jobs and to live in settings associated with SARS-CoV-2 transmission. 7,12,13 Such factors may decrease COVID-19 infection rates among nursing home workers, reduce the spread of COVID-19 between workers and nurs-ing home residents, and thereby lower resident COVID-19 mortality rates. ...
... Medications such as methadone and buprenorphine reduce risk of overdose and improve functional outcomes for people with opioid use disorder (Volkow et al., 2014); however, the COVID-19 pandemic may have disrupted access to these medications. For example, from May to June of 2020, one study of a sample of methadone clinics in the United States and Canada found more than 1 in 10 were not taking any new patients, with greater barriers to access in the United States than Canada (Joudrey et al., 2021). Another survey of drug users from Baltimore conducted between April and June of 2020 found fewer than half of respondents on methadone treatment had a four-week supply of methadone available (Genberg et al., 2021). ...
... In addition, the literature suggests that the prevention of sepsis plays an important role in the care of all types of opioid users. In a US cohort based in 373 hospitals, almost half of the mortality outcomes were associated with sepsis diagnosis (50). The proportion of sepsis hospitalizations related to opioid use in this cohort increased by 77% between 2009 and 2015. ...
... BMC also serves as a national hub for substance use disorder (SUD) resources. BMC's comprehensive substance use disorder management includes an office-based addiction treatment program, a low-barrier SUD urgent care clinic, integrated addiction and prenatal care programs, a multifaceted program for adolescents and young adults who use substances, a community-based harm reduction and street outreach program, and an inpatient addiction consult service [22]. ...
... As the decreasing use of punitive detention is the goal of the 2019 revision to the Juvenile Delinquency Act, it brings the long-standing lack of family programmes in schools, juvenile courts, and communities to the surface. As developing a harm reduction approach include minimizing the negative effects not only for adolescents but also for their families, this study aims to explore Taiwanese practitioners' perspectives on family-based programmes for drug-using adolescents [14]. ...
... People who use substances also experience higher rates of mental health issues [9] which were compounded by heightened feelings of isolation and hopelessness as well as restrictions on reaching mental health services and personal support workers during the COVID-19 pandemic [10]. Some healthcare and social services transitioned their appointments to virtual models in order to adhere to physical distancing, but this created barriers for individuals who do not have regular access to a phone or electronic device [11]. Additionally, lockdown measures altered the social context in which people were able to use substances with more individuals finding themselves socially isolated and consequently using substances alone [6,7]. ...
... Prior analyses of potential benefits of OAT after hospitalization with injecting-related infections have been limited by small sample sizes with wide confidence intervals (CIs) [38,39]. Three administrative linkage cohort studies (all from US insurance claims data) have assessed associations between use of OAT and outcomes after hospitalization with injecting-related bacterial or fungal infections [39][40][41]. One study identified a reduced risk of death after hospitalizations with injecting-related endocarditis, but did not assess rehospitalizations [40]. ...
... As of 31 July 2021, 2324 SARS-CoV-2 cases were reported from 45 LTCFs in eight of nine provinces in South Africa. Psychiatric facilities reported the most cases (918, 39.5%), followed by old age homes (420, 18 (Fig. 1 a). ...
... Chief among the disadvantaged and marginalized groups impacted by COVID-19 have been Americans experiencing homelessness. Individuals who experience homelessness have contracted COVID-19 at disproportionately higher rates [27]. For example, an early study in Boston found that 10% of the city's estimated homeless population had tested positive for COVID-19 with a 36% positivity rate within a 4-week period [2,3]. ...
... Introduction Injection drug use-associated bacterial and fungal infections (e.g., skin and soft-tissue infections, endocarditis, osteomyelitis, septic arthritis, and epidural abscess) are associated with significant morbidity and mortality among people who inject drugs (PWID) and are costly for healthcare systems [1][2][3][4][5][6]. The incidence of hospitalization for injecting-related infections is increasing in many parts of the world, including Australia [7], Canada [2,8,9], South Africa [10], the United Kingdom [11], the United States of America [12][13][14][15][16], and India [17]. ...