Amer Raheemullah

All Publications

• 24-Hour Induction of Transdermal Buprenorphine to Buprenorphine Extended-Release. Journal of psychoactive drugs Azar, P., Li, V. W., Wong, J. S., Nikoo, M., Machado, J., Ignaszewski, M. J., Mathew, N., Raheemullah, A., Wakeman, S. E., Mullen, R., Krausz, R. M., Montaner, J. S., Maharaj, A. R. 2024: 1-5

  Abstract

  Buprenorphine is an effective treatment for opioid use disorder but can be slow when using a standard low-dose titration protocol to avoid precipitated withdrawal. This presents a substantial practical barrier in clinical practice. Recent low-dose induction strategies have attempted to simplify and shorten the process required for successful induction, including our own transdermal buprenorphine method, which achieves induction to sublingual buprenorphine/naloxone after 48 h. Here, we present two inpatients with active unregulated fentanyl use that were successfully initiated on buprenorphine extended-release with a novel 24-h transdermal buprenorphine protocol without precipitating withdrawal. This protocol may represent a substantial improvement in the practical feasibility of initiating buprenorphine for patients and providers, although further study is required to confirm efficacy and tolerability.

  View details for DOI 10.1080/02791072.2024.2430616

  View details for PubMedID 39560320

• Characterization of Peer Support Services for Substance Use Disorders in 11 US Emergency Departments in 2020: Findings From a Nida Clinical Trials Network Study Site Selection Process Moreland, A., Jennings, L., Lander, L., Lawdahl, T., McClure, E., McCauley, J., Haynes, L., Matheson, T., Jones, R., Robey, T., Kawasaki, S., Moschella, P., Raheemullah, A., Miller, S., Gregovich, G., Waltman, D., Brady, K., Barth, K. ELSEVIER IRELAND LTD. 2024

  View details for DOI 10.1016/j.drugalcdep.2023.110530

  View details for Web of Science ID 001280690400540

• Characterization of peer support services for substance use disorders in 11 US emergency departments in 2020: findings from a NIDA clinical trials network site selection process. Addiction science & clinical practice Jennings, L. K., Lander, L., Lawdahl, T., McClure, E. A., Moreland, A., McCauley, J. L., Haynes, L., Matheson, T., Jones, R., Robey, T. E., Kawasaki, S., Moschella, P., Raheemullah, A., Miller, S., Gregovich, G., Waltman, D., Brady, K. T., Barth, K. S. 2024; 19 (1): 26

  Abstract

  Emergency departments (ED) are incorporating Peer Support Specialists (PSSs) to help with patient care for substance use disorders (SUDs). Despite rapid growth in this area, little is published regarding workflow, expectations of the peer role, and core components of the PSS intervention. This study describes these elements in a national sample of ED-based peer support intervention programs.A survey was conducted to assess PSS site characteristics as part of site selection process for a National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN) evaluating PSS effectiveness, Surveys were distributed to clinical sites affiliated with the 16 CTN nodes. Surveys were completed by a representative(s) of the site and collected data on the PSS role in the ED including details regarding funding and certification, services rendered, role in medications for opioid use disorder (MOUD) and naloxone distribution, and factors impacting implementation and maintenance of ED PSS programs. Quantitative data was summarized with descriptive statistics. Free-text fields were analyzed using qualitative content analysis.A total of 11 surveys were completed, collected from 9 different states. ED PSS funding was from grants (55%), hospital funds (46%), peer recovery organizations (27%) or other (18%). Funding was anticipated to continue for a mean of 16 months (range 12 to 36 months). The majority of programs provided "general recovery support (81%) Screening, Brief Intervention, and Referral to Treatment (SBIRT) services (55%), and assisted with naloxone distribution to ED patients (64%). A minority assisted with ED-initiated buprenorphine (EDIB) programs (27%). Most (91%) provided services to patients after they were discharged from the ED. Barriers to implementation included lack of outpatient referral sources, barriers to initiating MOUD, stigma at the clinician and system level, and lack of ongoing PSS availability due to short-term grant funding.The majority of ED-based PSSs were funded through time-limited grants, and short-term grant funding was identified as a barrier for ED PSS programs. There was consistency among sites in the involvement of PSSs in facilitation of transitions of SUD care, coordination of follow-up after ED discharge, and PSS involvement in naloxone distribution.

  View details for DOI 10.1186/s13722-024-00453-x

  View details for PubMedID 38589934

  View details for PubMedCentralID 9192111

• A telehealth inpatient addiction consult service is both feasible and effective in reducing readmission rates. Journal of addictive diseases Deng, H., Raheemullah, A., Fenno, L. E., Lembke, A. 2022: 1-8

  Abstract

  The COVID-19 pandemic compelled fast adaptation of telehealth to addiction treatment services. This study aims to examine the feasibility and effectiveness of transitioning an in-person hospital addiction consult service (ACS) to telehealth. The Stanford Hospital ACS adapted to the pandemic by transforming an in-person ACS to a telehealth ACS. We compared 30-day readmission rates in patients with and without an addiction medicine consult pre-pandemic (in-person ACS) and during the pandemic (telehealth ACS). The ACS completed 370 and 473 unique patient consults in the year preceding (in-person consults) and during the pandemic (telehealth consults) respectively. Patients seen by telehealth ACS had decreased 30-day readmission rates consistent with those seen before COVID-19. A telehealth ACS is feasible and effective in the in-patient setting. Telehealth ACS holds promise to extend the reach of substance use disorder evaluation and treatment in underserved areas.

  View details for DOI 10.1080/10550887.2022.2090822

  View details for PubMedID 35819268

• Dopamine Nation: Finding Balance in the Age of Indulgence by Anna Lembke, New York: Dutton, 2021 Cambridge Quarterly of Healthcare Ethics Raheemullah, A. 2022; 31 (4): 573-574

  View details for DOI 10.1017/S0963180122000032

• Alcohol and Other Substance Use Disorders Concise Guide to Neuropsychiatry and Behavioral Neurology Raheemullah, A., Benhamou, O. American Psychiatric Publishing, Inc.. 2022; 3rd: 337-348
• Buprenorphine Microdosing Cross Tapers: A Time for Change International Journal of Environmental Research and Public Health Raheemullah, A., Benhamou, O., Kuo, J., Lembke, A. 2022; 19 (24): 16436

  View details for DOI 10.3390/ijerph192416436

• Inpatient Addiction Medicine Consultation on Readmission Rates and Length of Stay Journal of Addiction and Prevention Raheemullah, A., Deng, H., Fenno, L., Lembke, A. 2022; 10 (1)
• Inpatient Motivational Interventions for Substance Use Disorder J Mod Nurs Pract Res Raheemullah, A., Magana, M. 2022; 2 (4): 11

  View details for DOI 10.53964/jmnpr.2022011

• Peer Review Report For: Creating a standard inpatient opioid withdrawal protocol. MedEdPublish Raheemullah, A. 2022; 12 (7)

  View details for DOI 10.21956/mep.18808.r31926

• Buprenorphine Induction Without Opioid Withdrawal: A Case Series of 15 Opioid-Dependent Inpatients Induced on Buprenorphine Using Microdoses of Transdermal Buprenorphine AMERICAN JOURNAL OF THERAPEUTICS Raheemullah, A., Lembke, A. 2021; 28 (4): E504-E508

  View details for Web of Science ID 000681356600019

• Improving Residency Education on Chronic Pain and Opioid Use Disorder: Evaluation of CDC Guideline-Based Education. Substance use & misuse Raheemullah, A., Andruska, N., Saeed, M., Kumar, P. 2019: 1–7

  Abstract

  Background: National surveys show that primary care physicians feel responsible for addressing the opioid epidemic. They feel their training in managing chronic pain and addiction was insufficient, and commonly endorse the need for more residency training in these areas. However, residency training in these areas remains low, with a lack of faculty expertise and time as the most commonly cited barriers for improvement. Objective: To evaluate the feasibility of an educational program for chronic pain management and addiction that does not rely on faculty expertise or additional time, and assess resident opioid-prescribing practices and confidence in managing chronic pain after its implementation. Methods: A 16-week educational curriculum was incorporated into existing residency didactics. Internal medicine residents attended six educational sessions in 2016 over a 16-week period and implemented a protocol based on CDC Guidelines for Prescribing Opioids for Chronic Pain. Surveys were completed pre- and post-intervention. Results: Implementation of this educational intervention was feasible. Surveys showed improvement in resident confidence in detecting and managing addiction and improved prescribing practices and adherence to CDC recommendations. Conclusion: This pilot study demonstrates that increasing residency education in managing chronic pain and opioid use disorder is feasible, and no longer needs to be postponed due to lack of time or faculty expertise.

  View details for DOI 10.1080/10826084.2019.1691600

  View details for PubMedID 31757179

• Initiating Opioid Agonist Treatment for Opioid Use Disorder in the Inpatient Setting: A Teachable Moment. JAMA internal medicine Raheemullah, A., Lembke, A. 2019

  View details for PubMedID 30640372

• Buprenorphine Induction Without Opioid Withdrawal: A Case Series of 15 Opioid-Dependent Inpatients Induced on Buprenorphine Using Microdoses of Transdermal Buprenorphine. American journal of therapeutics Raheemullah, A. n., Lembke, A. n. 2019

  View details for DOI 10.1097/MJT.0000000000001108

  View details for PubMedID 31833872

• Exercise and Addiction LIFESTYLE PSYCHIATRY Lembke, A., Raheemullah, A., Noordsy, D. L. 2019: 127–39

  View details for Web of Science ID 000552225000010

• Cocaine Cessation for Levamisole-Induced Vasculitis: Treating the Underlying Disease. Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases Raheemullah, A. n., Melhem, M. n., Andruska, N. n. 2019

  View details for DOI 10.1097/RHU.0000000000001123

  View details for PubMedID 31415474

• Exercise and Addiction Lifestyle Pscyhiatry Lembke, A., Raheemullah, A. American Psychiatric Association Publishing. 2019: 127
• Fentanyl analogue overdose: Key lessons in management in the synthetic opioid age. Journal of Opioid Management Raheemullah, A., Andruska, N. 2019; 15 (5): 428-432

  View details for DOI 10.5055/jom.2019.0531

• Eccrine Porocarcinoma Presenting as a Hand Cyst. journal of hand surgery Raheemullah, A., Allamaneni, S., Weber, S., Singh, R. 2016; 41 (11): e425-e427

  Abstract

  Eccrine porocarcinoma is a rare tumor that arises from the epithelium of the eccrine ducts, with a tendency for metastatic spread and a high rate of local recurrence after excision. It was first described in 1963 by Pinkus and Mehregan and can present clinically as a nodule, erosive plaque or a polypoid growth that may ulcerate. The variable clinical appearance of these lesions can make diagnosis challenging and could delay appropriate treatment. If metastasis occurs the prognosis is poor, with a reported mortality rate of up to 80%. We report an uncommon presentation of porocarcinoma as a cyst on the dorsum of the right hand in a 37-year-old man. Only 8% of porocarcinomas occur in the upper extremity and only 3% are on the hand. Furthermore, the tumor is more common in females and mean age at diagnosis is 67 years. Treatment is with wide local excision with free tumor borders confirmed by biopsy, which has been shown to be curative in 70% to 80% of patients.

  View details for DOI 10.1016/j.jhsa.2016.07.112

  View details for PubMedID 27593487

• REPEATED THROMBOSIS AFTER SYNTHETIC CANNABINOID USE JOURNAL OF EMERGENCY MEDICINE Raheemullah, A., Laurence, T. N. 2016; 51 (5): 540-543

  Abstract

  Synthetic cannabinoids are swiftly gaining popularity and have earned a reputation of being relatively safer than other illicit drugs. However, there is a growing body of literature associating thromboembolic events with their use.A 32-year-old woman presented on four separate occasions with a new thromboemoblic event after smoking synthetic cannabinoids. She had no medical history, and over the span of 9 months she developed two kidney infarcts, pulmonary emboli, and an ischemic stroke. Each of these events occurred within 24 hours of smoking synthetic cannabinoids. During periods of abstinence, she remained free of thrombotic events. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This report shows that an association between thrombosis and the use of synthetic cannabinoids is reproducible and involves both venous and arterial thrombosis, suggesting activation of coagulation or inflammatory pathways. As the popularity of this drug continues to grow, we can expect to see a growing number of these cases. Synthetic cannabinoid use should be included in the differential diagnosis of young patients with no risk factors who present with venous or arterial thrombosis.

  View details for Web of Science ID 000389520200012

  View details for PubMedID 27595371