Joshua D. Lee, MD

  • Specialty: Internal Medicine
  • Language: English
  • Phone: 212-263-4242
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About Me

Conditions and Treatments

addiction

Credentials

Positions
  • Associate Professor, Department of Population Health
  • Associate Professor, Department of Medicine
  • Director, NYU Fellowship in Addiction Medicine
Board Certifications
  • American Board of Internal Medicine - Internal Medicine, 2002
Education and Training
  • Fellowship, Cornell University Medical College, Medicine (Internal), 2005
  • Residency, NYU Medical Center, Internal Medicine, 2003
  • MD from University Of Tennessee, 1999

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Locations and Appointments

550 First Avenue, VZ30 622
New York, NY 10016

Research My Research

Interests

addiction, alcohol, criminal justice, primary care, opioid pharmacotherapy, naltrexone, buprenorphine

Research Summary
Personal Statement

I have the required research and leadership experience to co-lead this Multiple PI R01 proposal to study the impact of jail-based methadone on overdose, recidivism and health outcomes in New York City from 2011 to 2016. I am an experienced NIH PI studying correctional populations, opioid disorders, and pharmacotherapies, as well as a NYC jail and community addiction medicine provider.  I intimately understand the patient population, jail electronic medical record, and treatment interventions we now propose to study.  I will provide leadership and content expertise to all Aims and aspects of this project, and among the 3 Multiple PIs have the most experience leading large NIH studies and multi-site research efforts. I am currently PI and Co-Lead Investigator of several NIH single-site, collaborative, and multi-site trials examining the implementation of methadone, buprenorphine, and extended-release naltrexone in jail, primary care, and community opioid treatment populations. This includes a NIDA U01, ‘SOMATICS,’ a collaboration with NYU-Friends Research Institute-UCLA/U.New Mexico on 3 jail-based opioid treatment trials, NIDA Clinical Trials Network CTN-0051, X:BOT, comparing XR-NTX to buprenorphine maintenance (main results now in press at The Lancet), and a NIAAA R01 of XR- vs. oral naltrexone as primary care alcohol treatment.  I chair the publication committee and led the primary outcomes analysis for a recent NIDA 5-site RCT of XR-NTX among outpatient CJS-involved adults (NEJM 2016).  I have worked as a correctional medical provider and researcher in the NYC jails since 2002, and have conducted numerous clinical trials and secondary data analyses of jail opioid treatments (methadone and buprenorphine) in collaboration with the NYC Department of Health and Mental Hygiene and Correctional Medical Services.  I look forward to continuing this NYC inter-agency collaboration.  

Positions and Honors:         

Other Experience and Professional Memberships

2007 - Certification in Addiction Medicine, American Board of Addiction Medicine 2008-2012 Secretary, Board of Directors, Alcoholism Council of New York

2010 - Community Treatment Representative, NIDA Clinical Trials Network 2011-  Journal of Substance Abuse Treatment, Editorial Board

2011 - Member, Ad hoc review committee, NIGMS, Minority Biomedical Research Support; NIDA, NO1 DA 11-1147, “Development of E-Tools on Prescription Drug Abuse and Treatment”

2011 - Addiction Science & Clinical Practice, Editorial Board

2012 - Member, Ad hoc review committee, NIDA ZDA1 NXR-B (13), “Phased Services Research Studies of Drug Use Prevention, Addiction, Treatment and HIV”

2012 - Commissioner’s Medical Advisory Committee, New York State Office of Alcoholism and Substance Abuse Services

2013 - Substance Use & Misuse, Editorial Board

2013 - Academic Consortium for Criminal Justice Health, Board of Directors

2013 - NIAAA AA-3 ad hoc reviewer, Clinical, Treatment and Health Services Research Review 2013  NIAAA 2014/01 ZAA1 DD (03) 1 ad hoc review, NIAAA Member Conflict Applications -

Epidemiology and Clinical studies

2013 - NIDA 2014/05 ZDA1 NXR-B (11) ad hoc review, DA-14-012 Co-morbid HIV, Chronic Pain, and Substance Abuse Among Older Adults (R21)

2014 - NIAAA 2014/10 ZAA1 DD (03) 1 ad hoc reviewer, Clinical, Treatment and Health Services Research, Members Conflict Special Emphasis Panel

2015 - NIDA 2015/01 RPIA, ad hoc reviewer, Risk, Prevention and Intervention for Addictions Study Section

2015 - College of Problems of Drug Dependence, Member

Selected Honors

2006               Abstract Semi-Finalist, Association of Medical Education and Research on Substance Abuse

2007               Finalist, Milton W. Hamolsky Junior Faculty Award, Society of General Internal Medicine

2007               Outstanding Abstract, Interactive Resources in Medical Education, SGIM

2007               Award for Excellence in Research, NYU Department of Medicine

2007               Best Abstract, Association of Medical Education and Research on Substance Abuse

2008               Top Research Paper, July 2008, NYU Department of Medicine

2009              Top Research Paper, Feb 2009, NYU Department of Medicine

2010               Michael Saperstein Medical Scholar, NYU Department of Medicine

2011               NIDA-ISAM 2011 Travel Fellowships for Young Investigators

2013               Abstract Semi-Finalist, Association of Medical Education and Research on Substance Abuse

2013               Distinguished Faculty, National Judicial College

2015               NYU School of Medicine Dean’s List (Research Incentive Program)

2016               NYU School of Medicine Dean’s List (Research Incentive Program)

2017               Clinical Research Forum, 2016 Top Ten Clinical Research Achievement Award (LeeJD et al, NEJM 2016, PMID:27028913)

2017               Award of Tenure, NYU School of Medicine

 

Contribution to Science
  1. Evaluating the adoption of effective pharmacotherapies for criminal justice settings has been a core line of research.  I have been a NYC jail physician since 2002.  Our findings have contributed significantly to the evidence base supporting the use of medications in jail, prison, and community supervision populations. This has included co-investigating the first RCT ever conducted of buprenorphine for opioid treatment in a correctional setting and in the context of established jail methadone treatment (a), as PI estimating the effectiveness of extended-release naltrexone (XR-NTX) as opioid relapse prevention among community-dwelling CJS clients (b), and XR-NTX inititated just prior to release from jail (c).  Our findings and those of our international colleagues and collaborator heavily favor policies to broadly implement medication-assisted therapies in CJS settings. I have authored national practitioner guidelines in favor of these approaches (d) and am a frequent invited speaker on these topics.
  • Magura S, Lee JD, Hershberger J, Joseph H, Marsch L, Shropshire C, Rosenblum A. Buprenorphine Maintenance in Jail and Post-Release: A Randomized Clinical Trial, Drug Alcohol Depend, 99(1-3), 2009: 222-230; PMID:2658719
  • Lee JD, Friedmann PD, Kinlock TW, Nunes EV, Boney TY, Hoskinson R, Wilson D, McDonald R, Rotrosen J, Gourevitch MN, Gordon M, Fishman M, Chen DT, Bonnie RJ, Cornish JW, Murphy SM, O’Brien CP, Extended-Release Naltrexone to Prevent Opioid Relapse in Criminal Justice Offenders, New England J Med 2016;374(13):1232-42; PMID: PMC4380547
  • Lee JD, McDonald R, Grossman E, McNeely J, Laska E, Rotrosen J, Gourevitch MN. Opioid treatment at release from jail using extended-release naltrexone: a pilot proof-of-concept randomized effectiveness trial. Addiction 110;2015:1008–1014;PMID:25703440.
  • Lee JD, Extended-Release Naltrexone.  Drug Court Practitioner Fact Sheet, Sept 2013;8(2). National Drug Court Institute

      2. Mainstreaming’ these same opioid and alcohol pharmacotherapies into primary care populations and settings, particularly urban underserved general medical practices, has been another agenda which I have contributed as a PI, practitioner, and as a research mentor. This included piloting and                establishing            the feasibility and safety of unobserved ‘home’ buprenorphine treatment induction (a,b) and broadening the support for simple, replicable, and low intensity primary care Medical Management platforms for delivery of opioid and alcohol medication therapies (a-d). These findings have              become particularly                    relevant to national efforts and trends supporting medical and behavioral health integration.

  • Lee JD, Grossman E, Dirocco D, Gourevitch MN. Home Buprenorphine Induction in Urban Primary Care, J Gen Intern Med, 24(2), 2009: 226-32.PMID:2628995
  • Lee JD, McNeely J, Grossman E, Vocci F, Fiellin DA. (2014). Clinical case conference:  unobserved ‘home’ induction onto buprenorphine.  J Addiction Med, 8(5):309-14.PMID:25254668.
  • Lee JD, Grossman E, Truncali AT, DiRocco D, Truncali A, Rotrosen J, Rosenblum A, Magura S, Gourevitch MN. Buprenorphine/Naloxone Maintenance following Release from Jail. Subst Abus, 33(1);2012:40-47.PMID:3310898
  • Lee JD, Grossman E, Huben L, Manseau M, McNeely J, Rotrosen J, Stevens D, Gourevitch MN. Extended-Release Naltrexone plus Medical Management Alcohol treatment in Primary Care: findings at 15 months. J Subst Abus Treat 43(4);2012:458-62.PMID:22985676

      3. Large effectiveness and comparative effectiveness NIH trials have defined my mid-career as a Principal Investigator. The RCTs have employd open-label, non-blinded, ‘real-world’ interventional designs to further characterize the effectiveness in community practice and underserved populations of           already  proven and efficacious therapies.  By doing, so we hope to foster the dissemination of effective interventions into everyday practice and to the most vulnerable patients.  My initiation into these trials began with a study clinician role in CTN-0030 Prescription Opioid Addiction Treatment                   Study  (a) and as one of 5 PIs for a multisite R01 RCT of XR-NTX opioid relapse prevention in CJS outpatient (b). More recent studies are: CTN-0051 XR-NTX vs. Buprenorphine Opioid Treatment (X:BOT) (c, Co-Lead Investigator), a national multi-site evaluation of XR-NTX opioid treatment in the           context of buprenorphine  standard of care; XR-NTX Opioid Treatment at Jail Re-Entry (XOR) (d, PI), a definitive effectiveness trial of XR-NTX opioid treatment among persons leaving jail, and XR vs. Oral Naltrexone Alcohol Treatment in Primary Care (XON) (PI), a comparative effectiveness                     evaluation of XR-NTX in the context  of oral naltrexone medical management for alcohol use disorders.

  • Nielsen S, Hillhouse M, Weiss R, Mooney L, Potter JS, Lee JD, Gourevitch MN, Ling W. The relationship between primary prescription opioid and buprenorphine-naloxone induction outcomes in a prescription opioid dependent sample.  Am J Addict, 2013.PMID:4151625
  • Lee JD, Friedmann PD, Kinlock TW, Nunes EV, O’Brien CP et al. Extended-Release Naltrexone To Prevent Relapse Among Opioid Dependent, Criminal Justice System Involved Adults: Rationale  and Design of a Randomized Controlled Effectiveness Trial. Cont Clin Trials 2015; 41:110-117.PMID:4380547
  • LeeJD, NunesEV, NovoP, et al, RotrosenJ. Comparative effectiveness of extended-release naltrexone versus buprenorphine-naloxone for opioid relapse prevention (X:BOT): a multicenter open-label randomised controlled trial.  The Lancet 2017, in press.
  • McDonald RD, Tofighi B, Laska E, Goldfeld K, Bonilla W, Flannery M, Santana-Correa N, Johnson CW, Leibowitz N, Rotrosen J, Gourevitch MN, Lee JD. Extended-release naltrexone opioid treatment at jail reentry (XOR). Cont Clin Trials 2016;49:57-64.PMID:27178765.
Research Support: Ongoing Research Support U10 DA013035 Nunes and Rotrosen (Co-PI)  -  9/1/2015 – 8/31/2020 NIH/NIDA Clinical Trials Network: Greater New York Node; CTN-0051 X:BOT Study The NIDA Clinical Trials Network mission is to translate new clinical therapies from research settings to community based treatment programs and to evaluate effectiveness in these settings. The X:BOT CTN 0051 study, Extended-Release Naltrexone vs. Buprenorphine for Opioid Treatment, is led by the Greater NY Node. Role: Co-Lead Investigator of CTN-0051 X:BOT   1U01DA033336-01  -  Lee (PI) -  6/1/2013-5/31/2018 NIH/NIDA Laura and John Arnold Foundation (LJAF) -11/1/2017-2/28/2021 Extended-Release Naltrexone Opioid Treatment at Jail-to-Community Re-entry This RCT compares XR-NTX to treatment-as-usual for opioid relapse prevention during jail-to-community re- entry in New York City. Two collaborative jail opioid treatment studies are in Baltimore and Albuquerque. Recently awarded supplemental funding from LJAF allows additional months of recruitment and extends follow-up to 24 months from 12 months.  Role: Principal Investigator   R01 AA020836 - Lee (PI) - 8/01/2013 – 4/30/2018 NIH/NIAAA Extended-Release vs. Oral Naltrexone Alcohol Treatment in Primary Care This proposed comparative effectiveness R01 compares XR-NTX to oral naltrexone alcohol pharmacotherapy in a primary care medical management model. Role: Principal Investigator Completed Research Support Alkermes-Lee-0017-  Lee (PI) - 9/01/2010-12/31/2014 NYU School of Medicine; Alkermes Extended-Release Naltrexone for Opioid Relapse Prevention at Release from Jail A pilot effectiveness RCT of XR-NTX for opioid relapse prevention among persons leaving NYC jails Role: Principal Investigator   R01 DA024555 - Lee (PI) -  7/15/2008-2/28/2016 NIH/NIDA Treatment Study Using Depot Naltrexone (3/6) NY/Bellevue Protocol Treatment Site This RCT compares the effectiveness of XR-NTX vs. treatment-as-usual for the treatment of opioid dependence among parolees and probationers across five U.S. sites Role: Principal Investigator

Academic Contact

Academic office

227 East 30th Street

Seventh Floor

New York, NY 10016

Phone

212-263-4242

Fax

646-501-2706

Research Interests Timeline

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Publications

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