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R. Douglas Bruce, M.D.
blue arrow Clinical Instructor of Medicine, Internal Medicine, Infectious Diseases
blue arrow Investigator, Clinical and Health Services Research (CHSR) Core

Contact:
blue arrow robert.bruce@yale.edu
blue arrow Ph: (203) 737-1370
 R. Douglas Bruce


Brief Bio:
Clinical Interests
Dr. Bruce's interests reside at the intersection of substance abuse/dependence and infectious diseases, particularly HIV and Hepatitis C. Dr. Bruce is currently the Medical Director of South Central Rehabilitation Center which is the first Federally Qualified Health Center (FQHC) to become an integrated health clinic: providing addiction medicine (buprenorphine and methadone), primary care (including HIV and Hepatitis C treatments), and mental health treatment all in one integrated setting. Dr. Bruce has worked clinically in the treatment of HIV and Hepatitis C in drug treatment settings, jail/prison, and in mobile healthcare settings. Dr. Bruce has assisted in the development and implementation of buprenorphine in each of these clinical environments. Finally, Dr. Bruce has worked over the last several years training medical providers on evidenced based treatments for addiction and HIV. Dr. Bruce has trained clinical providers from Armenia, Azerbaijan, China, Georgia, Indonesia, Kazakhstan, Kyrgyzstan, Lithuania, Malaysia, Moldova, Poland, Tajikistan, The Russia Federation, and Ukraine.

Research Interests
Dr. Bruce's scholarly work focuses on the intersection of substance abuse/dependence and infectious diseases, particularly HIV and Hepatitis C. Dr. Bruce is the recipient of a NIDA Career Development Award to improve health outcomes among drug users at the intersection of infectious diseases (especially HIV and HCV) and addiction. There are several specific sub-themes that are embedded in that overall focus and they are:
  1. integration efforts to improve health outcomes;
  2. pharmacokinetic interaction studies between HIV/HCV/TB treatments and treatments for substance dependence (e.g., buprenorphine/methadone);
  3. ethical issues regarding the conduct of research and the provision of clinical care at the intersection of infectious diseases and addiction.

Areas of Expertise:
HIV/AIDS,Mental Health,Substance Use/Abuse

CIRA Affiliated Projects:
Substance Abuse, HIV and HCV Treatments to Improve Health Outcomes in Drug Users
Funder:
National Institute on Drug Abuse
Status: Active
Region:
U.S. - Connecticut

Selected Publications:
2009

Bruce, R.D., Govindasamy, S., Sylla, L.N., Kamarulzaman, A., Altice, F.L.  (2009). Lack of Reduction in Buprenorphine Injection After Introduction of Co-formulated Buprenorphine/Naloxone to the Malaysian Market. American Journal of Drug & Alcohol Abuse, 35(2), 68-72.

Maru, D.S.R., Bruce, R.D., Walton, M., Springer, S.A., Altice, F.L.  (2009). Persistence of Virological Benefits Following Directly Administered Antiretroviral Therapy among Drug Users: Results from a Randomized, Controlled Trial. Journal Of AIDS, 50(2), 176-181.

2008

Bruce, R.D., Altice, F.L., Friedland, G.  (2008). A Review of Pharmacokinetic Drug Interactions Between Drugs of Abuse and Antiretroviral Medications: Implications and Management for Clinical Practice. Expert Review of Clinical Pharmacology, 1(1), 115-127.

Bruce, R.D., Govindasamy, S. Sylla, L.N., Kamarulzaman, A., Altice, F.L.  (2008). Case Series of Buprenorphine Injectors in Kuala Lumpur, Malaysia. American Journal of Drug & Alcohol Abuse, 34(4), 511-517.

Smith-Rohrberg Maru, D., Bruce, R.D., Basu, S., Altice, F.L.  (2008). Clinical Outcomes of Hepatitis C Treatment in a Prison Setting: Feasibility and Effectiveness for Challenging Treatment Populations. Clinical Infectious Diseases, 47(7), 952-961.

2007

Copenhaver, M.M., Bruce, R.D., Altice, F.L.  (2007). Behavioral counseling content for optimizing the use of buprenorphine for opoid dependence in community-based settings: A review of the empirical evidence. American Journal of Drug & Alcohol Abuse, 33(5), 643-54.

Bruce, R.D., Altice, F.L.  (2007). Case series of the Safe Use of Buprenorphine/Nalaxone in Individuals with Acute Hepatitis C Infection and Abnormal Liver Transaminases. American Journal of Drug & Alcohol Abuse, 33(6), 869-874.

Bruce, R.D., Altice, F.L.  (2007). Clinical Care of the HIV-Infected Drug User. Infectious Disease Clinics of North America, 21(1), 149-179.

Maru, D.S.R., Kozal, M.J., Bruce, R.D., Springer, S.A., Shield, D.S., Altice, F.L.  (2007). Directly Administered Antiretroviral Therapy for HIV-Infected Drug Users Does Not Have an Impact on Antiretroviral Resistance: Results From A Randomized Controlled Trial. Journal Of AIDS, 46(5), 555-563.

Bruce, R.D., Dvoryak, S., Sylla, L.N., Altice, F.L.  (2007). HIV Treatment access and scale up for delivery for Injection Drug Users in Ukraine for Opiate Substitution Therapy with Buprenorphine: Program Description and Policy Implications. International Journal of Drug Policy, 18(4), 326-8.

Maru, D.S., Bruce, R.D., Walton, M., Mezger, J.A., Springer, S.A., Shield, D., Altice, F.L.  (2007). Initiation, Adherence, and Retention in a Randomized Controlled Trial of Directly Administered Antiretroviral Therapy. AIDS and Behavior, 11(7), 946-57.

Sylla, L.N., Bruce, R.D., Kamarulzaman, A., Altice, F.L.  (2007). Integration and Co-Location of HIV/AIDS, Tuberculosis and Substance Abuse Treatment Services: Paradigms for Complex Patient Populations. International Journal of Drug Policy, 18(), 306-12.

Basu, S., Bruce, R.D., Barry, D., Altice, F.L.  (2007). Pharmacological Pain Control for HIV-Infected Adults With a History of Drug Dependence. Journal of Substance Abuse Treatment, 32(4), 399-409.

Bruce, R.D., Smith-Rohrberg, D., Altice, F.L.  (2007). Pharmacological Treatment of Substance Abuse in Correctional Facilities: Prospects and barriers To Expanding Access To Evidence-Based Therapy. In: Public Health Behind Bars, From Prisons to Communities. New York: Springer.

Altice, F.L., Smith-Rohrberg, Maru D., Bruce, R.D., Springer, S.A., and Friedland, G.H.  (2007). Superiority of Directly Administered Antiretroviral Therapy over Self-Administered Therapy among HIV-Infected Drug Users: A Prospective, Randomized, Controlled Trial. Clinical Infectious Diseases, 45(6), 770-778.

2006

Smith-Rohrberg, D., Mezger, J., Walton, M., Bruce, R.D., and Altice, F.L.  (2006). Impact of Enhanced Services on Virologic Outcomes in a Directly Administered Antiretroviral Therapy Trial for HIV-Infected Drug Users. Journal of Acquired Immune Deficiency Syndromes, 43(s1), 88-95.

Sullivan, L.E., Bruce, R.D., Haltiwanger, D., Lucas, G.M., Eldred, L., Finkelstein, R., Fiellin, D.A.  (2006). Initial Strategies for Integrating Buprenorphine into HIV Care Settings in the United States. Clinical Infectious Diseases, 43(Suppl 4), S191-S196.

Basu, S., Smith-Rothberg, D., Bruce, R.D., Altice, F.L.  (2006). Models for Integrating Buprenorphine Therapy into HIV Care. Clinical Infectious Diseases, 42(5), 716-721.

Bruce, R.D., Altice, F.L., Gourevitch, M.N., and Friedland, G.H.  (2006). Pharmacokinetic Drug Interactions Between Opioid Agonist Therapy and Antiretroviral Medications: Implications and Management for Clinical Practice. Journal of Acquired Immune Deficiency Syndromes, 41(5), 563-572.

Bruce, R.D., McCance-Katz, E., Kharasch, E.D., Moody, D.E., Morse, G.D.  (2006). Pharmacokinetic Interactions between Buprenorphine and Antiretroviral Medications. Clinical Infectious Diseases, 43(Suppl 4), S216-S223.

2005

Altice, F.L., Bruce, R.D., Walton, M.R. and Buitrago, M.I.  (2005). Adherence to Hepatitis B Virus Vaccination At Syringe Exchange Sites. Journal of Urban Health, 82(1), 151-161.

Kresina, T.F., Bruce, R.D., Litwin, A.H., Sylvestre, D.,  (2005). Hepatitis C Treatment of Substance Abusers in Pharmacotherapy for Addiction. Current Hepatitis Reports, 4(3), 112-119.

Kresina, T.F., Bruce, R.D., Cargill, V.A., and Cheever, L.W.  (2005). Integrating Care for Hepatitis C Virus (HCV) and Primary Care for HIV for Injection Drug Users Coinfected with HIV and HCV. Clinical Infectious Diseases, 41(Suppl 1), S83-S88.

Kresina, T.F., Eldred, L., Bruce, R.D., and Francis, H.  (2005). Integration of Pharmacotherapy for Opioid Addiction into HIV Primary Care for HIV/Hepatitis C Virus-Co-Infected Patients. Journal of Acquired Immune Deficiency Syndromes, 19(Suppl 3), S221-226.

2004

Altice, F.L., Mezger, J., Hodges, J., Bruce, R.D., Marinovich, A., Walton, M., Springer, S.A., and Friedland, G.  (2004). Developing a Directly Administered Antiretroviral Therapy Intervention for HIV-Infected Drug Users: Implications for Program Replication. Clinical Infectious Diseases, 38(Suppl 5), S376-387.

Altice, F.L. and Bruce, R.D  (2004). Hepatitis C Virus Infection in United States Correctional Institutions. Current Hepatitis Reports, 3(3), 112-118.

Smith-Rohrberg, D., Bruce, R.D., and Altice, F.L.  (2004). Review of Corrections Based Therapy for Opiate-Dependent Patients: Implications for Buprenorphine Treatment Among Correctional Populations. Journal of Drug Issues, 34(2), 451-480.

2003

Bruce, R.D., Altice, F.L.  (2003). Why Treat Three Diagnoses When It Is One Patient?. AIDS Reader, 13(8), 375-382.

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