Preventing and effectively treating alcohol and drug addiction is a benefit to patients and the broader community.
Drug and alcohol addiction, addiction medicine, clinical trials, medical education, addiction and drug policy, harm reduction
My research focus is on addiction treatment and related policies. I am responsible for a large addiction medicine training program aiming to train the next generation of addiction physicians and clinician scientists. We conduct clinical trials of new addiction pharmacotherapies and behavioral interventions. Collectively, we are trying to bring the disease of addiction into the healthcare system and provide evidence-based solutions to a disease that has traditionally faced huge barriers due to stigma and an ineffective response.
- Informing HIV treatment strategies: I have made several contributions to the development of HIV treatment strategies. In a first author paper that was fast-tracked for publication in the Lancet to coincide with the XIII International AIDS conference in Durban, South Africa, I described a statistical model demonstrating the population impact of low-level use of HIV treatments on preventing mother-to-child transmission of HIV in South Africa (Wood E et al., Extent to which low-level use of antiretroviral treatment could curb the AIDS epidemic in sub-Saharan Africa. Lancet, 2000; 355: 2095-2100 [Fast Track]). This publication led several pharmaceutical companies to offer free antiretrovirals to prevent mother-to-child transmission of HIV throughout Africa. I have also published high impact papers demonstrating the role of highly active antiretroviral therapy adherence in contributing to the survival of HIV-infected patients (e.g., Wood E et al., Effect of medication adherence on survival of HIV-infected adults who start highly active antiretroviral therapy when the CD4+ cell count is 0.200 to 0.350 x 109 cells/L. Annals of Internal Medicine, 2003; 139(10): 810-816). My overall body of work in this area resulted in an invited review paper from Lancet Infectious Diseases that was published to coincide with the 2005 International Conference on HIV Pathogenesis and Treatment (Wood E et al., When to initiate antiretroviral therapy in HIV-1-infected adults: a review for clinicians and patients. Lancet Infectious Diseases, 2005; 5(7): 407-414). Together these studies had a significant impact on the clinical care of HIV-infected patients locally, as they informed the province of British Columbia’s HIV Therapeutic Guidelines, and internationally, as they were noted in the various international HIV treatment guidelines.
- Investigating & addressing HIV infection & other harms among injection drug users: In 2003, I successfully obtained a five-year operating grant from the Canadian Institutes of Health Research (CIHR) to support an ongoing prospective cohort study of injection drug users, known as the Vancouver Injection Drug Users Study (VIDUS). In 2004, I also obtained a five-year operating grant from the US National Institutes of Health (NIH) to expand this work. Together, this provided several million dollars in competitive peer-reviewed funding that enabled the creation of an infrastructure that has made major international research and educational contributions (please see the International Leadership section). The VIDUS study, along with the related work described below, had a high level of involvement with local and national policy-makers, as well as ongoing community engagement and consultation. The operation and management of the VIDUS study has involved oversight of a large research infrastructure involving more than 1,000 injection drug users who are followed every six months at a storefront research office in Vancouver’s Downtown Eastside. During each visit, participants answer a detailed study instrument and provide a blood sample for HIV and hepatitis C testing. Since 2003, the VIDUS study has provided a platform for the training of dozens of medical and graduate students and produced several hundred peer-reviewed publications. I am the first or senior author on the majority of these papers, several of which were published in very high impact publications, including the American Journal of Public Health, Journal of the American Medical Association, Canadian Medical Association Journal and other top medical and public health journals. Since Aboriginal health is among my clinical and research interests, I will describe one of these papers (Wood E et al., Burden of HIV infection among Aboriginal injection drug users in Vancouver, British Columbia. American Journal of Public Health, 2008; 98(3): 515-519). This paper demonstrated elevated rates of HIV infection among Aboriginal injection drug users in Vancouver’s Downtown Eastside, and I led an effort to reach out to Aboriginal community-based organizations in advance of the paper’s publication to raise awareness about this issue. This paper, which was published on February 1, 2007, resulted in an emergency debate in the Canadian House of Commons on February 7, 2007, bringing national attention to the health crisis among this population. In a separate paper, published in the Canadian Medical Association Journal, I reported on how elevated rates of HIV infection among Aboriginal persons may be due, in part, to lower access to addiction treatment (Wood E et al., Rate of methadone use among Aboriginal opioid injection drug users. Canadian Medical Association Journal, 2007; 177(1): 37-40). These papers have received widespread media attention and have been used for ongoing political advocacy by the Aboriginal community. In June 2011, I was invited to meetings with members of Canada’s Assembly of First Nations for the purpose of expanding these collaborations.
- Evaluating innovative public health programs to address the harms of injection drug use: Through my research with the VIDUS study, I have been involved in evaluating a range of HIV prevention and other programs. Among the most well recognized contribution is my work evaluating Vancouver’s supervised injecting facility (SIF), known as Insite. Recent review papers have suggested that more than 65 SIFs exist internationally, and for many years there were debates about the potential value of an SIF in Vancouver—beginning soon after the Vancouver Health Board declared a public health emergency in Vancouver’s Downtown Eastside in the late 1990s. This debate was escalated in 2002, when I conducted a feasibility study for an SIF in Vancouver that was subsequently fast-tracked for publication (Wood E et al., Potential public health and community impacts of safer injecting facilities: evidence from a cohort of injecting drug users. Journal of Acquired Immune Deficiency Syndromes, 2003; 32: 2-8 [Fast Track]). This paper was the first to demonstrate the public health rationale and potential impact of SIFs for injecting drug users in Canada. The scientific support for these interventions provided by this research was cited by policy-makers as critical for the opening of Vancouver’s SIF, which opened in September 2003. As a result of my track record of research with the VIDUS study, I was awarded (as Principal Investigator) five-year funding from Health Canada to evaluate the Vancouver SIF after it opened. This research, known as the Scientific Evaluation of Supervised Injecting (SEOSI), involved the establishment and supervision of a prospective cohort study of more than 1,000 randomly recruited SIF users. The result has been first or last author manuscripts in the Canadian Medical Association Journal, British Medical Journal, Lancet and the New England Journal of Medicine. This research was summarized in a 2006 review paper (Wood E et al., Summary of findings from the evaluation of a pilot medically supervised safer injecting facility. Canadian Medical Association Journal, 2006; 175 (11): 1331-1337), which has been cited over 40 times. These papers illustrate the impact that Insite has had on SIF users: fewer overdose deaths, reduced HIV risk behaviour, less public disorder, and improved uptake of addiction treatment.
For a full list of publications, please view PubMed.
- DeBeck K, Cheng T, Montaner J, Beyrer C, Elliott R, Sherman S, Wood E, Baral S. HIV and the Criminalization of Drug Use among People Who Inject Drugs: A Systematic Review. Lancet HIV. (Accepted).
- Mah A, Hull M, DeBeck K, Milloy M-J, Dobrer S, Nosova E, Wood E, Kerr T, Hayashi K. Knowledge of Hepatitis C and Treatment Willingness Amongst People who Inject Drugs in an Era of Direct Acting Antivirals. International Journal of Drug Policy. 24 February 2017.
- Klimas J, Fernandes E, deBeck K, Hayashi K, Milloy M-J, Kerr T, Cullen, Wood E. Preliminary Results and Publication Impact of a Dedicated Addiction Clinician Scientist Research Fellowship. Journal of Addiction Medicine. 2017. Jan;11(1):80-81. doi: 10.1097/ADM.0000000000000270.
- Klimas, Jan, Evan Wood, and Daniel Werb. “How can we investigate the role of topiramate in the treatment of cocaine use disorder more thoroughly?.” Addiction1 (2017): 182-183.
- Krebs E, Wang L, Olding M, DeBeck K, Hayashi K, Milloy MJ, Wood E, Nosyk B, Richardson L. Increased drug use and the timing of social assistance receipt among people who use illicit drugs. Soc Sci Med. 2016 Dec;171:94-102. doi: 10.1016/j.socscimed.2016.11.006. PubMed PMID: 27842998.
- Lake S, Kerr T, Buxton J, Guillemi S, Parashar S, Montaner J, Wood E, Milloy MJ. Prescription Opioid Injection Among HIV-Positive People Who Inject Drugs in a Canadian Setting. AIDS Behav. 2016 Dec;20(12):2941-2949. PubMed PMID: 27146887.
- Rieb LM, Norman WV, Martin RE, Berkowitz J, Wood E, McNeil R, Milloy MJ. Withdrawal-associated injury site pain (WISP): a descriptive case series of an opioid cessation phenomenon. Pain. 2016 Dec;157(12):2865-2874. PubMed PMID: 27598412.
- Loh J, Kennedy MC, Wood E, Kerr T, Marshall B, Parashar S, Montaner J, Milloy MJ. Longer duration of homelessness is associated with a lower likelihood of non-detectable plasma HIV-1 RNA viral load among people who use illicit drugs in a Canadian setting. AIDS Care. 2016 Nov;28(11):1448-54. doi: 10.1080/09540121.2016.1189498. PubMed PMID: 27248328.
- Fairbairn N, Hayashi K, Milloy MJ, Nolan S, Nguyen P, Wood E, Kerr T. Hazardous alcohol use associated with increased sexual risk behaviors among people who inject drugs. Alcohol Clin Exp Res. 2016 Nov;40(11):2394-2400. doi: 10.1111/acer.13216. PubMed PMID: 27638501.
- Hadland SE, Wood E, Levy S. How the paediatric workforce can address the opioid crisis. Lancet. 2016 Sep 24;388(10051):1260-1. doi: 10.1016/S0140-6736(16)31573-2. PubMed PMID: 27673455.
- Luchenski S, Ti L, Hayashi K, Dong H, Wood E, Kerr T. Protective factors associated with short-term cessation of injection drug use among a Canadian cohort of people who inject drugs. Drug Alcohol Rev. 2016 Sep;35(5):620-7. doi: 10.1111/dar.12364. PubMed PMID: 26661408.
- Heath AJ, Kerr T, Ti L, Kaplan K, Suwannawong P, Wood E, Hayashi K. Healthcare avoidance by people who inject drugs in Bangkok, Thailand. J Public Health (Oxf). 2016 Sep;38(3):e301-e308. PubMed PMID: 26491067.
- Escudero DJ, Marshall BD, Kerr T, Hayashi K, Feng C, Guillemi SA, Hogg RS, Montaner J, Wood E, Milloy MJ. No association between HIV status and risk of non-fatal overdose among people who inject drugs in Vancouver, Canada. Addict Behav. 2016 Sep;60:8-12. doi: 10.1016/j.addbeh.2016.03.029. PubMed PMID: 27082262.
- Hepburn K, Barker B, Nguyen P, Dong H, Wood E, Kerr T, DeBeck K. Initiation of drug dealing among a prospective cohort of street-involved youth. Am J Drug Alcohol Abuse. 2016 Sep;42(5):507-512. PubMed PMID: 27315200.
- Hayashi K, Wood E, Kerr T, Dong H, Nguyen P, Puskas CM, Guillemi S, Montaner JS, Milloy MJ. Factors associated with optimal pharmacy refill adherence for antiretroviral medications and plasma HIV RNA non-detectability among HIV-positive crack cocaine users: a prospective cohort study. BMC Infect Dis. 2016 Aug 27;16(1):455. doi: 10.1186/s12879-016-1749-y. PubMed PMID: 27568002.
- Krebs E, Kerr T, Wood E, Nosyk B. Characterizing Long-Term Health Related Quality of Life Trajectories of Individuals With Opioid Use Disorder. J Subst Abuse Treat. 2016 Aug;67:30-7. doi: 10.1016/j.jsat.2016.05.001. PubMed PMID: 27296659.
- DeBeck K, Wood E, Dong H, Dobrer S, Hayashi K, Montaner J, Kerr T. Non-medical prescription opioid use predicts injection initiation among street-involved youth. Int J Drug Policy. 2016 Aug;34:96-100. doi: 10.1016/j.drugpo.2016.05.009. PubMed PMID: 27450321.
- Singh M, Keer D, Klimas J, Wood E, Werb D. Topiramate for cocaine dependence: a systematic review and meta-analysis of randomized controlled trials. Addiction. 2016 Aug;111(8):1337-46. doi: 10.1111/add.13328. Review. PubMed PMID: 26826006.
- Young SV, Wood E, Dong H, Kerr T, Hayashi K. Daily alcohol use as an independent risk factor for HIV seroconversion among people who inject drugs. Addiction. 2016 Aug;111(8):1360-5. doi: 10.1111/add.13256. PubMed PMID: 26639363.
- Lyons T, Shannon K, Richardson L, Simo A, Wood E, Kerr T. Women Who Use Drugs and Have Sex with Women in a Canadian Setting: Barriers to Treatment Enrollment and Exposure to Violence and Homelessness. Arch Sex Behav. 2016 Aug;45(6):1403-10. doi: 10.1007/s10508-015-0508-2. PubMed PMID: 26014823.
- British Columbia Persons With AIDS Society AccolAIDS award (Science, Research and Technology category), 2004.
- Peter Lougheed Award (number 1 ranked CIHR New Investigator in 2003 competition), 2004 (declined).
- Lydia Sikora Memorial Award for Excellence in Health Research, 2005-2006.
- Ron Ghitter Award in Human Rights, 2005-2006.
- Canadian Medical Association Award for Young Leaders, 2007.
- American College of Physicians Award 2008.
- British Medical Journal (BMJ) Awards – International Junior Doctor of the Year Award, 2010.
- Canadian Society for Clinical Investigation Research Prize, 2010.
- CIHR-Institute of Population and Public Health and Canadian Public Health Association – Population and Public Health Research Milestones, 2010.
- National Institute on drug Abuse (NIDA) International Program, 2011.
- Distinguished International Scientist Collaboration Award (DISCA), 2011.
- Business in Vancouver’s Top 40 Under 40, 2012.
- The Queen’s Diamond Jubilee Award, 2013.
- Providence Health Care Research and Mission Award, 2013.
- UBC Martin M. Hoffman Award for Excellence in Research, 2013.
- UBC President’s Award for Public Education through Media, 2013.
- University of Victoria Distinguished Alumni Award, 2014.
- UBC Faculty of Medicine Distinguished Achievement Award – Service to the University and Community, 2014.
|US National Institutes of Health (NIH)||HIV Researchers Mentoring the Next Generation of Addiction Clinician Scientists|
|CIHR Operating Grant||Sexual Health, HAART and HIV Care Amongst Women Living with HIV: A Longitudinal Investigation of the Impacts of Structural, Social, and Policy Environments|
|US National Institutes of Health (NIH)||Vancouver drug users study: evaluating the natural history of injection drug use|
|CIHR, Canadian Research Initiative in Substance Misuse||The British Columbia Addiction Network|
|CIHR Operating Grant||llicit drug use, income and poverty: analyses to inform health and social policy|
|MAC AIDS Fund||Advancing addiction care and harm reduction policy to prevent and treat HIV/AIDS among PWUD|
|CIHR Foundation Scheme||Positioning Canada as an international leader in addiction research and education to improve care and reduce costs to the health care system|
|CIHR, Canadian Research Initiative in Substance Misuse||Initiation of opioid agonist therapy with daily witnessed methadone or flexible take-home dosing of buprenorphine/naloxone for prescription opioid users: A pragmatic patient-centred randomized controlled trial|
|CIHR Foundation Grant||Improving healthcare and health outcomes among people who use drugs in Canada|
Training the Next Generation of Addiction Clinical Physicians:
Through my research and medical practice, I became aware of the lack of physicians trained in treating substance abuse. In 2012, I founded the St. Paul’s Hospital Goldcorp Addiction Medicine Fellowship, which was made possible by a 3 million dollar donation to the St. Paul’s Hospital Foundation / the UBC Division of AIDS by Goldcorp Inc. The program is a multidisciplinary Addiction Medicine Fellowship that strives for excellence in clinical training, scholarship, research and advocacy. The program accepts 6 medical trainees per year who can come from any medical background, typically Psychiatry, Internal Medicine, and Family Medicine. In addition, the program accepts one position for Nursing and one position for Social Work. The program is accredited by the American Board of Addiction Medicine and includes specialty training in in-patient and out-patient addiction management as well as related concurrent disorders training.
Training the Next Generation of Addiction Medicine Researchers:
The enormous burden of disease related to drug and alcohol addiction remains a global public health challenge. In particular, the lack of clinician researchers in addiction medicine creates major barriers to developing and implementing evidence-based prevention and treatment modalities for substance use disorders. In response, I founded the Canada Addiction Medicine Research Fellowship, which has been created for addiction medicine physicians to develop the skills required for a career in addiction research. The fellowship is a US National Institute on Drug Abuse (NIDA) funded research training fellowship in partnership with St. Paul’s Hospital, the University of British Columbia, and the Urban Health Research Initiative of the BC Centre for Excellence in HIV/AIDS.