Research in the substance abuse epidemiology unit addresses the etiology, prevention, distribution, natural history, and treatment of substance use disorders, including and not limited to alcohol, marijuana and opioids. Faculty in our unit conduct epidemiologic research on the causes, consequences and interventions for substance use and substance use disorders (SUD), with a multi-level, cells-to-society perspective.
Research within this unit extends from local NYC data to work in other cities, the U.S. nationally, and also internationally. Our faculty have expertise across a range of epidemiologic study designs including international, national and local population-based studies, follow-up studies, and randomized controlled field trials. Our studies integrate approaches across many different disciplines and specialties including substance abuse epidemiology, lifecourse epidemiology, social epidemiology, injury epidemiology, and health outcomes.
Our unit maintains and continues to expand innovative collaborative research and a training program. Primary Columbia collaborators include: the departments of Sociomedical Sciences, Biostatistics, Anesthesiology, Psychiatry and the New York State Psychiatric Institute. We benefit greatly by drawing on expertise from many of our faculty in the unit who share appointments in other departments across Columbia University Medical Center.
Unit faculty teach several courses open to the department. The unit's training program has a weekly faculty/fellow seminar open to all trainees in the department that sparks new interest in the field of substance abuse epidemiology and trains the next generation of leaders in the field.
The influence of changing marijuana laws
Over half of US states have legalized marijuana use for medical purposes, and several have also legalized marijuana for recreational use. In several projects using national adult and adolescent datasets, investigations are underway on the relationship between these changing laws and several substance-related outcomes, including cannabis use, cannabis use disorder, cannabis to self-medicate depressive or anxiety disorders, use of other substances, perceived harmfulness of marijuana, and driving while intoxicated from cannabis or alcohol.
The U.S. opioid crisis
The unit’s faculty are conducting studies of the epidemic of opioids and their consequences. These include national time trends in opioid and heroin use, the relationship of state-level prescription drug monitoring programs (PDMPs) to various substances, urban health studies on injection drug users in multiple cities, opioids and their relationship to injuries and violence, and best ways to conceptualize and measure opioid addiction among chronic pain patients.
Substance use policy from national surveys and big data analyses
Data indicate that in U.S. adults, alcohol and drug use and related problems have increased since 2000. NESARC and NSDUH data are being used to determine when these increases started, and how they differ by important population sub-groups, including men and women (pregnant and non-pregnant), younger and older adults, and those in disadvantaged groups, e.g., race/ethnicity, or low income. At the same time, adolescent attitudes towards drug use are changing, although rates of use are not increasing, another topic of current investigation.
Field randomized controlled trials and natural experiments
Urban residents see abandoned buildings, vacant lots, and alcohol outlets every day on their way to work or school. In multiple cities, we are conducting the first citywide randomized controlled trials and other natural and quasi-experimental studies of the effects of abandoned building and vacant lot interventions on various health and safety outcomes including substance abuse and violence. Along with a numerous other university and municipal partners, transformational interventions to tens of thousands of abandoned spaces in multiple cities will be longitudinally tested.
Alcohol consumption, liquor stores, and bars
A reasonable way to prevent injuries and other negative health outcomes may be to focus on alcohol sales outlet zoning and policies and the consumption of alcohol that may be associated with a proliferation of these outlets. Through multiple population-based case-control studies, our research teams have established relationships between high availability of alcohol outlets, alcohol consumption, and health and safety outcomes. These studies have been also complemented with qualitative work and data collected from field observation teams.
Epidemiology is central to understanding the role of substance abuse in a global health context. Many faculty are involved in global substance use research projects. These projects include: Substance use and other risky behaviors in Puerto Rico, effects of marijuana legalization in Uruguay, genetic and environmental influences on alcohol and tobacco use in Israel, and relationship between exposure to violence and substance use in Brazil and Guatemala.
Receipt of health services, diagnosis, treatment
Systems of care are continually evolving, as are treatment technologies. Clinical epidemiology and health services studies by the unit’s faculty include topics such as factors associated with substance treatment; efficacy trials of brief, technologically-enhanced interventions in HIV and other health settings; how women view substance use during pregnancy; psychometric properties of DSM-5 substance use disorders; and substance and psychiatric comorbidity in patients who received prescription opioids.
Affiliated Centers and Programs
Our unit is establishing a Columbia University interdisciplinary population-based center for the study of substance abuse policy, including marijuana, opioids, and alcohol.
Unit leader: Silvia S. Martins