Dr. Jo-Hanna Ivers
Associate Professor, Public Health & Primary Care

Projects

• Title
  • An analysis of treatment patterns and trends in opioid use, with a particular emphasis on the older population, from 2015-2021.
• Summary
  • Opioid Use Disorder (OUD) is characterised by a loss of control over the use of opioids, resulting in physical, psychological, and social harm. Examples of opioids include heroin, morphine, codeine, fentanyl, and oxycodone. The misuse of prescription and illegally obtained opioids are major public health issues and are associated with significant mortality and morbidity (WHO, 2009). Across Europe, it is estimated that there are 1.3 million people with high-risk opioid use, with opioids being found in up to three-quarters of overdoses. In Ireland, it has been estimated that in 2019 there were 19,875 problematic opioid users. In addition, opioids are the main drug group implemented in poisoning deaths, with more people treated for opioids than any other drug. As opioid users age, they also experience co-morbid health problems requiring treatment.
• Funding Agency
  • National Office of Social Inclusion

• Title
  • Non-Fatal Overdose
• Summary
  • Non-fatal opioid overdose is a significant cause of opioid-related morbidity globally. As the number of non-fatal overdoses continues to grow, and it is crucial to understand the short and long-term consequences. There is a dearth of literature on non-fatal overdose in Ireland, with no published studies exploring the experiences of persons who use drugs and who experienced a non-fatal overdose. Timely data can help enhance coordination among service providers, community members, healthcare providers, public health, law enforcement, and government agencies. Timely, robust data can enable readiness for increasing change and response to overdose. For example, evidence suggests individuals who have had at least one overdose are more likely to have another. However, if an individual who has had an overdose is seen in the ED, there is an opportunity to intervene and prevent further overdose by individual care that can improve their health outcomes. The current study will use a mixed methods approach to examine data and capture the experiences of relevant stakeholders for the last decade.
• Funding Agency
  • North East Innercity Programme

• Title
  • A proposed plan to develop a strategy on reducing drug-related stigma in Ireland
• Summary
  • Stigma can affect self-esteem, physical and psychological health, and relationships with others, directly affecting an individual accessing the necessary support services and resources. The social disadvantage and stress people experience can lead to inequalities and impact health and life expectancy.1 The hidden element of those living with active drug use disorders due to the stigma associated with their condition means the wider public has no opportunity to hear from them and no opportunity to reflect on their prejudices, such as the opinion that addiction is a moral failing or a form of deviance. Research has consistently shown that interacting with members of a stigmatised group and listening to their stories has a profound destigmatising effect on listeners. It is far more powerful than merely educating the public about the science underlying a condition. However, while a growing number of people in recovery are sharing their stories, there is still a significant stigma attached to illicit drug use. Thus, speaking openly about a history of drug use carries a fear of public stigma and, in some instances, the threat of legal retribution. An effective public health response to substance use and substance use disorders must consider the policy landscape of criminalising substance use, which constitutes a primary socially sanctioned form of stigma. In addition, there is a pressing need to develop the research on the outcomes associated with alternative policy models that prioritise treatment over punishment, such as health diversion programmes, that reframe drug use as a health need rather than a criminal act. The current study aims and objectives set out in the tender call, namely, to develop a strategy for reducing drug-related stigma.
• Funding Agency
  • National Office of Social Inclusion

• Title
  • Unravelling Neurobiological Profiles to Develop Pathways for Opioid Addiction Recovery'
• Summary
  • To investigate biological ageing and mechanisms driving accelerated ageing in individuals with relapsed OUD, on OAT, and in sustained recovery from addiction compared to non-OUD individuals, to then explore these factors in a group of patients in early-stage addiction treatment and recovery to identify predictors for ageing and for recovery, and the acute and longer-term impact of treatment and recovery as a basis to guide interventions.
• Funding Agency
  • Wellcome Trust

• Title
  • A single supplier framework agreement for Secondary data analysis of GUI datasets for an alcohol and other drugs study under a three-year agreement to the HRB
• Summary
  • To advance the evidence in the area of youth substance use, we plan to combine measures of multiple risk factors into a cumulative measure of substance use vulnerability that could be used to identify specific thresholds or unique combinations of risk factors (e.g., substance use risk profiles) associated with substance use initiation and associated harms.
• Funding Agency
  • Health Research Board
• Date From
  • 02/2022
• Date To
  • 02/2024

• Title
  • INCLUDE: Integrating National Repositories for the Cooperation Linkage and Understanding of a Data Driven approach to the needs of Excluded people
• Summary
  • The research will develop and validate an accessible integrated longitudinal national-level database of health and social care utilisation with a derived variable to identify those who are socially excluded.
• Funding Agency
  • Health Research Board

• Title
  • Pilot Project of a Court based Health Diversion Programme
• Summary
  • This project is the first evaluation a court based health diversion programme for people with problematic drug and alcohol use facing a prosecution. The Health Diversion Programme, which allows for those found with small quantities of drugs to be directed to the health service instead of being prosecuted.
• Funding Agency
  • Health Service Executive
• Date From
  • 01/2022
• Date To
  • 10/2022

• Title
  • Developing a sustained method of health care for individuals experiencing homelessness, who use drugs: informed by lessons learned and lived experience during the COVID-19 pandemic.
• Summary
  • During the COVID-19 pandemic in Dublin, homeless people were identified as a particularly vulnerable group due to their morbidity profile, living conditions and drug use behaviour. A vital component of the health services' strategy to protect homeless people from COVID-19 involved the expansion of harm reduction practices that resulted in improved access to healthcare. The project aims to develop a sustained and improved way of providing healthcare by defining and evaluating the policies and practices that were implemented during the COVID-19 pandemic to minimise the risk of infection in homeless patients who use drugs. The study design incorporates both qualitative and quantitative methods. Mixed methods research capitalises on the strengths of both qualitative and quantitative methodologies by combining approaches in a single research study to increase the breadth and depth of understanding. The mixed-methods design is well suited to health service research because it enables the research team to simultaneously evaluate the extent to which targeted outcomes are achieved, while also examining the processes by which these outcomes occur as well as the context. The study consists of 5 distinct work packages that will collectively result in a protocol for sustained and improved ways of delivering healthcare to homeless individuals who use drugs. Both separate and integrated use of qualitative and quantitative approaches for data collection and analysis to address the research objectives will be employed. Knowing the practices that were developed during the COVID-19 pandemic is essential. However, systematically reviewing how these policies were implemented from the lived experience of those involved is imperative to building a sustained model of health care
• Funding Agency
  • Health Service Executive

• Title
  • Development, Implementation & Evaluation Of A Basic Peer-Led Addiction Recovery Coach Programme For Individuals With Complex Needs
• Summary
  • This project will use a two-phased approach (figure 1) to assist in the development, delivery, evaluation and implementation of a Peer-Led Addiction Recovery Model for Individuals with Complex Needs. This phased approach will identify process and outcome measures, which are essential for the successful implementation of this Peer-Led Addiction Recovery Model for Individuals with Complex Needs in an Irish context.
• Funding Agency
  • Health Service Executive
• Date From
  • 01/01/2021
• Date To
  • 01/01/2022

• Title
  • Neurocognitive Functioning Opioid Dependent Patients
• Summary
  • This project examines neurocognitive functioning in opioid dependent patients. Data is being collected in Ireland, Bulgaria, Pakistan and the United States (Virginia) using a crossover battery of instruments. The data includes persons across the recovery spectrum, from detoxification through to long-term recovery (10 years+). The data is unique globally.
• Funding Agency
  • TCD
• Date From
  • July 2019
• Date To
  • Ongoing

• Title
  • Supporting Women to Access Appropriate Treatment Services (SWAAT)
• Summary
  • Exploration of barriers to addiction treatment in disadvantaged communities
• Funding Agency
  • Genio Reform Funding
• Date From
  • March 2020
• Date To
  • August 2020

• Title
  • A case-management approach for high and very high-frequency attendees to the Emergency Departments in Cork.
• Summary
  • The Service Reform Fund (SRF) has been established to support the implementation of reforms in Disability, Mental Health and Homelessness in Ireland. The Homelessness programme is being implemented through an integrated approach by the Department of Housing, Planning, and Local Government; Local Authorities; the Department of Health; and the HSE. This is in line with the 'Rebuilding Ireland - Action Plan for Housing and Homelessness' (Department of Housing, 2016). Dr Ivers was a co-applicant for: A case-management approach for high and very high-frequency attendees to the Emergency. Departments in Cork.
• Funding Agency
  • Government of Ireland
• Date From
  • September 2018
• Date To
  • September 2020

• Title
  • Evaluation of Parents Under Pressure Programme
• Summary
  • The PuP programme aims to improve family functioning and child outcomes by supporting parents who are, or have been, drug or alcohol dependent. Evaluations of the PuP have been carried out in other countries but never in Ireland. In addition, this is the first evaluation anywhere of the PuP programme in a residential setting.
• Funding Agency
  • Coolmine Therapeutic Community
• Date From
  • September 2017
• Date To
  • March 2018

• Title
  • Evaluation of Tabor Group
• Funding Agency
  • Health Service Executive
• Date From
  • September 2017
• Date To
  • March 2018

• Title
  • Mortality Amongst the Homeless 2005-2015 Dublin
• Summary
  • Development of National Index Mortality Amongst Homeless.
• Funding Agency
  • Health Service Executive & Dublin Regional Homeless Executive
• Date From
  • August 2015
• Date To
  • June 2016

• Title
  • Evaluation of Implementation of National Drug Rehabilitation Framework.
• Summary
  • Evaluation of Implementation of National Drug Rehabilitation Framework. Funder: Health Service Executive.
• Funding Agency
  • Health Service Executive
• Date From
  • September 2013
• Date To
  • September 2014

• Title
  • Evaluation of Implementation of National Drug Rehabilitation Framework in the Cork and Kerry region.
• Summary
• Funding Agency
  • Health Service Executive
• Date From
  • September 2016
• Date To
  • March 2017

• Title
  • Neuopsychological functioning in opioid dependant patients
• Summary
  • The aim of the current study is to compare cognitive function in Opioid Dependent Patients (ODP) receiving OST (Opioid Substitute Therapy) with Opioid Dependent Patients (ODP) with long-term abstinence who are not receiving (Opioid Substitute Therapy).
• Funding Agency
  • Health Research Board