Start Up
Between 2002 and 2006, PRISM commissioned ten systematic reviews and five de novo research grants exploring the influence of alcohol or drug consumption on such common chronic disorders as hypertension, diabetes, sleep disorders, breast cancer, chronic pain and bone disease. Review.

Conferences/Meetings
In June 2007, TRI hosted a one-day conference of experts to discuss evidence of the effects of alcohol on overall health. Featured presentations were by Dr. Kenneth Mukamal, Professor of Medicine at Harvard and Timothy Roehrs, Director of Research at the Sleep Disorders and Research Center of the Henry Ford Hospital. Meeting Notes.

In November 2007, a PRISM conference on medical management of patients in opioid therapy was co-hosted in Washington, D.C. by Dr. Barbara J. Turner, Professor of Medicine at the University of Pennsylvania, and Dr. Richard Denisco, Health Scientist Administrator at the Division of Epidemiology, Services and Preventions Research at the National Institute on Drug Abuse (NIDA). Two distinguished experts in the field of substance abuse and chronic pain management presented: Dr. Daniel Alford, Associate Professor of Medicine at Boston University School of Medicine and Dr. David Fiellin, Associate Professor of Medicine at Yale University. Meeting Notes.

Medical Societies
With core funding from the Robert Wood Johnson Foundation, three of the four medical societies have launched pilot projects geared to fundamental change in health care practice through integration of alcohol and drug use issues:

American College of Physicians (ACP): The ACP seeks to re-design practice guidelines through a project involving 20 primary care clinics in urban and rural settings. Through focus groups, surveys and chart reviews, the team will identify issues that could impede or facilitate guidelines fostering early detection and management of substance use or abuse in chronic care patients. The project is modeled after ACP’s “Bridging the Gaps” to improve diabetes management.

American Association of Family Physicians (AAFP): The AAFP is collecting patient surveys in its clinical network to assess whether physicians have addressed the impact of alcohol on heart disease or sleep disorders, and the extent of patient awareness of potential risks and benefits of alcohol consumption.

American Geriatric Society (AGS): The AGS is conducting a chronic pain management study in two large geriatrics clinics. Researchers will review electronic medical records (EMR) as well as interview patients and physicians to examine attitudes toward safe and effective use of opiates for chronic pain, ultimately defining practice guidelines to optimize opioid use while avoiding severe side effects and dependence. Use of opiate drugs to treat chronic pain in geriatric patients is on the rise due to the significant side effects of non-steroidals and aspirin.