Tsai Researches Opioid Misuse Risk

November 28, 2018 by Michelle Bookless

Matt Tsai, UVM Medical Student, Class of 2021

Last spring, as the mirage of a few medical school-free weeks danced on the horizon, Matt Tsai '21 began to consider his summer vacation options. "Aside from sun tanning and grilling burgers, I wanted to spend my summer developing some skills in medical research and data analysis in order to prepare myself for the upcoming years of training centered on evidence-based medicine," he said. Much like one plans for a camping trip or beach vacation, Tsai started making lists. But, instead of flip flops and sunglasses, his lists contained research topics that interest him, including opioid addiction and pain management.  

Next, Tsai reached out to Associate Professor of Medicine and Director of Medical Student Research Renee Stapleton, M.D., Ph.D. She connected him with Professor of Medicine Charles MacLean, M.D., and, as Tsai says, "The rest is history."

Throughout the summer and into the fall, Tsai and MacLean analyzed electronic health record data from University of Vermont Medical Center (UVMMC) patients, paying particular attention to the Current Opioid Misuse Measure (COMM). The COMM is an annual brief self-report survey that is administered by UVMMC primary care sites to assess a patient's risk for developing opioid misuse. Although UVMMC recently standardized the survey for all of its patients on chronic pain therapy, the collected data was still largely unexplored. 

Given the glut of data and the lack of its analysis, MacLean and Tsai set out to "characterize the use of the COMM and distribution of COMM responses in the primary care population, identify clinical or sociodemographic factors that might predict a positive COMM score (at least a 9 on a scale of 0 to 68), and to assess whether patients with positive scores are more likely to experience increased opioid surveillance.

Tsai and MacLean found the results compelling and cause for further research. "For one, our data suggests patients taking benzodiazepines (or a similar GABA agonist) concurrently with a prescription opioid and patients with severe mental illnesses are more likely to have a positive COMM score," Tsai said. "Furthermore, both of these traits are fairly prevalent in our population."

Tsai and MacLean are planning on submitting their research findings to a national research conference and hope to present their study to researchers there in early May. In preparation, Tsai presented their initial findings to a group of UVM researchers in early October and received positive feedback.  

While the two prepare to submit their research, Tsai says that although he plans to pursue future projects with MacLean, "my ambition may have to wait until I am further along this busy season of boards preparation and third-year clinical rotations." Stay tuned for further updates on MacLean and Tsai's research at http://med.uvm.edu and in future editions of this Larner College of Medicine Student Newsletter.