Opioid Research Program

The vision of the University of Colorado Department of Emergency Medicine Opioid Research Program is to perform cutting edge research and programmatic implementation in the high priority and high impact areas of opioid use for pain and access to treatment for emergency department patients with an opioid use disorder (OUD).

We strive to be leaders in the field opioid research by examining how interventions for healthcare providers and patients can help advance clinical care and guide policymakers/administrators on systems-level reforms with the potential to achieve the triple aim of advancing population health, reducing health care costs, and improving the quality of care.

To date, we have developed and completed a variety of projects addressing the opioid crisis including: PDMP–EHR integration, clinical decision support to improve prescription opioid safety, improved decision-making for opioid prescribing, quantifying long-term consequences of opioid prescribing, evaluating the impact of legislative changes, and built a community collaboration to initiate treatment for opioid use disorder in the ED with a warm hand-off to community care.

All of our projects have the shared vision of providing accurate information and interventions that are: usable in a variety of settings, technologically feasible within provider workflows and sustainable beyond project funding. To accomplish these projects we have developed successful collaborations with multiple key stakeholders including: Colorado Department of Regulatory Agencies, the Bureau of Justice Assistance, Colorado Department of Public Health and Environment, Colorado Office of Behavioral Health, UCHealth Informatics, the Department of Defense, and the Office of the National Coordinator for Health Information Technology, amongst others.

Our Team

Picture of Jason HoppeJason Hoppe, MD is a clinician-researcher, medical toxicologist and Associate Professor in the Department of Emergency Medicine at the University of Colorado School of Medicine. He is also a consultant in medical toxicology at Denver Health, Children’s Hospital Colorado and the Rocky Mountain Poison and Drug Center. His clinical work, research, and public health efforts are aimed at addressing the complicated decision-making process regarding the opioid prescribing and effectively initiating treatment for patients with an opioid use disorder. He recently developed and piloted a program to initiate buprenorphine treatment in the Emergency Department with a warm hand-off to community partners. He is a national expert in prescription opioid safety, prescription drug monitoring programs (PDMP), and provider decision-making. Dr. Hoppe is a founding member of the Colorado Consortium for Prescription Drug Abuse Prevention and has assisted with multiple public health efforts, education programs and successful legislative changes in Colorado regarding PDMP access, opioid prescribing and medications for opioid use disorder.

Picture of Kennon HeardKennon Heard, MD is Section Chief of Medical Toxicology at the University of Colorado School of Medicine where he is a Professor of Emergency Medicine. He is also an attending physician for the Rocky Mountain Posion and Drug Center. He works and teaches at the University of Colorado Hospital Emergency Department. His research interests include improving opioid use, medical conditions associated with cannabis use, acetaminophen poisoning and research design. He has authored over 100 papers and 20 book chapters in various areas of Emergency Medicine and Toxicology. 

person-placeholderCheryl Napier, MS, MPA joined UCDenver in the spring of 2019 as Project Manager for Dr Jason Hoppe after several years doing nursing research at an overseas military facility. Prior to that adventure, she has a long history in research, starting with benchtop basic research. She has degrees from the Pennsylvania State University, California Institute of Technology and the University of Oklahoma.  She worked for a number of years as a Project Manager and Outsourcing Manager in the oncology drug development world, before switching to clinical research. 
seanMichaelConsulting Subject Matter Expert Sean Michael, MD (Informatics) is currently the Emergency Department Medical Director at the University of Colorado Hospital and the Fellowship Director of the Emergency Medicine Administration, Operations, and Quality Fellowship at the University of Colorado School of Medicine. Raised in Denver, CO, he attended medical school at the University of Colorado and completed emergency medicine residency at Detroit Receiving Hospital. He attended fellowship training in administration, operations, and leadership at the University of Massachusetts, where he also earned an MBA. His research interests focus on ED and hospital crowding, patient flow, and provider behavior change, particularly around high-variation resource utilization and opioid prescribing. He is also board-certified in Clinical Informatics and holds a number of Epic builder and analyst certifications that support his work on clinical decision support systems, data analytics, and workflow design.

Picture of Matt ZuckermanMatt Zuckerman, MD is an award-winning emergency physician, medical toxicologist and educator. He is the creator and host of the ToxNow podcast, which has been cited as a toxicology resource by iTunes, BMJ, Annals of Emergency Medicine, and the American Academy of Clinical Toxicology. He is passionate about FOAMed, social media, and spreading the gospel of tox. He is an Assistant Professor at the University of Colorado Anschutz Medical Campus and currently works on projects supporting physician use of social media and ED medications for opioid use disorder. He has experience developing curricular materials for learners from undergraduate medical education to continuing medical education.

 

Current Grant Support

“A Health System Wide Evaluation of Mandated Use and Clinical Decision Support Tools to Improve PDMP Utilization and Patient Outcomes” Bureau of Justice Assistance. Subcontract with Colorado Department of Regulatory Agencies. Action Researcher:  2020-2022

“Advancing PDMP and EHR integration Project: Integration Demonstration and Clinical Decision Support Proof of Concept (POC) test site” CDC/ONC. Site lead. 2019-2021

“EMBED: Pragmatic trial of user-centered clinical decision support to implement Emergency department-initiated BuprenorphinEfor opioid use Disorder. NIH/NIDA UG3/UH3. PI Edward Melnick Yale. Site PI. $315K. 2019-2021

“Development and Piloting of a Decision Tool for Emergency Department Opioid Initiation to Decrease Future Substance Abuse and Chronic use”  Department of Defense: JPC 5 Substance Abuse Research Grant. Principle investigator. 2018-2021

“Assess the Implementation of Colorado Senate Bill 18-0252 on Prescriber Behaviors” Comprehensive Opioid Abuse Program: Site Based Program Category 6 via subcontract with Colorado Department of Public Health and Environment. Action Researcher. 2018-21

Past Grant Support

“Colorado Opioid State Targeted Response: Expanding Access to Opioid Use Disorder Treatment Through Emergency Departments” SAMHSA State Targeted Response (STR) grant via Colorado Office of Behavioral Health. Principle investigator. 2018-2019

“Pilot expansion of EHR-PDMP Integration” CDC via subcontract with Colorado Department of Public Health and Environment. Principle Investigator. 2017-19

“The risk of long-term prescription opioid use and aberrant prescription behavior following an emergency department opioid prescription for acute back pain”  Department of Defense; JPC 5 Substance Abuse Research Grant. Co-PI.  2016-18

“A Stepwise Evaluation of Prescription Drug Monitoring Program Electronic health Record Integration, Decision Support and Mandated use.” Harold Rogers Prescription Drug Monitoring Program: PDMP Practitioner and Research Partnership Grant. Bureau of Justice Assistance. Principal Investigator.  2015-18

Ryan White HIV/AIDS Treatment Extension Act Part A: early intervention services grant. US Department of Health and Human Services. Co-investigator. 5% cFTE. 2010-2015. 

“Prescription Opioid Safety in Emergency Departments.” University of Colorado Department of Emergency Medicine seed grant. Principal investigator. $3K. 2014

“The Use of Prescription Drug Monitoring Programs and Geographic Information Systems to Identify Communities at Risk of Prescription Opioid Overdose Fatalities.” Emergency Medicine Foundation (EMF) Health Policy Research Grant. Principal Investigator. $50K. 2013

“Long-term Opioid use after Discharge from the Emergency Department.” University of Colorado Department of Emergency Medicine seed grant. Principal investigator. $5K. 2013

“Reducing Central Line-Associated Bloodstream Infections and Procedure Related Complications Through Simulation.” University of Colorado Department of Emergency Medicine Education Grant. Co-investigator. $7,147. 2012

“The Efficacy and Safety of Epic Medication Alerts.” University of Colorado Hospital Clinical Efficacy and Patient Safety Grant. Co-Investigator. $20,000. 2012

Peer-reviewed Journals 

Kelly T, Hoppe JA, et al. A Novel Social Work Approach to Emergency Department Buprenorphine Induction and Warm Hand-off to Community Providers. American J Emerg Med. 2020. Epub ahead of print. PMID: 31959523

Betz ME, Hyde H, DiGuiseppi C, Platts-Mills TF, Hoppe J, et al. Self-reported Opioid Use and Driving Outcomes among Older Adults:  Findings from the AAA LongROAD Study. J Am Board Fam Med. Accepted for publication.

Heard K, Bebarta VS, Hoppe JA, Monte AA. Does administration of haloperidol or ketorolac decrease opioid administration for abdominal pain patient? A retrospective study. Am J Emeg Med. 2019. Epub. PMID: 31138518

Weiner SG, Hoppe JA, Finkelman MD. Techniques to Shorten a Screening Tool for Emergency Department Patients. West J Emerg Med. 2019 Aug 20;20(5):804-809. PMID: 31539338

Wagner S, Hoppe JA, Zuckerman M, Schwarz K, McLaughlin J. Efficacy and safety of topical capsaicin for cannabinoid hyperemesis syndrome in the emergency department. Clin Tox. 2019. 2019 Sep 4:1-5. PMID: 31482758  

Kim,H, Hoppe JA, Emergency Department Provider Perspectives on Benzodiazepine-Opioid Co-Prescribing: A Qualitative Study. Academic Emerg Med.2018;25(1):15-24. PMID: 28791786

Wang GS, Hoppe JA, Brou L, Heard K. Medication Organizers (Pill Minders) Increase the Risk for Unintentional Pediatric Ingestions. Clin Toxicol (Phila). 2017;55(8):897-901. PMID: 28471310

Hoppe JA, McStay C, SunB, Capp R. Emergency Department Attending Physician Variation in Opioid Prescribing in Low Acuity Back Pain. West J Emerg Med. 2017;18(6): 135–1142. PMID: 29085548

Wang GS, Roosevelt G, Fagan K, Hoppe J. Pediatric Emergency Physician Knowledge and Utilization of Prescription Drug Monitoring Program. Clin Pediatr (Phila). 2017 Jan; 56(1):80-82. PMID: 26976807

Pomerleau AC, Nelson LS, Hoppe JA, Salzman M, Weiss PS, Perrone J. The Impact of Prescription Drug Monitoring Programs and Prescribing Guidelines on Emergency Department Opioid Prescribing: A Multi-Center Survey. Pain Med. 2017;18(5):889-897.PMID: 26995800

Burton JH, Hoppe JA, Echternach JM, Rodgers JM, Donato M. Quality Improvement Initiative to Decrease Variability of Emergency Physician Opioid Analgesic Prescribing. West J Emerg Med. 2016 May;17(3):258-63. PMID: 27330656

Pomerleau AC, Perrone J, Hoppe JA, Salzman M, Weiss PS, Nelson LS. Impact of Prior Therapeutic Opioid Use by Emergency Department Providers on Opioid Prescribing Decisions. West J Emerg Med. 2016 Nov;17(6):791-797. PMID: 27833690

Genco EK, Forster JE, Flaten H, Heard K, Goss F, Hoppe JA, Monte AA. Clinically Inconsequential Alerts: The Characteristics of Opioid Drug Alerts and Their Utility in Preventing Adverse Drug Events in the Emergency Department. Ann Emerg Med. 2016;67(2):240-48 

Frank JW, Levy C, Calcaterra SL, Hoppe JA, Binswanger IA. Naloxone Administration in US Emergency Departments, 2000-2011. J Med Toxicol. 2016 Jun;12(2):148-56. PMID: 26621354

Kim HS, Heard KJ, Heard S, Hoppe JA. Opioid prescription fill rates after emergency department discharge. Am J Health Syst Pharm. 2016 Jun 15;73(12):902-7. PMID: 27261241

Poon SJ, Nelson LS, Hoppe JA, Perrone J, Sande MK, Yealy DM, Beeson MS, Todd KH, Motov SM, Weiner SG. Consensus-Based Recommendations for an Emergency Medicine Pain Management Curriculum. J Emerg Med. 2016 Aug;51(2):147-54. PubMed PMID: 27369855

Hoppe JA, Kim H, Keard K. Association of emergency department opioid initiation with recurrent opioid use. Ann Emerg Med. 2015;65:493-499

Hoppe JA, Nelson L, Perrone JM, Weiner SG. Opioid prescribing in a Cross Section of US Emergency Departments. Ann Emerg Med. 2015;66:253-259

Monte AA, Heard KJ, Hoppe JA, et al. The accuracy of self-reported drug ingestion histories in emergency department patients. J Clin Pharmacol. 2015 Jan;55(1):33-8 

Monte AA, Bronstein AC, Heard KJ, Hoppe JA, et al. An outbreak of exposure to a novel synthetic cannabinoid. NEJM. 2014;370:389-90

Hoppe JA, Houghland J, Yaron M, Heard K. Recent Opioid Prescription History of Emergency Department Patients Prescribed Opioids. West J Emerg Med. 2013;14:247-252 

Alhelail MA, Hoppe JA, Rhyee SR, Heard KJ. Clinical Course of Repeated Supratherapeutic Ingestion of Acetaminophen. Clin Tox. 2011; 49:108-112

T Rhyee SH, Hoppe JA, Heard K. Multiple Aminotransferase Peaks Following Acute Acetaminophen Overdose. Pharmacotherapy 2010;30(10):1084-1088

Bebarta VS, Kao L, Froberg B, Hoppe JA, Et al. A Multicenter Comparison of the Safety of Oral Versus Intravenous Acetylcysteine for Treatment of Acetaminophen Overdose. Clin Toxicol. 2010; 48: 424-30

an HH, Hoppe JA, Heard K. A systematic review of the cardiovascular effects from overdose of atypical antipsychotic medications. Am J Emerg Med. 2009; 27(5):607-616.

Dart RC, Borron SW, Caravati EM, Hoppe JA, et al. Expert consensus guidelines for stocking of antidotes in hospitals that provide emergency care. Ann Emerg Med. 2009; 54(3):386-394

Book Chapters

Hoppe JA, Monte AA. Anticholinergics. Rosen’s Emergency Medicine 2015, 2020. 

Holst J, Hoppe JA. Acid Base status in Markovchick: Emergency Medicine Secrets, 6e. Oct 2015.

Hoppe JA. Vision Loss. Chapter: Rosen and Barkin’s 5 minute Emergency Medicine Consult 2010-2012 revision

Buchanan J, Hoppe JA, Mendoza C, Rhyee SH. Toxicology. In Blok, B.K. et al eds. First Aid for the Emergency Medicine Boards. New York, NY: McGraw-Hill, 2008, updated 2011.

Hoppe JA. Phencyclidine. Chapter: Up to Date 2008-2020. Uptodate.com

Hoppe JA. Heat Exhaustion and Heat Stroke. Chapter: Emedicine 2006. Emedicine.com

Su M, Hoppe JA. Caustic Ingestion Protocol. Long Island Poison Control Center. 2005

In the News



UC Research Shows Patients Avoiding the ED During the COVID Pandemic

Aug 3, 2020
Research by Dr. Ho/ppe’s lab shows dramatic decreases in ED use for most conditions as the COVID pandemic was accelerating, and concluded that public health officials should emphasize the importance of seeking care when it was needed.

Key Points
Question: How did emergency department visits and hospitalizations change as the coronavirus disease 2019 (COVID-19) pandemic intensified in the US?

Findings: In this cross-sectional study of 24 emergency departments in 5 health care systems in Colorado, Connecticut, Massachusetts, New York, and North Carolina, decreases in emergency department visits ranged from 41.5% in Colorado to 63.5% in New York, with the most rapid rates of decrease in visits occurring in early March 2020. Rates of hospital admissions from the ED were stable until new COVID-19 case rates began to increase locally, at which point relative increases in hospital admission rates ranged from 22.0% to 149.0%.

Graph showing decline in ED visits from January to April 2020

Meaning: The findings suggest that clinicians and public health officials should emphasize to patients the importance of continuing to visit the emergency department for serious symptoms, illnesses, and injuries that cannot be managed in other clinical settings.

See the full paper at jamanetwork.com >>>