In this month's Greater Intermountain Node (GIN) newsletter, we introduce 'Chalk Talk' where we speak with investigators, clinicians, researchers, and coordinators from our various studies. This month we speak with Michael Incze, MD who will be the clinical champion on the upcoming Healthy Living Study (CTN-0101) (formally known at the STOP Study).
The Greater Intermountain Node was founded in 2019 to expand the existing National Institute of Drug Abuse Clinical Trial Network (CTN) infrastructure by developing and testing innovative interventions for opioid use disorder, preventing overdose, expanding the settings for Network research, and bringing new research expertise to the Network. The GIN is housed within the Program for Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA) within the Division of Epidemiology within the Department of Internal Medicine within the University Of Utah School Of Medicine.
GIN: Hi Dr. Incze, can you tell us a little about yourself?
I’m a general internist and primary care doctor here at the U of U with clinical interests in addiction medicine, homelessness, chronic pain and social medicine. I came to Utah from UCSF in San Francisco. Most of my work here is clinical, but when I’m not directly caring for patients, I enjoy advocacy work, writing, medical education and research. Personally, I grew up moving between Miami, Wyoming, Washington State, Rhode Island, NYC and California. I did my undergraduate at the U of U and fell in love with the area. I’m thrilled to be back! In my spare time I enjoy cycling, backpacking, writing music and cooking. I’ve been vegan for about 20 years.
GIN: You will be the clinical champion on the upcoming Healthy Living Study (CTN-0101), which will test an intervention to reduce opioid use and overdose risk, and prevent progression to opioid use disorder, in adult primary care patients. Can you describe your role in this study?
My role will be to serve as a liaison and support person to our study sites as we integrate research personnel and protocols into the day-to-day clinic flow.
GIN: Why is this type of research important?
I think that this study is incredibly important because it is testing an intervention that aims to identify and address risky opioid use patterns before they develop into a full-blown use disorder. Risky prescription opioid use is far more prevalent than opioid use disorder, and it is clearly associated with increased risk for addiction and overdose, yet we know very little about how to address it. Most opioids are prescribed in primary care, so testing a practical intervention to reduce risky opioid use that can be easily replicated in the primary care setting has the potential to have a huge impact on patient health and safety.
GIN: What do you hope will be the positive impacts of the Healthy Living Study?
Supporting primary care physicians and patients in making safe decisions around prescription opioid use can have immense public health benefits. The question is: what is the best way to provide this support? The Healthy Living Study investigates a possible solution (integrated nurse care managers) that, if successful, could provide a practical and cost-effective template that primary clinics across the world can use to enhance care for patients using prescription opioids.
GIN: You have been vocal about your desire to incorporate more internal medicine doctors into opioid use disorder treatment and prevention. Can you tell us more about that?
Primary care is the sleeping giant in the fight against the opioid epidemic. No other specialty has the geographic reach and longitudinal care model that enable it to have such a large potential impact on public health, yet most primary care providers do not offer treatment for opioid use disorder because of perceived risk and/or inconvenience. Removing barriers and providing more resources to support primary care physicians (and hospitalists) in preventing and treating opioid addiction could impact thousands of lives. Advocating for national, state and institutional policy change is a part of the solution. So is serving as a mentor and resource for colleagues and trainees at one’s institution.
GIN: If you could only describe yourself in 3 words, what would they be?
Always humbly learning