Office of Research

Office of Sponsored Programs

May 16, 2013
4333 Brooklyn Avenue NE Box 359472 Seattle, WA 98195-9472
206.543.4043 fax 206.685.1732 www.washington.edu/research/osp
Washington State Attorney General
Consumer Protection Division
Grant Review Committee
800 5th Avenue, Ste. 2000
Seattle, WA 98104-3188
Dear Ladies and Gentlemen:
The University of Washington is pleased to submit this letter in support of the application entitled
"Chronic Pain Management and Marijuana Use: Science-based Education in Times of
Legalization." This application was prepared by Dr. Beatriz H. Carlini from our Alcohol and
Drug Abuse Institute.
We present this application for your review and request support in the amount of $110,299 for the
period October 01, 2013 through March 31, 2015.
Thank you for your consideration.
Sincerely,
Lynette Arias
Director
Office of Sponsored Programs
Please reference our #A85413 on all correspondence concerning this application.
L A i


Pfizer Project Proposal Application
Applicant Information
Organization Name: University of Washington
Primary Contact Person: Lynette Arias, Director, Office of Sponsored Programs
Mailing Address: 4333 Brooklyn Ave NE, Box 359472
City, State, Zip Code: Seattle, WA 98195-9472
County: King
Phone and Email: 206-543-4043, osp@uw.edu
Fax: 206-685-1732
Secondary Contact Person: Merrilee Gavigan, Administrator, Alcohol & Drug Abuse Institute
Mailing Address: 1107 NE 45
th
St., Suite 120, Box 354805
City, State, Zip Code: Seattle, WA 98105-4631
County: King
Phone and Email: 206-543-0937, mgavigan@uw.edu
Fax: 206-543-5473
Organization Type
501 c3 Private Non-Profit
Tribal Organization
Local, County, or State Government Agency
X Public/State Controlled Institution of Higher Education
Business Information
Tax Identification Number (TIN): 91-6001537
Uniform Business Identifier (UBI): 178 019 988
Does your organization currently receive funding from the AGO or any other state or
federal government agency?
X Yes No If yes, list the contracts by project title, contract number, and funding amount:
FEDERAL FUNDING
Alcohol Effects on Cognitive & Affective Mediation of
Women's Decision Making
5 R01 AA014512-09 540,318
Integrating Behavioral Interventions in Substance Abuse
Treatment
5 K23DA025678-04 179,226
Clinical Trials Network: Pacific Northwest Node 5 U10 DA013714-11 1,117,527
Clinical Trials Network: Pacific Northwest Node 3 U10 DA013714-11S1 296,982
A Trial to Prevent Opioid Overdose: E.D. Based
Intervention & Take-home Naloxone
5 R01 DA030351-02
554,542


Increasing Post-discharge Follow Up among
Hospitalized Smokers
QR852022amd2 22,539
The Healing of the Canoe (NCE) 5 R24 MD001764-08 542,451
NW Frontier Addiction Technology Transfer Center 1002661_ADAI 51,300
Northwest HIDTA Resource Center 28,000
STATE FUNDING
State of Washington
Liquor Control Board, license fees, 171 funds
Funds received April 2012 through March 2013
N/A 421,936
University of Washington
2011-13 biennium
N/A 114,365
Developing Overdose Prevention Programs for WA Celebrex CY Pres 58,712
Is the organization solely owned/operated by a current state employee?
Yes X No If yes, complete the Ethics Certification process at http://www.ethics.wa.gov.
How did you hear about available funds?
AGO Staff. If so, who and when:
X Request for Proposal Notice
Other:
Project Proposal
Project Title: Chronic Pain Management and Marijuana Use: Science-Based Education in Times
of Legalization.
Project Description.
This project addresses gaps in science-based training and education in the area of chronic pain
management and cannabis use. The ultimate goal is to increase awareness of treatment options to
treat pain and other medical conditions, and decrease unnecessary suffering among people living
with chronic pain in the state of Washington. The project will also provide information and
education about medical conditions and populations for whom cannabis is not recommended,
side-effects and risks.
Chronic pain is an emerging public health challenge aggravated by an aging U.S. population.
The Institute of Medicine reports that 100 million Americans suffer from chronic pain
conditions. A subset of this population is afflicted by intractable pain associated with cancer,
neuropathic diseases, and central pain states (e.g., pain associated with multiple sclerosis). These
conditions are often inadequately treated with available opiates, antidepressants and
anticonvulsant drugs. Meanwhile, there is a growing body of evidence demonstrating the
efficacy of cannabis in treating neuropathic pain, muscle spasms, fibromyalgia, and cacechexia,
among other conditions.
In 1998, Washington voters approved the use of medical cannabis for various conditions,
including intractable pain, defined as pain unrelieved by standard medical treatments and
medications (RCW 69.51A) and set a corresponding set of quality control standards in place to


assure the quality, consistency, and availability of medicinal cannabis for patients receiving
chronic pain management.
The addition of medical cannabis to the menu of options to treat chronic pain in our State brings
new hope to many Washingtonians. Washington has one of the highest rates of opiate-related
mortality in the country, often the result of mismanagement or abuse of medications prescribed
to alleviate chronic pain. Misconceptions about medical cannabis and the lack of science-based
education for professionals hinder the benefits that the medical cannabis law can bring to those
struggling with chronic pain. Health care providers are often reluctant to discuss marijuana use
for medical or recreational purposes - with their patients, due to lack of knowledge and training
about the endocannabinoid system, other effects of marijuana, uncertainty about legal issues, and
concern about abuse or dependence. Likewise, patients may be reluctant to ask their doctors
about safe and effective marijuana use for medical purposes.
The passage of I-502 authorizing the sale of marijuana for recreational purposes seems to be
creating even more confusion about the risks and benefits of medical cannabis. While the
initiative does not amend or repeal the medical marijuana laws it distracts public opinion and
health care providers from the medicinal properties of cannabis, including chronic pain
management. Meanwhile, it is likely that the availability of legal marijuana from regulated state
stores may motivate more Washingtonians to consider marijuana to treat pain and other
conditions.
This project proposes development and provision of training and education resources on chronic
pain and medical cannabis for the following target groups: a) staff and volunteers of community
organizations that provide information and referral for a range of situations involving substance
use and people struggling with chronic and acute conditions (Poison Center, Crisis Clinic and
WA Recovery Helpline); b) health care providers and c) the general public.
Given the new legal status of marijuana in WA and the scarcity of training materials, project
aims to assess training and information needs regarding marijuana and pain in the target groups
above; develop science-based curriculum content appropriate for the needs of these three
segments; evaluate the acceptability and feasibility of web-based training delivery of training and
information about marijuana and pain treatment.
This proposal builds the decades of commitment by the Alcohol & Drug Abuse Institute (ADAI)
to disseminate science-based information to researchers, policy makers, health care
professionals, and the public. The ADAI is a focal point for alcohol and drug abuse research at
the University of Washington and in the region, benefiting the citizens of Washington by
expanding knowledge and providing information. ADAI has created numerous web-based
resources for use by health care providers, researchers, and the public, such as StopOverdose.org.
Screening & Assessment Instruments, and the NIDA Clinical Trials Dissemination Library. The
project director for this project will be Dr. Beatriz Carlini, a Research Scientist at ADAI (see
description and resume in this application.)
Planning Process
The planning process for the proposed project will be directed by Dr. Carlini with guidance from
an advisory group. The advisory group will talk monthly and will include representatives from
the WA Recovery Helpline, WA Poison Center, a community physician with expertise in
palliative care, pain management and medical cannabis (Dr. Gregory Carter); an expert on


treatment for marijuana abuse and dependence in adults and adolescents (Dr. Roger Roffman);
and Dr. Dennis Donovan, Director of ADAI. We also plan to add members representing chronic
pain patients and representatives of WA State Dept. of Health and the Division of Behavioral
Health and Recovery (DBHR). The advisory group will be involved in all phases: development,
implementation and evaluation.
The planning phase comprises three basic steps:
Step 1: Collect information on the training needs and preferred modes of training delivery of
each segment involved in the project. As documented in the letters of support, WA Poison
Center and The Crisis Clinic/WA Recovery Helpline agreed to participate on a staff needs
assessment; we will conduct open discussions using a focus group format to assess their current
knowledge of medical cannabis, chronic pain management, marijuana and opiate abuse.
Health Care Providers will be assessed through a brief online confidential and anonymous on-
line survey. We will reach out to health care providers through ADAIs existing contacts and
networks, as well as other sources that we can access for low or no cost. ADAI has email lists of
3000+ recipients in Washington who subscribe to our email newsletters. We would also recruit
via numerous websites and blogs managed by the ADAI Library, and use Facebook and Twitter
accounts to publicize the survey. We obtained permission to post a notice recruiting participants
on website and Facebook page of HEAL-WA, a statewide service that provides free access to
evidence-based medical databases and journals to health providers in Washington. As of
November 2012, HEAL-WA had 19,104 registered users in Washington, 12.8% of health
professionals in the state. Finally, we will contact professional associations to place a notice in
their newsletters or distribute to members via email lists, e.g. WA State Medical Association;
WA Academy of Physician Assistants; WA Association of Naturopathic Physicians; WA State
Nursing Association; and the WA State Pharmacy Association.
The results of the health care providers` assessment will be limited in their representativeness but
will be helpful to identify the training needs of those more interested in the topic and therefore
most likely to enroll in training about medical cannabis and chronic pain.
We will assess the education and information needs of the general public on chronic pain and
medical cannabis by collecting information about the most common questions, misconceptions
and challenges they face when interacting with patients or callers among the professional groups
mentioned above.
The needs assessment will be conducted by Dr. Carlini with the assistance of Jennifer Velotta, a
masters level professional with extensive experience in telephone-based information and referral
services.
Step 2: Identifying the training and educational materials already available. Preliminary searches
indicate the existence of good web-based materials from other states, but not customized to the
unique reality of Washington post-I-502 approval (see Educational Resources, at the end of
Appendix B). The materials identified will be pre-screened in terms of content accuracy, source
credibility, and presentation quality.
Step 3: Present the results of the needs assessment and a selection of the materials identified to
the advisory group. The ADAI team and advisory committee will make decisions on which


materials are adequate, which topics are not covered and training materials in need of
development of adaptation.
Outreach Strategies
ADAI is part of a new state working group addressing marijuana prevention, research, treatment,
and evaluation. The work group comprises representatives from the state Dept. of Health (DOH),
Liquor Control Board (LCB), Div. of Behavioral Health & Recovery (DBHR), Washington State
Institute for Public Policy (WSIPP), and researchers from the UW and WSU. The group has
confirmed that the existing ADAI website on marijuana is the appropriate venue for
dissemination of web-based materials for the public. In this project, we propose to use that
website as the home for additional, new educational resources about chronic pain and medical
cannabis.
More specifically, our outreach approach will leverage ADAI and our partners resources and
involve a variety of strategies, including:
a) Expansion of the website Marijuana: Science-based Information for the Public,
http://adai.uw.edu/marijuana. Dr. Carlini is working with ADAI information sciences
staff to customize the current content to the Washington State public. The website will
function as a hub for all the training resources and will be expanded to include medical
cannabis and pain management education to the three target audiences of this project.
b) Online (webinars, e-learning modules) and onsite training will be made accessible during
working hours to staff and volunteers of the two community organizations selected - WA
Recovery helpline/Crisis Clinic and WA Poison Center. (see letters of support).
c) Development and distribution of an educational brochure on chronic pain and medical
cannabis through ADAI Clearinghouse. The WA Recovery helpline and WA Poison
Center offer statewide free 24-hour services to WA state residents. These services are in
daily contact with WA residents facing issues related to pain medication misuse;
marijuana abuse and chronic untreated pain (see data on letters of support). The staff
from these organizations will be encouraged to inform callers about materials available in
ADAI website and clearinghouse, as well as utilize the knowledge and skills obtained in
their training to better assist callers.
d) Health care providers the most successful strategies utilized in the needs assessment
phase will also be utilized to disseminate the availability of free training on chronic pain
and medical cannabis. We will work with the UW Continuing Medical Education
Department to obtain CME accreditation for the training modules as a way to increase the
likelihood the training will be utilized by our target audience.
Curriculum or Approach
This project will provide scientific-based information and utilize evidence-based approaches.
The training content will offer a balanced, non-moralistic approach to present up-to-date
information on medicinal cannabis, other medications indicated for pain management; chronic,
acute and untreatable pain prevalence and definitions; and abuse and dependence potential of
substances used to treat pain, including cannabis.
Our team of physicians and researchers with strong track records on the areas of pain
management, medical cannabis and marijuana abuse and dependence will work with community
members of the advisory group to offer education and training customized to respond to needs of
each target audience.


Based on assessment of information needs and preferred format, we anticipate that:
The training for staff and volunteers of the Recovery Helpline and Poison Center will include but
not be limited to:
Education on chronic pain, treatment options and potential of abuse and dependence of
medicines available, including opiates and cannabis
How to communicate about the benefits, risks and indication of medical cannabis for
treatment of chronic pain
The training for health care professionals will include but not be limited to:
Basic science on the endocannabinoid system and clinical pharmacology of cannabis
Complete review of drug interactions and side effects
Thorough review of all relevant side effects, including instruction on how to counsel a
patient regarding timing of safety for driving with respect to cannabis dosing, how to
properly and safely store medicinal cannabis
How to do a basic risk assessment and approach to a patient at risk for addictive behavior
with respect to medicinal cannabis
Clinical applications of cannabinoids, review of safety, efficacy, and specific conditions
legally authorized to be treated with medical cannabis (RCW 69.51A)
Information on strains of cannabis, ingestion methods, and dosing
Condition specific information
State and federal legal information
The goal of the health care professional training will be to expand their role from referral agents
to informed agents, prepared to answer patients questions with updated scientific evidence. As
part of this goal, we hope that the scientific evidence provided during the trainings will de-
stigmatize cannabis and increase providers comfort level in talking to patients about medical
cannabis.
Activities or Services
The specific activities and services will be defined based on the results of the planning process.
We anticipate developing a four-module online tutorial to be utilized by staff and volunteers at
the WA Recovery Help Line and WA Poison Center. The tutorials will be developed using the e-
learning platform Articulate which has the capability to insert quizzes, track users, and deliver
content in interactive ways, using images and clips imported from other sources. We plan to
follow up with site visits with our consultants to allow for an open discussion about the topics
addressed.
We anticipate developing a series of webinars or e-learning modules for health care providers,
addressing the topics outlined above, to be utilized by health care providers in WA.
We will also develop a color brochure for the general public, containing lay language and
illustrations, print 5,000 copies, distributed through the ADAI Clearinghouse.
ADAI will host all these resources on the marijuana website and make them freely available to
the general public in Washington. Resources from other states that are considered valuable by
the projects advisory group will be also uploaded, after permission is granted from the
producing agency.


Data from Google Analytics shows that in the first 24 months of operation, the ADAI marijuana
website had 322,140 visits, with 11,990 visitors from Washington. Pages from the site have been
shared 80 times (e.g. reposted to other sites). We believe that with the outreach strategies
outlined above we should be able to generate at least 3,000 new visits from WA to the website
and expect that at least 300 people (10%) would go through some of the online training provided.
Staffing levels and experience
University of Washington
Funds are requested to increase the FTE of Dr. Carlini and Ms. Velotta, and to cover a small
portion of Dr. Roffmans FTE. Requested funds do not supplant or reduce ADAI operating costs
or services, and are not administrative costs.
Beatriz H. Carlini, PhD, MPH is a part-time Research Scientist at the UW Alcohol and
Drug Abuse Institute (ADAI) and will be the project director for this project. Dr. Carlini
coordinated and delivered health care provider training for the WA State Department of Health
(Tobacco Cessation Resource Center) and for the Foundation of Care Management. She was co-
investigator in two health-care provider web-based training programs, aimed to develop
substance abuse screening, brief intervention and referral skills among clinicians. Her research
has focused on clinician education in integrating tobacco cessation into routine care and the use
of technology (telephone, web, Interactive Voice Response) to increase utilization and efficacy
of tobacco dependence treatment, with a focus on underserved smokers.
Nancy Sutherland, MLS and Meg Brunner, MLIS are librarians and information
specialists at ADAI. They have extensive experience in the development and management of a
numerous websites and information systems to disseminate information to a variety of audiences,
including students, researchers, clinicians, and the public. The librarians have developed a
number of special information sites, including the National Drug Abuse Treatment Clinical
Trials Network (CTN) Dissemination Library, the ADAI Screening & Assessment Instruments
Database, and the WA State Substance Use Data & Resources site, which presents statistics and
information by county for the entire state. Other projects include the development and
management of the StopOverdose.org website, developed to inform Washington state residents
about our 911 Good Samaritan Law and to train individuals in preventing and treating opioid
overdose; and the Marijuana: Science-Based Information for the Public web site, developed to
provide current evidence-based information about marijuana to the general public, with special
sections for parents and teens.
Jennifer Velotta, MNPL, CDP, ICPS, Outreach Specialist, will assist the project director
with needs assessment, development and delivery of training for staff and volunteers of the
Recovery Helpline and WA Poison Center. She will also assist in the development of
information materials for the general public. Ms. Velotta is especially suited for these tasks; her
experience includes 6 years as Teen Line Coordinator for the Alcohol & Drug Helpline, and 3.5
years as Tobacco Prevention Coordinator for King County. In 2004, she became Manager of the
WA State Alcohol/Drug Clearinghouse, and continued that role when the Clearinghouse moved
to ADAI in August 2011. For the Clearinghouse, Jennifer selects, develops, and distributes
materials about drug and alcohol abuse for a variety of audiences in Washington.
Dennis M. Donovan, PhD, Professor, UW Dept of Psychiatry & Behavioral Sciences and
Director, UW Alcohol & Drug Abuse Institute will represent ADAI on the Advisory Board
which will assist in setting the direction and policies of this project. Dr. Donovan has extensive
clinical and research experience in the assessment and treatment of alcohol and drug problems,


and in designing and testing science-based interventions. He has been the Director of ADAI
since 1993 and has been a UW faculty member since 1981. Dr. Donovan has served as Principal
Investigator on a number of federally-funded grants, including NIAAAs Project MATCH, the
NIAAA COMBINE Study, and the NIDA National Drug Abuse Treatment Clinical Trials
Network (CTN). He has published more than 230 articles, chapters, and books in the area of
alcoholism and addictive behaviors. Dr. Donovan is also the assistant editor for the Americas for
the journal Addiction, and has served as an ad-hoc reviewer for over 25 other peer-reviewed
journals.
Roger A. Roffman, DSW, professor emeritus, has served on the faculty of the UW
School of Social Work since 1972. One emphasis of Roffmans research has been the design and
evaluation of interventions in the field of substance abuse, with a particular focus on marijuana
dependence. His studies of behavioral counseling interventions focus on supporting adults and
adolescents who desire to change their behaviors. Roffman is co-editor of Cannabis
Dependence: Its Nature, Consequences, and Treatment published in 2006 by Cambridge
University Press. Roffman also maintains a private practice specializing in substance abuse
counseling. Roffman was a co-sponsor of Initiative 502; he has written and lectured frequently
about marijuana to a wide range of audiences. Dr. Roffmans role in the project will be to assist
on developing the training content, particularly about the law and policy in Washington State,
and as a trainer in webinars about marijuana use, dependence and evidence-based interventions.
He will also be part of the advisory group for the project.
Consultant
Gregory T Carter, MD, MS from Providence Medical Group in Southwest WA will
support this project by serving as a consultant, reviewing training and educational materials,
participating in webinars, and writing up cases with examples of clinical uses based on his
numerous years in clinical practice. Dr. Carter is a physiatrist with subspecialty fellowship
training in neuromuscular medicine and chronic pain. He did his pain management fellowship at
the UW. He was one of the principal authors of former Governor Christine Gregoires petition
to the Federal Drug Enforcement Agency to get cannabis rescheduled to a category II drug. Dr.
Carter has advised the DOH in matters of physician behaviors in authorizing medical cannabis.
He is a court-recognized expert witness in the area of cannabinoid pharmacology. Having co-
authored over 157 peer-reviewed journal articles, Dr. Carter has extensive research experience,
with much of his work focusing on the potential role of cannabis as a viable chronic pain
management option for patients with a variety of conditions. Dr. Carter is also on the faculty of
the UC Davis School of Medicine, as well as the UW SOM MEDEX Northwest Division
(previously the Department of Rehabilitation Medicine).
Community Advisory Board Members
Robin Smith, MSW, CDP, Coordinator of the Washington Recovery Help
Line, will represent the WRHP on the Advisory Board which will assist in
setting the direction and policies of this project.
Jim Williams is the Executive Director, WA Poison Center, will represent the
Washington Poison Center on the Advisory Board which will assist in setting the direction and
policies of this project.
Relevance of Project to AGO Funding Objectives
As detailed in the Request for Proposal, this project directly addresses the goals of providing
counseling on chronic pain management to Washington residents. The proposal targets the


gaps in education, training and counseling skills among health care workers and educates the
public on medical cannabis. This focus increases the chances that Washington residents suffering
from chronic pain will be counseled on pain management and medical cannabis based on current
scientific information.
The multiple target groups and modes of education and training we plan to provide at no cost to
community members should allow underserved populations to readily access educational
programming through whatever mechanism best suits their needs. The training and education we
propose, webinar-based, is far less expensive, and potentially more cost-effective than in-person
trainings. Lastly, education on pain management and medical cannabis is a unique and
necessary service to the state, given the epidemic proportion of chronic pain patients in our state
and the legalization of medical cannabis and recreational marijuana in Washington.
Benefits to WA Residents Suffering from Chronic Pain
This project can benefit Washingtonians suffering from chronic pain, especially those afflicted
by intractable pain and those experiencing problems from chronic opioid use:
Patients afflicted by intractable chronic pain are often inadequately treated with available
opiates, antidepressants and anticonvulsant drugs. This type of chronic pain is particularly
common among patients with cancer-associated pain, neuropathic pain, and central pain
states (e.g., pain associated with multiple sclerosis). Medical cannabis can be a beneficial
option for these patients, but they often are not properly counseled about this option given the
lack of training and misconceptions held by health care professionals about cannabis.
Individuals suffering from chronic pain may experience severe problems as a consequence of
chronic opioid-based therapy. These potential problems include not only addiction, but also
behaviors potentially indicative of poor pain control (raising opioid dose on ones own,
which increases risk of overdose) and various forms of abuse and misuse of prescription
opioids (e.g., forging prescriptions, going to multiple doctors to obtain opioids). These
individuals have the right to learn accurate and scientifically updated information about
medical cannabis, from adequately trained health care professionals.
Describe the demographics of the consumers you serve.
Is the population: Statewide
What is the total number of constituents you expect to serve during this grant cycle?
Comprehensive chronic pain and medical cannabis training will be provided and completed by at
least 380 people: 80 through online trainings and 300 web-based. We believe that several
thousand more will view education materials on the marijuana-dedicated ADAI website,
including the archived webinars, request and receive print brochures and obtain counseling and
education about chronic pain and medical cannabis via the WA Recovery Help Line and the
Poison Center and via other health care providers.
Is this a:
X New project
Expansion of existing project (Eligibility considered on a case by case basis)
Enhancement of a current project (Eligibility considered on a case by case basis)
Other: (describe)


Project Date
October 1, 2013 March 31, 2015
Project Budget
Salaries/Benefits: 77,358
Goods and Services (i.e., printing, production, consulting, etc.): 22,144
Advertising/Outreach (directly related to the project): 0
Travel: 770
Administrative Overhead (limited to 10%) 10,027
Total AGO Funding Request: 110,299
What percentage of your total project budget does AGO funding request represent?
100%
List type and amount of other funding sources for this project.
N/A
Does your organization plan to sustain this project upon completion of this contract?
Once training videos and other resources for are developed under this project, ADAI will make
those resources available indefinitely on our existing website.
Findings from the needs assessment and evaluation of the training will inform planning for a
Marijuana Helpline, a new service mandated in Initiative 502 in the following language: A
marijuana use public health hotline that provides referrals to substance abuse treatment
providers, utilizes evidence-based or research-based public health approaches to minimizing the
harms associated with marijuana use, and does not solely advocate an abstinence-only
approach. The new helpline will be funded by revenue from marijuana license and sales and
administered by the DOH.
Assuming that the program is feasible and acceptable based on evaluation findings, we will
submit future grant applications to organizations such as the state DOH, Centers for Disease
Control, National Institute of Health, and Substance Abuse and Mental Health Services
Administration. Preliminary data obtained from the evaluation of the three different education
programs will provide essential information that will significantly increase the odds of funding
success.
Organizational Structure
Administration: Beatriz Carlini, PhD, MPH, Research Scientist, UW Alcohol and Drug Abuse
Institute (bia@uw.edu, 206-616-5880)
Fiscal and Budget: Merrilee Gavigan, Administrator, UW Alcohol and Drug Abuse Institute
(mgavigan@uw.edu, 206-543-1901)
Service Delivery: Beatriz Carlini, PhD, MPH, Research Scientist, UW Alcohol and Drug Abuse
Institute (bia@uw.edu, 206-616-5880)


Community Collaboration
We are partnering with two community organizations in the proposal, The Washington Poison
Center and the Crisis Clinic/ Washington Recovery Help Line (letters of support are attached).
They will participate in this project in two ways:
1) They will be part of the Advisory Board which will assist the project team in setting the
direction and policies of this project.
2) Their respective call centers staff will: a) be consulted in terms of their training needs in
the area of chronic pain and medical cannabis; b) participate in free training, delivered
online or in person, during working hours, addressing chronic pain and medical cannabis
and c) provide feedback on training impact on their knowledge and comfort level in
assisting people with questions related to the training topics.
Project Evaluation
List two goals you expect to achieve as a result of this project.
This project will increase awareness of medical cannabis as an option for treating chronic pain
among citizens of Washington.
This project will provide up-to-date, science-based information via education programs to
increase knowledge and counseling skills among health care professionals and potentially
decrease unnecessary suffering among Washingtonians with chronic pain.
List two outcomes you expect to see as a result of achieving those goals.
Participants in all education programs will significantly improve their knowledge about chronic
pain and medical cannabis at the time of training and in follow-up 30 days later.
Participants in education programs will increase their level of clinical confidence and comfort in
discussing medical cannabis as an option for chronic pain management among the population
they serve.
Describe how you plan to measure and evaluate your project.
The numbers of participants in each education session will be documented. Visitors to the ADAI
marijuana website will be tracked, as will those who view education materials, and who begin
and complete the training modules.
Evaluation will occur at three points:
1. Brief surveys prior to delivering educational programs about knowledge and attitudes to
obtain a baseline measure. (SEE APPENDIX A)
2. Assessment immediately following educational programs knowledge and attitudes.
Planned behavior changes in response to the training will be documented.
3. A subset of those trained will be contacted one month post-training to reassess
knowledge and attitudes. .
For those accessing the web based training we will be able to track web utilization in great detail
including the number of unique and returning visitors, which pages are viewed, and responses to
post-training knowledge assessments.
Have you applied for a similar grant in the past, and if so, to which entity, when, and how
much funding did you apply for?
ADAI received funding from the Attorney General in May 2012 for the amount of $58,712.
That project, Developing Overdose Prevention Programs for Washington State, is ongoing
through August 2013 (see http://stopoverdose.org website). The source of the funds was the
Celebrex CY Pres Grant.
Application Submission Checklist
X Completed, signed and dated application.
X (2) Letters of Support from collaborating organizations
X Current organizational chart
X Evidence of tax status
X Resume for agency director and for lead project staff person
X Budget detail in Excel
I certify that I have the authority to submit this proposal, and that the information in this proposal
is true and accurate. If my organization is faith-based, I understand that federal and state law
prohibit the use of public funds for religious worship, exercise, instruction or support of any
religious establishment.
http://www.acf.hhs.gov/programs/ccb/law/state_faith_based.htm
http://www.leg.wa.gov/LawsAndAgencyRules/constitution.htm
I understand that my organization will not receive reimbursement for any costs incurred in
preparing this proposal. If awarded funding, I understand that our proposal will be incorporated
into the final contract.
Printed Name and Title
Lynette Arias, Director, UW Office of Sponsored Programs
Signature (by entering name
here, form is electronically
signed)
Date
p g
05/16/2013

Northgate Executive Center II | 9725 3rd Avenue NE | Suite 300 | Seattle WA 98115 Phone 206.461.3210 Fax 206.461.8368 Web www.crisisclinic.org


May 14, 2013



Beatriz H. Carlini, Ph.D., MPH
Alcohol and Drug Abuse Institute
University of Washington
1107 NE 45
th
Street, Suite 120
Seattle, WA 98105

Dear Dr. Carlini;

This letter confirms our interest in partnering with University of Washington Alcohol and Drug
Abuse nstitute in the proposal "Chronic Pain Management and Marijuana Use: science-based
education in times of legalization", being submitted to the Attorney General Office.

We understand that one of the goals of this project is to educate our Recovery Specialists,
Mental Health Professionals, Crisis Line volunteer phone workers and Crisis Clinic staff on
chronic, acute and intractable pain as well as on medical cannabis indications to manage
chronic pain. The training will include the risks and counter-indications of medical cannabis,
interactions with other substances, Marijuana dependence and abuse, among other topics
selected.
Crisis Clinic offers telephone-based crisis intervention and information and referrals to
community services for youth and adults in Seattle-King County, WA. The Washington
Recovery Help Line (WRHL) is a 24-hour help line that provides emotional support and
linkage to local treatment resources for individuals struggling with substance abuse, problem
gambling and mental health issues. Thus, Crisis Clinic is accredited by Washington State as
a chemical dependency provider. Since the WRHL started in July 2011, we have received
1,357 calls about marijuana and another 4,337 calls related to prescription and over-the-
counter medications. We anticipate an increase in calls related to medical cannabis as our state
residents become more comfortable in discussing this topic with the recent approval of I-502.
We will be involved in this project in two ways:

1. Robyn Smith, MSW, CDP, WRHL Coordinator, will be our
representative to serve on the Advisory Board which will assist in
setting the direction and policies of the project.

2. Our call center staff will be consulted in terms of their training needs in the area of
chronic pain and medical cannabis and will receive free training, delivered online or in
person, during working hours, as part of this project. They will also be invited to
provide feedback on training impact on their knowledge and skills to assist people
with questions in this area.



Northgate Executive Center II | 9725 3rd Avenue NE | Suite 300 | Seattle WA 98115 Phone 206.461.3210 Fax 206.461.8368 Web www.crisisclinic.org
We request $2,500 to partially compensate our agency for the extra staff hours needed in order
not to disrupt our existing services. Our participation and support to this project is not contingent
on this fee.

We are excited to be part of this project and look forward to collaborating further. If you have
any questions, do not hesitate to contact me at ksouthwick@crisisclinic.org or 206-436-2980.


Cordially,



Kathleen Southwick
Executive Director








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Beatriz H. Carlini, Ph.D., MPH
Alcohol and Drug Abuse Institute
University of Washington
1107 NE 45th Street, Suite 120
Seattle, WA 98105
Dear Dr. Carlini:
I am most honored by your invitation to participate in your project "Chronic Pain Management
and Marijuana Use: science-based education in times of legalization", which aims to provide training to
health services workers and the general public about chronic pain management and marijuana. My reply
is a fervent Yes, I would be honored to assist you!
You have my complete and enthusiastic endorsement and I will support this project by
reviewing training and educational materials, participating in webinars, writing up of cases showing
examples of clinical uses, based on my clinical experience. You will be able to use this and other
materials I may provide, in the training program that you are developing. I do believe my research and
scientific writing skills will be of significant value to you as you carry out this grant project.
For the purposes of supporting your grant, I will provide more of my background here for you.
As you know I have a strong interest in this area, and my medical training is in physiatry, with
subspecialty fellowship training in neuromuscular medicine and chronic pain. I did my pain management
fellowship training at the University of Washington under the tutelage of Dr. John Loeser. I have worked
closely with the State of Washington previously in this area as I was one of the principle authors of
former Governor Christine Gregoires petition to the Federal Drug Enforcement Agency to get cannabis
(marijuana) re-scheduled to a category II drug. I have also advised the Department of Health in matters
relating to physician practices in this area and I am a court-recognized expert witness in the area of
cannabinoid pharmacology, testifying on behalf of the State of WA as well as private citizens,
I have extensive research experience, having currently co-authored 157 peer reviewed journal
publications. Many of these publications examine the potential role of cannabis as a viable chronic pain
management option for patients with neuromuscular disease, including amyotrophic lateral sclerosis
(ALS), Charcot Marie Tooth disease (CMT) and various forms of muscular dystrophy, among others. I
was the first investigator to report the effectiveness of cannabis in treating ALS and I was also among the
first investigators to document the severity of pain associated with these disorders, most of which had
previously been described in medical texts as "painless." For this work I was honored this past year by
receiving the Distinguished Researcher Award from the American Association of Neuromuscular and
2
Electrodiagnostic Medicine. I am also a past recipient of the Best Research Paper Award from the
American Academy of Physical Medicine and Rehabilitation (PM&R). Thus I believe I can bring some
valuable skills assist you with this project, which aims to develop and delivers training and educational
materials about chronic pain and cannabis to health services workers and the general public. This project
has the potential to improve the quality of life of tens of thousands of people living with chronic pain,
which I find extremely valuable and important. As you well know this is an area surrounded by
prejudice, misconception and gross misinformation. The recent legalization of marijuana use for
recreational purposes will likely make the discussion of this topic a more frequently occurring event
among patients and local and statewide health services providers. The medical/health care community
needs to be better prepared to address it.
In return for my services I would request co-authorship on publications that arise from this
project, of which I will assist in the writing and editing of, as well as submitting to medical journals. I
also request a $3,000 (three thousand dollars in US funds) consultant fee. Knowing your background and
skills, I have no doubt you will be successful with this project and I very much look forward to being a
part of it. I am also enclosing a CV with this letter.
With warm regards,

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Gregory T. Carter, MD, MS
Contact information:
(360) 330-8626 [main office]
(360) 388-0534 [cell phone/pager]
gtcarter@uw.edu [academic e-mail]
gregory.carter@providence.org [clinic e-mail]
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Beatriz H. Carlini
May 2013
bia@u.washington.edu
Education
2005 - Master of Public Health, University of Washington, Department of Health
Services, Social and Behavioral Sciences track.

1993-1995 - Post-Doctoral Training, Boston University School of Public Health Social
and Behavioral Sciences Department, Boston, MA, USA
1986-1992 - Ph.D., Social Psychology, Pontifcia Universidade Catlica, So Paulo,
Brazil
1976-1980 - B.A., Universidade de So Paulo, So Paulo, Brazil. Major in Social
Sciences
Academic Positions and Employment
Research Scientist, Alcohol and Drug Abuse Institute, University of Washington,
Seattle, Washington; August 2010 present
Associate Investigator, Clinical and Behavioral Sciences Department, Alere
Wellbeing (formerly Free & Clear Inc.)
Seattle, Washington; September 2009 present
Research Scientist, Clinical and Behavioral Sciences Department, Free & Clear
Inc.
Seattle, Washington; September 2005 August 2009
Contractor, Research and Design Department, at Free & Clear Inc.
Seattle, Washington, February to August 2005
Graduate Research Assistant, Department of Psychiatry and Behavioral
Sciences, University of Washington.
Seattle, Washington; January to December 2006
Assistant Professor, Department of Preventive Medicine University of So
Paulo School of Medicine, So Paulo, Brazil
So Paulo, SP, Brazil; September 1997 to January 2000
Researcher, CEBRID (Brazilian Center on Drug Information) Psychobiology
Department, Federal University of So Paulo .
So Paulo, Brazil; 1986 - 1996
Scholarships
2004 - Tobacco Scholarship in Public Health - American Legacy Foundation and
University of Washington, School of Public Health. Support for tobacco-related studies
during MPH training.
2003 - Tobacco Scholarship in Public Health - American Legacy Foundation and
University of Washington, School of Public Health. Support for tobacco-related studies
during MPH training.
1993-95 CNPq - Conselho Nacional de Pesquisa. Scholarship to pursue Pos-
Doctoral Training at Boston University School of Public Health.
1991-92 CNPq - Conselho Nacional de Pesquisa. Scholarship to pursue Doctoral
Degree in Social Psychology at Pontifcia Universidade Catlica.
Teaching and mentoring experience
2010 - 2011 - Systems Change Specialist
Contract with Foundation of Care Management: Training and Mentoring of 3 rural
clinical teams in Alaska, Washington and Oregon State. Goals: needs assessment,
plan and implement changes aimed to integrate tobacco use and cessation in the
routine of care.
2005- 2008 Training and Systems Change Coordinator
Contract with Tobacco Cessation Resource Center (TCRC), Washington State
Department of Health: Mentoring of 6 health care staff teams in Washington-based
clinics and hospitals. Goals: needs assessment, plan and implement changes aimed
to integrate tobacco use and cessation in the routine of care.
1998-2001 - Advisor
PhD Student Cynthia Gazal Carvalho, Preventive Medicine Department, University of
So Paulo School of Medicine
1999-2000 - Advisor
Master of Sciences student Paulina Duarte, University of So Paulo School of
Medicine.
2001-2005 - Advisor
PhD student Paulina Duarte, University of So Paulo School of Medicine
2001 to 2005 - Instructor
Drug Abuse Specialist Degree, Catholic University of Paran, Curitiba, Brazil.
1997-2001 - Instructor
Course - Health Services in Brazil for Medical Students, 3
rd
semester.
Preventive Medicine Department, University of So Paulo School of Medicine.
Grants Received
2011 - 2012
Principal Investigator
ADAI Small Grants Program
University of Washington
Using the Internet to Recruit Immigrants with Limited English Proficiency for Tobacco
Use and Alcohol-Related Disorders Screening: A Pilot Study Among Brazilian
Immigrants.
2009- 2012 (no cost extension)
Principal Investigator
5 R21 CA141568-02 (Carlini)
NIH/NCI
Re-Engagement in Evidence-Based Quitline Treatment for Low Income Smokers
The purpose of this proposed study is to develop, refine and test the use of IVR
technology as a means of increasing re-engagement of low income smokers in
telephone support for tobacco cessation (quitlines).
2009- 2014
Co-investigator
5 R01 CA138936-02 (McDaniel)
NIH/NCI
Technology-Enhanced Quitline Services to Prevent Smoking Relapse
The purpose of this study is to test the efficacy of IVR technology for enhancing
telephone-based smoking cessation services to prevent smoking relapse and
achieve abstinence interventions.
2011- 2016
Co-Investigator
1 R01 CA152093-01A1 (McIntosh)
NIH-NCI
Web-Assisted Tobacco Intervention with Community College Students
The proposed study combines mixed methods of qualitative and quantitative
research with a group randomized design to test the effectiveness of Web-Assisted
Tobacco Interventions (WATI) with Community College students in Western New
York.
2010- 2014
Co- Investigator
1 U01 HL105232-01 (Richter)
NIH/NHLBI
Increasing Post-discharge Follow-up Among Hospitalized Smokers
The primary aim of this project is to test the effects of warm transfer versus fax
referral on quitline enrollments, post-discharge counseling adherence and smoking
cessation. The secondary aim of this project is to determine mediators of the
treatment effects on enrollment, post-discharge counseling and cessation.
2009 - 2011
Co- Investigator
271200900035C-2-0-1 (Stoner)
NIDA/SBIR
SBIRT, Screening, Briefly Intervene and Referral to Treatment
The goal of the present project is to develop a web-based training program to
instruct PCPs in screening, risk assessment and intervention for substance use
disorders, SBIRT-PC.
2010 - 2012
Associate Director and Health System Specialist
(Halperin)
Public Health - Seattle & King County
Smokefree Hospitals Initiative
The goals of this project are support the institution of 100% smoke-free campus
policies at University of Washington Medical Center (UWMC) and all other King
County hospitals and affiliated clinics without an existing policies and pilot a systems
change project to integrate evidence-based treatment of tobacco use and
dependence at the UWMC campus that can be used as a basis for programs at
other hospitals.
2008 - 2009
Co-Investigator
PHS 2007-01 - CDC SBIR
Centers for Disease Control and Prevention
Increasing Quitline Utilization with Multimedia Education, Phase II
Principal Investigator: Kelly Carpenter
2007
Co-Investigator
PHS 2007-01 - CDC SBIR
Centers for Disease Control and Prevention
Increasing Quitline Utilization with Multimedia Education, Phase I
Principal Investigator: Kelly Carpenter
2005 - 2007
Co-investigator
NIH P30 CA023100-22
National Cancer Institute.
Reach and Assist Underserved Smokers through Quitlines.
Principal Investigator: Shu Hong Zhu
1999 - FAPESP Fundao de Amparo Pesquisa do Estado de So Paulo
Support for a Visiting Professor at University of So Paulo Preventive Medicine
Department. (1999/01751-0)
1996-98 Principal Investigator - FAPESP
Fundao de Amparo Pesquisa do Estado de So Paulo.
Alcohol and solvents related problems among youth: mortality, psychiatry morbidity,
intoxication, accidents and social problems.
1997 - WHO World Health Organization - Program on Substance Abuse - Project:
Alcohol-related injuries in So Paulo city, 1994-95.
Publications and Papers
B. Journal Articles and Chapters in English
1. Cerutti B, Stratton RM, Carlini BH, McDaniel AM, Kauffman RM. (2013)
Utilization of interactive voice response (ivr) technology in clinical trials: what
you should consider when selecting a vendor. Journal of Society of Clinical
Research Associates;75:11-14.
2. Richter KP, Faseru B, Mussulman LM, Ellerbeck EF, Shireman TI, Hunt JJ,
Carlini BH, Ayars CL, Cook DJ, Preacher KJ. (2012) Using "warm handoffs"
to link hospitalized smokers with tobacco treatment after discharge: Study
protocol of a randomized controlled trial. Trials. 2012 Aug 1;13(1):127.
DOI:10.1186/1745-6215-13-127
3. Carlini BH, Ronzani TM, Martins LF, Gomide HP, de Souza IC. Demand for
and availability of online support to stop smoking. Rev Saude Publica. 2012
Dec;46(6):1074-81. PubMed PMID: 23503543.
4. Carpenter KM, Carlini BH, Painter I, Mikko AT, Stoner SA. (2012).
Refer2Quit: Impact of web-based skills training on tobacco interventions and
quitline referrals. Journal of Continuing Education in the Health Professions
32:3: 187-95 DOI: 10.1002/chp.21144.
5. Carlini BH, McDaniel AM, Weaver MT, Kauffman RM, Cerutti B, Stratton RM,
Zbikowski SM.(2012) Reaching out, Inviting back: Using Interactive Voice
Response (IVR) technology to recycle relapsed smokers back to Quitline
treatment a randomized controlled trial. BMC Public Health 12(1):507. doi:
10.1186/1471-2458-12-507.
6. Witkiewitz K, Bush T, Magnusson B, Carlini BH, Zbikowski S. (2011)
Trajectories of cigarettes per day during the course of telephone tobacco
cessation counseling services: A comparison of missing data models.
Nicotine & Tobacco Research Advance Access published December 16,
2011 doi: 10.1093/ntr/ntr291.
7. Stoltzfus K, Ellerbeck EF, Hunt S, Rabius V, Carlini B, Ayers, C, & Richter KP
(2011). A pilot trial of proactive versus reactive referral to tobacco quitlines.
Journal of Smoking Cessation, 6(2), 133137. DOI 10.1375/jsc.6.2.133.
8. Carlini BH, Schauer, G, Zbikowski, S, Thompson, J. (2010) Using the Chronic
Care Model to address tobacco in health care delivery organizations: a pilot
experience in Washington State. Health Promotion Practice 15, 401-408.
9. Carlini BH, B, Zbikowski S, Javitz H, Deprey TM, Cummings S, Zhu S
Telephone-Based Tobacco Cessation Treatment: Re-enrollment Among
Diverse Groups. (2008) American Journal of Preventive Medicine. 35(1): 73-
76.
10. Carlini BH, Patrick D; Santos V & Halperin A (2006) The Tobacco Industrys
Response To The Commit Trial: An Analysis Of Legacy Tobacco Documents.
Public Health Reports 121:501-508.
11. Carlini-Marlatt B, Gazal-Carvalho C, Gouveia N & Marinho F. (2003). Drinking
Practices and Other Health-Related Behaviors among Adolescents of So
Paulo city, Brazil. Substance Use and Misuse 38(7): 905-932.
12. Medina-Mora ME; Carlini-Cotrim B & Madrigal E (2000) Alcohol Policies in
developing countries: Latin America. Journal of Substance Use 5 (1): 47-55.
13. Room R, Carlini-Cotrim B, Gureje O, Jernigan D, Mkel K, Marshall M,
Monteiro M, Medina-Mora ME, Parry C, Partanen J, Riley L & Saxena S.
(2000) Alcohol Policies in developing societies: perspectives from a project.
Journal of Substance Use 5: 2-5.
14. Carlini-Cotrim B; Chasin, AAM. (2000) Blood alcohol content (BAC) and
deaths from external causes: A study in the Metropolitan area of So Paulo,
Brazil Journal of Psychoactive Drugs 32(3): 269-275.
15. Carvalho VA; Pinsky ; Souza e Silva R; Carlini-Cotrim B. (1995) Drug and
alcohol use and family characteristics: a study among Brazilian high-schools
students. Addiction 90:65-72.
16. Carlini-Cotrim B. Inhalant use among Brazilian youths (1995) In: Epidemiology
of inhalant abuse: an international perspective. NIDA Research Monograph 148.
17. Carlini-Cotrim B; Coelho G (1994-95). Identifying Risk Factors for Drug Abuse
Among Portuguese Speaking Youth in the Boston Area: A Preliminary
Assessment Using Key Informant Networks. International Quarterly of
Community Health Education 15(3): 267- 277.
18. Carlini-Cotrim B. (1994) An Overview on Drug Abuse Prevention in Brazilian
Schools. Drugs: Education, Prevention & Policy 1(3): 275-288.
19. Caetano R & Carlini-Cotrim B (1993). Perspectives on Alcohol Epidemiology
Research in South America. Alcohol Health and Research World17(3): 244-250.
20. Carlini-Cotrim B; Carvalho V (1993). Extracurricular activities: are they an
effective strategy against drug consumption? Journal of Drug Education 23(1):
97-104.
21. Carlini-Cotrim B. (1993) An overview on drug abuse prevention in Brazilian
schools. In: Monteiro, M.G. & Inciardi, J. (eds.), Brazil-United States Binational
Research (So Paulo, Brasil: CEBRID).
22. Carlini EA ; Carlini-Cotrim B. (1993). Illicit use of Psychotropic substances
among Brazilian students: 1987 and 1989 surveys. In: Monteiro, M.G. e Inciardi,
J. (eds.), Brazil-United States Binational Research (So Paulo, Brasil; CEBRID).
23. Carlini-Cotrim B & Rosemberg F (1991) Dealing with psychotropic drugs in
school textbooks: the case of Brazil. Contemporary Drug Problems Fall: 417-
432.
24. Carlini EA; Carlini-Cotrim B ; Nappo S. (1990). Illicit use of Psychotropic Drugs
in Brazilian cities:1987-1989, Epidemiologic Trends in Drug Abuse, NIDA, USA.
25. Carlini-Cotrim B e Carlini EA (1988). The use of solvents and other drugs
among children and adolescents from a low socioeconomic background. A
study in So Paulo, Brazil. International Journal of the Addictions. 23(11):
1145-1156.
26. Carlini-Cotrim B e Carlini, E.A. (1988). The use of solvents and other drugs
among homeless and destitute children living in the streets of So Paulo city,
Brazil. Social Pharmacology. 2(1): 51-62.
27. Carlini BH; Pires, MLN, Fernandes R; Masur J(1986). Alcohol use among
adolescents in So Paulo, Brazil. Drug and Alcohol Dependence 18: 235-246.
Presentations in scientific meetings in North America (2005 to date)
Oral Presentation- McDaniel AM, Carlini BH, Stratton RN, Cerutti B, Monahan PO,
Stump, Kauffman RM, Zbikowski SM. Automated Telephone Monitoring for Relapse
Risk among Recent Quitters Enrolled in Quitline Services. 2011 Society for
Research on Nicotine and Tobacco (SRNT) 17th Annual Meeting, Toronto, Ontario,
Canada February 16 - 19, 2011
Poster - Carlini BH; Ronzani TM; Souza ICW and Gomide H. Web-Assisted
Tobacco Interventions (WATIs) beyond mainstream languages: A review of support
available for Brazilian smokers who want to quit. Consortium of Universities on
Global Health (CUGH) 2010 Annual Meeting, Seattle, Washington, September 19th -
21
st
, 2010.
Poster Carpenter K, Carlini BH, Dolan E & Mikko T. Refer2Quit: Web-based
provider training in tobacco Quitline referral skills. Society of Behavioral Medicine
Annual Meeting, Seattle, April, 2010.
Poster - Carlini BH, Schauer G, Zbikowski S & Thompson J. Integrating Tobacco
Cessation Interventions into the Routine of Care in Rural Settings. The Value of
Prevention: American College of Preventive Medicine 2009 Conference: Poster #39;
February 11, 2009.
Oral Presentation Carlini BH; Schauer GS, Zbikowski S and Thompson J.
Addressing Tobacco Identification and Treatment in Health Delivery Organizations: A
Pilot Experience. Society of Behavioral Medicine Annual Meeting, San Diego, May
2008.
Oral presentation Carlini BH, Yepassis-Zembrou P, Mahoney L, Padilla J , Heilman
NJ and Adondakis S. Hispanics and non-Hispanic quit rates among participants of
New Mexico Helpline, National Conference on Tobacco or Health, Minneapolis,
October 2007.
Poster Carlini B, Zbikowski S, Deprey M, Zhu SH and Cummins S. Testing Methods
for Re-engaging Smokers in Cessation Treatment. National Conference on Tobacco
or Health, Minneapolis, October 2007.
Oral Presentation Carlini B, Carpenter K. Using the Web to Build Referral Skills
among Clinicians. North American Quitline Consortium Annual Meeting, Minneapolis,
October 2007.
Panel/Oral Presentation - Carlini BH, Zbikowski S, Deprey M, Zhu SH and Cummins
S. Testing Methods for Re-engaging Smokers in Cessation Treatment. North
American Quitline Consortium Annual Meeting, Minneapolis, October 2007.
Poster Carlini BH, Bush T, Stewart T, Zbikowski S, Padilla P and Adondakis S.
What does this have to do with quitting smoking? Push & pull of asking sensitive
questions of callers seeking tobacco treatment through Quitlines World Conference
on Tobacco or Health, Washington DC, May 2006.
Poster Carlini BH, Halperin A, Santos V and Patrick D. The tobacco industrys
response to the commit trial: an analysis of legacy tobacco documents, Washington
DC, May 2006.
Panel/Oral presentation You can hear the kids in the background: A qualitative
study of QuitLine participants from Latino descent. National Conference on Tobacco
or Health, Chicago, May 2005.
Selected Presentations in International meetings and events (2000 to date)
Key Note speaker Online interventions. Third Congress of Multidisciplinary
Association for Drug Studies (ABRAMD), Bento Gonalves, Rio Grande do Sul, Brazil,
November 1, 2011.
Oral Presentation - Carlini BH, McDaniel A, Cerutti B, Kauffman R, Weaver M,
Stratton R, Zbikowski S. Reaching out, inviting back - Using Interactive Voice
Response (IVR) technology to recycle low income relapsed smokers back to
treatment a randomized control trial. 2011 UK National Smoking Cessation
Conference, London, England, June 13
th
14
th
, 2011.
Invited Speaker - E-Health Health interventions in the digital era.
Social Psychology and Public Health Seminar, Federal University of Juiz de Fora.
November 23
rd
, 2009. Juiz de Fora, Minas Gerais, Brazil.
Invited Speaker - Phone-based support for tobacco cessation state of the art
Federal University of Health Sciences of Porto Alegre.
November 26st, 2009. Porto Alegre, RS, Brazil.
Invited Speaker - Prevention state of art. First Congress of ABRAMD (Associacao
Brasileira de Estudos Multidisciplinares sobre drogas), August 6
th
2008, So Paulo, SP,
Brazil.
Invited Speaker - Experience of Quitline Networks in North America in Using Phone
Quitlines to support smoking cessation experiences in Latin America and North
America session. First Latin American SRNT Congress and Second Iberoamerican
Conference on Tobacco Control, , September 7
th
, 2007, Rio de Janeiro, Brazil.
Invited Speaker Drug Abuse Prevention state of the art . Forum Nacional sobre
Drogas, SENAD, Braslia, DF, Brazil (National Drug Forum, by National Anti-Drug
Secretary), November 24th, 2004, Brasilia, DF, Brazil
Invited Speaker - Harm Reduction August 18-19
th
2001, Sociedad Chilena
Psicoterapia de Familia, Santiago, Chile.
Invited Speaker - Alcohol and Youth. First International Symposium on Alcohol,
Tobacco, Drugs and Health. June 1-3, 2000, Lisbon, Portugal.
Invited Speaker - Substance abuse prevention myths and reality. First International
Symposium on Alcohol, Tobacco, Drugs and Health. June 1-3, 2000, Lisbon, Portugal.
International Initiatives
2009 Temporary Advisor World Health Organization, Department of Mental Health
and Substance Abuse (MSD)- E-Health and Substance Abuse, October 14-19.
Role as temporary advisor included a) discuss the implementation of the project E-
health and Substance Abuse to develop, test and disseminate eHealth technologies
in the area of substance abuse and b) exchange recent experience and best
evidence in e-health and examine the feasibility of pilot eHealth portals on substance
abuse in Brazil, Mexico, Belarus and India.
2008 Peer Grant reviewer ZonMw, Netherlands (http://www.zonmw.nl/en)
1994-current Advisor
Scientific Advisory Network (SAN), MENTOR Foundation International
Non-profit organization with mission to prevent substance abuse among youth
(www.mentorfoundation.org)
Involves working with a multi-country group of experts to advice where and how to
invest resources globally.
2005-2006 Consultant
Best Practices Initiative.
Mentor Foundation International.
Available at http://www.mentorfoundation.org/towards_best_practice.php
This initiative aimed to illustrate evidence-based principles of substance abuse
prevention projects using real-world examples. My responsibilities included establish
contacts with more than 200 community organizations around the world, select best
35 projects and develop description of them in partnership with each work team site.
Special emphasis was given to highlight initiatives in developing societies.
2005 Contractor
Grandparents Project.
Mentor Foundation UK, Adfam and GrandParents Plus
Develop literature review presenting the state of the art on tools to support
grandparents raising their grandkids, due to the absence of the biological parents.
More details at http://www.mentorfoundation.org/projects.php?pg=1&id=91
2004-2006 Project leader
Join initiative Catholic University of Paran, Curitiba, Brazil and Centre of Addiction
and Mental Health, Toronto, Ontario, Canada.
Coordination of website localization (www.virtual-party.org) to Brazilian teenagers.
Activities included supervision of six Brazilian professionals and 4 Canadians in
website translation, administration of surveys and focus groups among Brazilian
youth, data analysis and development of a teacher workbook on how to use this
prevention resource in Brazil. The web site is now available in Portuguese at
http://www.pucpr.br/template.php?codlink=178
2005- Contractor
National Anti-Drugs Secretary of Brazil (SENAD), Brasilia, Brazil
Develop educational materials for parents, teachers, primary care providers,
community leaders and adolescents on substance abuse issues, including tobacco
and alcohol.
The publications are available on line at http://www.senad.gov.br/ (click
Publicacoes)
2005 Member of Scientific Committee for the 1
st
Pan American Conference on
Alcohol Policies, 28-30
th
November 2005, Brasilia, Brazil.
2003 - 2005, Coordination of partnership between Office of International Health,
Centre of Addiction and Mental Health (CAMH), in Canada and Catholic University of
Paran, Curitiba, Brazil.
Leadership on establishing an exchange program of professionals and graduate
students between the two organizations, aiming to opportunities of international
exposure to Brazilian and Canadian health professionals on substance-abuse
issues.
2003, Site visit coordination of Office of International Health Centre of Addiction and
Mental Health (CAMH), Toronto Canada to Brazil.
Included making contacts, organizing agenda and facilitating meetings between CAMH
and Brazilian universities, research centers and federal government aimed to explore
partnerships on tobacco, alcohol and substance abuse education, prevention and
research.
2000 2002, Coordination and technical supervision
Hospital Albert Einstein, Sao Paulo, Brazil.
Idealization, content development and update of Portal www.einstein.br/alcooledrogas.
This portal was the first of its kind in Brazil and had modules target to 3 different
audiences: teachers (on-line drug education training), adolescents (editorials, on-line
party, ask the expert) and health professionals (weekly updates on scientific findings).
2001 2002, Senior Technical Advisor, MENTOR Foundation International
Technical Development of Information Centre (IC) at portal www.mentorfoundation.org
This IC aims to promote exchange of information on substance abuse prevention and
health promotion among adults who work with youth around the world
1998-99 -President of Scientific Committee of the 13th Meeting of Brazilian Association
of Alcohol and Other Drugs (ABEAD) ,August 15
th
-19th, Rio de Janeiro, 1999.
1999, Consultant
UNDCP (United Nations Drug Abuse Control Program).External evaluator of Project
AD/BRA/96/C88 Drug Use Prevention Program for Street children and adolescents
1996- 1999 - Member, Editorial Group.
APDS - Alcohol Policies in Developing Societies, Program on Substance Abuse/World
Health Organization.
Worked as member of editorial group representing 13 developing countries in the
Americas, Asia and Africa. During these 4 years, the editorial group reviewed scientific
evidence of effective policies on alcohol control, conducted site studies and wrote a
book for policy makers of evidence-based policies for alcohol control in developing
societies (see book citation in publication section).
1994-1995 - Temporary Advisor
World Health Organization, Substance Abuse Department, Social Change and Mental
Health (Obligation HQ/95/042834)
Development of theoretical framework and guidelines for action to prevent inhalant
abuse among children and adolescents from developing societies
The project is published at Volatile Solvent Use a strategy for community
involvement. (1999). World Health Organization, Substance Abuse Department, Social
Change and Mental Health, Geneva (WHO/HSC/SAB/99.8), 23 pages
Professional Offices Held
Vice-President (1991-1993 and 1997- 1999)
Brazilian Association on the Studies of Alcohol and Other Drugs (ABEAD)
Peer reviewer of scientific journals
! Addictive Behaviors (USA)
! American Journal of Preventive Medicine (USA)
! Nicotine & Tobacco Research (USA)
! Psychology of Addictive Behaviors (USA)
! Journal of Health Psychology (USA)
! Journal of Clinical Psychology in Medical Settings (USA)
! Cadernos de Sade Pblica (Brazil)
! Revista de Sade Pblica (Brazil)
BIOGRAPHICAL SKETCH
Provide the following information for the Senior/key personnel and other significant contributors.
Follow this format for each person. DO NOT EXCEED FOUR PAGES.
NAME
Donovan, Dennis M.
POSITION TITLE
Professor
eRA COMMONS USER NAME (credential, e.g., agency login)
ddonovan
EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as nursing, include postdoctoral training and
residency training if applicable.)
INSTITUTION AND LOCATION
DEGREE
(if applicable)
MM/YY FIELD OF STUDY
Seattle University, Seattle, WA B.S. 06/70 Psychology
Western Washington University, Bellingham, WA M.A. 12/72 Psychology
University of Washington, Seattle, WA Ph.D. 12/80 Clinical Psychology
A. PERSONAL STATEMENT
Dennis Donovan, Ph.D. is the director of the Alcohol and Drug Abuse Institute at the University of Washington
(UW) and Professor in the Department of Psychiatry and Behavioral Sciences. Dr. Donovan has over 30 years
experience as a direct service provider, clinical trainer and supervisor, program administrator, and clinical
researcher in the alcohol and drug dependence field. He has expertise in assessment of addictive behaviors;
screening, brief interventions and referral to treatment for alcohol and drug problems in medical settings;
motivational and cognitive-behavioral interventions such as motivational interviewing, motivational
enhancement, and relapse prevention therapies; mindfulness approaches; client-treatment matching;
treatment outcome evaluation; clinical trials methodology; and services research. He has participated in
development and manualization of behavioral prevention and treatment interventions and measures of
treatment integrity, therapist competence, and implementation fidelity. He has been the site PI in a number of
large-scale multisite clinical trials, including the NIAAA-funded Project MATCH and COMBINE Study. He has
also been involved in NIAAA- and NIDA-funded trials of screening, brief intervention, and referral to treatment
(SBIRT) targeting hazardous drinking and illicit drug use in primary care, trauma center, and emergency
department settings. He is a PI of the Pacific Northwest Node and Regional Research and Training Center of
the National Institute on Drug Abuse (NIDA) National Drug Treatment Clinical Trials Network (CTN), which
translates efficacious, evidence-based substance abuse interventions to community-based treatment programs
and providers where their effectiveness is evaluated. He will serve as a member of the proposed projects
Advisory Board and will provide expertise in every aspect of the study as a senior scientist in alcohol and drug
use research. Specifically, he will collaborate on study and training design, training delivery, program
evaluation, planning of analyses, interpretation of study results, contributing to the manuscripts, and
dissemination of study findings.
B. POSITIONS AND HONORS
1981 present Assistant Professor (1981-1984), Associate Professor (1984-1994), Professor (1994-present),
Department of Psychiatry & Behavioral Sciences, UW School of Medicine, Seattle
1981 1986 Assistant Chief, Alcohol Dependence Treatment Program, Seattle VA Medical Center, Seattle
1985 1991 Chief, Inpatient Section, Addictions Treatment Center, Seattle VA Medical Center, Seattle
1985 1992 Field Editor for Neuropsychology, Journal of Studies on Alcohol
1985 1998 Member, Editorial Board, Journal of Studies on Alcohol
1987 1993 Assistant Director, Addictions Treatment Center, Seattle VA Medical Center, Seattle
1987 1991 Member, NIAAA Clinical & Treatment Alcohol Psychosocial Research Review Group (IRG)
1988 present Adjunct Associate Professor (1988-1994), Adjunct Professor (1994-present), Department of
Psychology, University of Washington, Seattle
1988 1990 Secretary-Treasurer, Society of Psychologists in Addictive Behaviors
1989 1998 Principal Investigator, Seattle Clinical Research Unit, Matching Alcoholism Treatments to
Client Heterogeneity (Project MATCH), National Institute on Alcohol Abuse and Alcoholism
1990 1992 Associate Editor, Psychology of Addictive Behaviors
1991 1992 President, Society of Psychologists in Addictive Behaviors
1991 1996 Director, Interdisciplinary Fellowship Training Program in Substance Abuse Treatment,
Addictions Treatment Center, Seattle VA Medical Center, Seattle
1993 1996 Associate Director, Center of Excellence in Substance Abuse Treatment and Education,
Addictions Treatment Center, Seattle VA Medical Center, Seattle
1993 present Director, Alcohol and Drug Abuse Institute, University of Washington, Seattle
1996 1997 Acting Director, Center of Excellence in Substance Abuse Treatment and Education,
Addictions Treatment Center, Seattle VA Medical Center, Seattle
1997 1998 Member, NIDA AIDS Behavioral Research Review Committee (IRG)
1997 2007 Principal Investigator, Seattle Clinical Research Unit, Pharmacological and Behavioral
Treatment with Alcoholics (COMBINE), National Institute on Alcohol Abuse and Alcoholism
1998 2007 Member, Scientific Advisory Panel, Hazelden Foundation, Hazelden Institute - Butler Center
for Research and Learning, Center City, MN
1999 present Fellow, Division 50 (Addictions), American Psychological Association (APA)
2001 present Principal Investigator and Director, Pacific Northwest Node and Regional Research and
Training Center, NIDA National Drug Abuse Treatment Clinical Trials Network, University of
Washington
2002 present Assistant Editor, Addiction
2005 2009 Consulting Editor, Psychology of Addictive Behaviors
2009 present Fellow, Division 28 (Psychopharmacology & Substance Abuse), APA
2011 present Member, Editorial Board, Journal of Addiction Research & Therapy
2011 present Board Member, Science and Management of Addictions Foundation, Seattle
Honors and awards
Graduated summa cum laude, Seattle University, 1970; Alpha Sigma Nu (Jesuit Universities National Honor
Society), 1969-1970; Outstanding Young Man of America, U.S. Jaycees, 1977; Certificate of Merit, Third
Annual Government Employees Insurance Company (GEICO) Public Service Award Program in Alcoholism,
1983; Professional Services Award, Association of Veterans Administration Chief Psychologists, 1984; Elected
member, International Committee on Alcohol, Drugs and Traffic Safety, 1992
C. SELECTED PEER-REVIEWED PUBLICATIONS
Most recent (from a total of 185 peer-reviewed articles, 35 book chapters, and 5 books)
1. Donovan, D.M., Bigelow, G.E., Brigham, G.S., et al. Primary outcome indices in illicit drug dependence
treatment research: Systematic approach to selection and measurement of drug use endpoints in clinical
trials. Addiction, 107(4): 694-708, 2012.
2. Price, C.J., Wells, E.A., Donovan, D.M., & Brooks, M. Implementation and acceptability of Mindful
Awareness in Body-oriented Therapy in women's substance disorder treatment. Journal of Alternative and
Complementary Medicine, 18(5): 1-9, 2012.
3. Donovan, D.M., & Witkiewitz, K. Relapse prevention: From radical idea to common practice. Addiction
Research and Theory, 20(3), 204-217, 2012.
4. Price, C.J., Wells, E.A., Donovan, D.M., & Rue, T. Mindful Awareness in Body-oriented Therapy as an
adjunct to womens substance use disorder treatment: A pilot feasibility study. Journal of Substance
Abuse Treatment, 43(1): 94-107, 2012.
5. Witkiewitz, K., Donovan, D.M., & Hartzler, B. Drink refusal training as part of a combined behavioral
intervention: Effectiveness and mechanisms of change. Journal of Consulting and Clinical Psychology,
80(3): 440-449, 2012.
6. Donovan, D.M., Bogenschutz, M.P., Perl, H., et al. Study design to examine the potential role of
assessment reactivity in Screening, Motivational Assessment, Referral and Treatment in Emergency
Departments (SMART-ED) Protocol. Addiction Science & Clinical Practice, 7:16, 2012.
7. Radin, S.M., Banta-Green, C.J., Thomas, L.R., Kutz, S.H., & Donovan, D.M. Substance use, treatment
admissions, and recovery trends in diverse Washington State Tribal communities. American Journal of
Drug and Alcohol Abuse, 38(5): 511517, 2012.
8. Krupski, A., Joesch, J.M., Dunn, C., Donovan, D., et al. Testing the effects of brief intervention in primary
care for problem drug use in a randomized controlled trial: Rationale, design, and methods. Addiction
Science & Clinical Practice, 7: 27, 2012.
9. Zatzick, D., Donovan, D., Dunn, C., et al. Substance use and PTSD in trauma center patients receiving
mandated alcohol SBI. Journal of Substance Abuse Treatment, 43: 410-417, 2012.
10. Donovan, D.M., Daley, D.C., Brigham, G.S., et al. Stimulant Abuser Groups to Engage in 12-Step (STAGE-
12): A multisite trial in the NIDA Clinical Trials Network. Journal of Substance Abuse Treatment, 44(1): 103-
114, 2013.
11. Morasco, B.J., Turk, D.C., Donovan, D.M., & Dobscha, S.K. Prescription opioid misuse among patients
with a history of substance use disorder. Drug and Alcohol Dependence, 127(1-3): 193-199, 2013.
12. Gueorguieva, R., Wu, R., Krystal, J.H., Donovan, D.M., & OMalley, S.S. Temporal patterns of adherence
to medications and behavioral treatment and their relationship to patient characteristics and treatment
response. Addictive Behaviors, 38(5): 2119-2127, 2013.
13. Zatzick, D.F., Donovan, D.M., Dunn, C., et al. Developing and implementing randomized trials targeting the
sustained integration of alcohol screening and brief intervention services at US trauma centers. General
Hospital Psychiatry, 35(2):174-180, 2013.
14. Donovan, D.M., Knox, P.C., Skytta, J.A.F., et al. Buprenorphine from detox and beyond: Preliminary
evaluation of a pilot program to increase heroin dependent individuals' engagement in a full continuum of
care. Journal of Substance Abuse Treatment, 44(4): 426-432, 2013.
15. Winhusen, T., Lewis, D., Adinoff, B., Brigham, G., Kropp, F., Donovan, D.M., et al. Impulsivity is associated
with treatment non-completion in cocaine- and methamphetamine-dependent patients but differs in nature
as a function of stimulant-dependence diagnosis. Journal of Substance Abuse Treatment, 44(5):541-547,
2013.
D. RESEARCH SUPPORT
Ongoing Research Support
5 U10 DA013714-11 Donovan & Roll (PIs) 01/10/01 08/31/15
NIDA
Clinical Trials Network: Pacific Northwest Node
One of 13 regional centers in the NIDA Clinical Trials Network (CTN), which will evaluate effectiveness in
community treatment agencies of drug abuse therapies with demonstrated efficacy.
Role: PI
5 R24 MD001764-08 Donovan (PI) 09/30/05 02/28/14
NIMHD
The Healing of the Canoe
This collaborative project between the Suquamish and Port Gamble SKlallam Tribes and the Alcohol and Drug
Abuse Institute works in partnership to refine, implement, and evaluate a community-based and culturally
congruent intervention to prevent or reduce alcohol and drug use/abuse, to increase youths connection with
tribal culture, values, and traditions, and promote health among American Indian youth in tribal communities.
Role: PI
5 R01 AA016102-05 Zatzick (PI) 08/01/07 07/31/13
NIAAA
Disseminating Organizational SBI Services (DO-SBIS) at Trauma Centers
The goal is to capitalize on the unique opportunity afforded by the 2005 the American College of Surgeons
landmark resolution mandating alcohol screening and brief interventions in level I trauma centers, by taking
early steps to insure high quality, evidence-based SBI services are implemented and outcomes are assessed.
Role: Co-Investigator
5 R01 DA026014-05 Roy-Byrne (PI) 09/01/08 06/30/13
NIDA
Brief Intervention in Primary Care for Problem Drug Use and Abuse
The study has four aims: (1) to determine if brief intervention (BI) is effective in reducing drug use and
increasing completed referral to treatment; (2) to test whether higher fidelity to a BI model that emphasizes
motivational interviewing is more effective than lower fidelity; (3) to estimate the impact of BI on several public
health outcomes; (4) to estimate the costs of the intervention, potential cost offsets, and incremental cost-
effectiveness from the payer perspective based on health care service use and drug use frequency.
Role: Co-Investigator
1 R01 AA020252-01A1 Kaysen (PI) 02/10/12 01/31/17
NIAAA
Sequence of Symptom Change during AUD or PTSD Treatment for Comorbid PTSD/AUD
The long-term objective of this research is to improve treatment outcomes for individuals with comorbid PTSD
and alcohol abuse and dependence (AUD), comparing relapse prevention and cognitive processing therapies.
Role: Co-Investigator
5 P60 MD006909-02 Walters (PI) 08/02/12 02/28/17
NIMHD
Indigenous Wellness Research Institute National Center of Excellence
Goals: To establish a national NIMHD Comprehensive Center of Excellence (P60), which aims to improve
American Indian and Alaska Native (AIAN) health and eliminate health disparities by: (1) developing an
integrated, comprehensive, and centralized trans-disciplinary research infrastructure that builds on the
successes of the Indigenous Wellness Research Institutes (IWRI) research, training activities, and community
capacity building; (2) cultivating existing and establishing novel partnerships with AIAN tribal communities and
other organizations to facilitate truly collaborative research; (3) developing new and enhancing existing
research training activities at IWRI that prepare researchers to conduct scientifically rigorous and culturally
grounded health research; and (4) strengthening and consolidating AIAN engagement, outreach and
institutional partnerships.
Role: Co-Investigator
5 R01 DA030351-02 Banta-Green (PI) 05/15/12 04/30/17
NIDA
A Trial to Prevent Opioid Overdose: E. D. Based Intervention & Take-home Naloxone
The goals of this study are to determine the impact of an emergency department based intervention on opiate
overdose risk behaviors and overdose occurrence. The intervention will include a brief behavioral change
counseling session, opiate overdose education and prescribing of an opiate antidote for use in possible future
opiate overdoses. A RCT of 500 heroin users and 500 pharmaceutical opiate users at risk for overdose will be
conducted to test the intervention; subjects will be followed longitudinally via interviews and medical records.
Role: Co-Investigator
1 R25 MH099132-01 Mathai (PI) 09/18/12 08/31/15
NIMH
Linked Mental Health Research Training for Improved Health Outcomes in Kenya
This award aims to improve mental health research capacity by training University of Nairobi (UON) faculty and
postgraduates and by establishing a Mental Health Resource Center to support these efforts at UON.
Role: Key Personnel
5 R01 DA029001-04 Duran (PI) 09/30/09 08/31/13
NIDA
CBPR with Tribal Colleges & Universities: Alcohol Problems/Solutions
This project with Tribal Colleges and Universities: Alcohol, Drug and Mental Disorder Problems and Solutions
Study (CBPR-TCU ADM PSS) will use Community-Based Participatory Research (CBPR) methods to conduct
the first investigation of Alcohol, Drug and Mental Disorders (ADM) at Tribal Colleges and Universities (TCU)
and is a preliminary step on a path toward developing culturally appropriate and sustainable interventions at
TCU.
Role: Investigator
5 T32AA007455-29 Larimer (PI) 07/01/84 06/30/14
NIAAA
Psychology Training in Alcohol Research
A program for post-doctoral fellows to train psychologists in social learning, clinical, and physiological aspects
of the etiology and treatment of alcohol abuse and dependence.
Role: Core faculty member
Completed Research Support
HHSN271201200014C Luchansky (PI) 08/20/12 05/19/13
NIDA
The Drugged Driving Information Service
This sub-contract proposal will support the development of a web based system to track drugged driving
incidents in Washington State and a web based knowledge database for effective drugged driving
interventions.
Role: Co-Investigator
OPP1038263 Thomas (PI) 07/01/11 01/31/13
Bill & Melinda Gates Foundation
Washington Tribes and RAIO Health Priorities Summit
The Summit will invite leaders from the 29 federally recognized Tribes and the 5 RAIOs in WA State for 1-1/2
days to identify and document health priorities/issues of greatest concern in the Tribal and AIAN communities
and urban areas; promising practices in these communities; and gaps in health services and strategies for
addressing these shortcomings. It will result in a report that prioritizes health needs, resources and gaps in
order to make recommendations and guide policy with regards to the health of AIAN people in WA State.
Role: Co-Investigator
Appendix A
Instruments for Evaluation
Given the novelty of our proposal, there are few instruments available to evaluate health care
professionals knowledge and attitudes on medical cannabis. For this project, we will consider
two instruments utilized in recently published studies for adaptation to the specific needs of our
target populations.
The first instrument assesses attitudes among physicians toward medical cannabis in Colorado
and the second assesses knowledge, views and experiences among hospice health care providers.
A more detailed description of these instruments and their references can be found below:
Physician Attitudes
The instrument is a 3-part survey starting with demographic information (age, sex, and years in
practice). The second part assesses respondents experience with medical marijuana, including
whether they have ever recommended medical marijuana to a patient, how many times, and for
which medical conditions; which factors most influenced their decision to recommend medical
marijuana; and from which sources they obtained most of their information about medical
marijuana. In the third part, respondents are asked to rate, on a 5-point Likert scale, the extent to
which they agree or disagree with 17 statements about marijuana policy in Colorado and
nationally (including legalization of marijuana for recreational use, reclassifying marijuana from
schedule I, and distribution of medical marijuana through a dispensary model); the risks and
benefits of marijuana use; and educational opportunities about marijuana at various levels of
medical training.
Reference: Kondrad E, Reid A. Colorado family physicians' attitudes toward medical marijuana.
J Am Board Fam Med. 2013 Jan-Feb;26(1):52-60. doi: 10.3122/jabfm.2013.01.120089.
Knowledge, views and experience
This is a 16-item questionnaire, comprised of two open-ended questions soliciting participant's
knowledge of potential medical uses and adverse effects of marijuana. A series of multiple
choice questions query participants' experience and views regarding the use of marijuana to
palliate symptoms.
Examples of the multiple choice questions are to rate symptoms improved by medical marijuana
use among patients ( pain, mood, nausea/vomiting, anorexia/appetite) or to identify possible side
effects associated with marijuana use (hunger, sedation, brain function, altered mental status,
improved mood, etc.)
Reference: Tanya J. Uritsky, Mary Lynn McPherson, and Franoise Pradel. Assessment of
Hospice Health Professionals' Knowledge, Views, and Experience with Medical Marijuana
Journal of Palliative Medicine. December 2011, 14(12): 1291-1295.
doi:10.1089/jpm.2011.0113.


Appendix B
Relevant Literature and Resources
1. Abrams DI, Couey P, Shade SB, et al. Cannabinoid-opioid interaction in chronic pain. Clin
Pharmacol Ther 2011;90(6):844-51.
2. Aggarwal SK. Cannabinergic pain medicine: a concise clinical primer and survey of
randomized-controlled trial results. Clin J Pain 2013;29(2):162-71.
3. Aggarwal SK, Carter G, Sullivan M, et al. Distress, coping, and drug law enforcement in a
series of patients using medical cannabis. J Nerv Ment Dis 2013;201(4):292-303.
4. Aggarwal SK, Carter GT, Sullivan MD, et al. Characteristics of patients with chronic pain
accessing treatment with medical cannabis in Washington state. J Opioid Manag
2009;5(5):257-86.
5. Banta-Green C, Brunner M. Opiate use and negative consequences in Washington State.
(ADAI Info Brief) Seattle: UW Alcohol & Drug Abuse Institute, August 2011. URL:
http://adai.uw.edu/pubs/infobriefs/ADAI-IB-2011-03.pdf
6. Carter GT, Flanagan AM, Earleywine M, et al. Cannabis in palliative medicine: improving
care and reducing opioid-related morbidity. Am J Hosp Palliat Care 2011;28(5):297-303.
7. Carter GT, Abood ME, Aggarwal SK, Weiss MD. Cannabis and amyotrophic lateral
sclerosis: hypothetical and practical applications, and a call for clinical trials. Am J Hosp
Palliat Care 2010;27(5):347-56.
8. Carter GT, Ugalde V. Medical marijuana: emerging applications for the management of
neurologic disorders. Phys Med Rehabil Clin N Am 2004;15(4):973-54.
9. Centers for Disease Control and Prevention (CDC). Overdose deaths involving prescription
opioids among Medicaid enrollees Washington, 2004-2007. MMWR Morb Mortal Wkly
Rep 2009;58(42):1171-1175.
10. Charuvastra A, Friedmann PD, Stein MD. Physician attitudes regarding the prescription of
medical marijuana. J Addict Dis 2005;24(3):87-93.
11. Irvine G. Rural doctors attitudes to and knowledge of medicinal cannabis. J Law Med
2006;14(1):135-42.
12. Johnson TP, Booth AL, Johnson P. Physician beliefs about substance misuse and its
treatment: findings from a U.S. survey of primary care practitioners. Subst Use Misuse
2005;40(8):1071-84.
13. Kondrad E, Reid A. Colorado family physicians attitudes toward medical marijuana. J Am
Board Fam Med 2013;26(1):52-60.
14. McCambridge J, Strang J, Platts S, Witton J. Cannabis use and the GP: brief motivational
intervention increases clinical enquiry by GPs in a pilot study. Br J Gen Pract
2003;53(493):637-9.
15. Russo EB. Cannabinoids in the management of difficult to treat pain. Ther Clin Risk Manage
2008;4(1):245-259.
16. Russo EB. The solution to the medicinal cannabis problem. IN: Schatman ME (ed.). Ethical
Issues in Chronic Pain Management. New York: Informa Healthcare, 2007, pp. 165-194.
17. Russo EB. The role of cannabis and cannabinoids in pain management. IN: Boswell MV,
Cole BE (eds.). Pain Management: A Practical Guide for Clinicians (7
th
ed.). New York:
Taylor & Francis, 2006, pp. 823-844.
18. Russo EB, Hohmann AG. Role of cannabinoids in pain management. IN: Deer TR et al
(eds.). Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative
Approaches. New York: Springer, 2013, pp. 181-197.


19. Wilsey B, Marcotte T, Deutsch R, et al. Low-dose vaporized cannabis significantly improves
neuropathic pain. J Pain 2013;14(2):136-148.
Educational Resources
Americans for Safe Access: http://safeaccessnow.org. Founded in 2002, ASA is the largest
organization of patients, medical professionals, scientists, and concerned citizens promoting safe
and legal access to cannabis. Web site features legal information, advocacy, online trainings,
and a variety of medical and scientific information about cannabis. The sites Training Center
includes a collection of videos and online trainings to help inform patients, clinicians, and
advocates about the history of medical cannabis, cannabidiol science (for doctors), resources for
finding local legislation information, patient rights, testifying before civic bodies, public
speaking, and more.
The Answer Page, co-sponsored by Harvard Medical School and the Massachusetts Medical
Society, uses a Question of the Day teaching format for online trainings with CME. Users
who register for the site read a daily set of 4-5 questions and answers based on a specific topic
(such as Pharmacology of Cannabis and Cannabinergic Medicines) and then complete a
weekly quiz based on the content. The site presents information in a brief, but frequent (daily),
format to help keep users engaged and make CME accessible to physicians who are pressed for
time. It has been recognized by the Accreditation Council for Continuing Medical Education
(ACCME) as an example of particularly high-quality online education.
Canadian Consortium for the Investigation of Cannabis: http://www.ccic.net. The CCIC is a
federally registered Canadian nonprofit organization of basic and clinical researchers and health
care professionals interested in promoting evidence-based research and education about the
endocannabinoid system and its therapeutic applications. Site includes educational elements,
research, resources, symposia, networking forums, and more.
StopOverdose.org: http://stopoverdose.org. This site, developed and maintained by the Alcohol
& Drug Abuse Institute at the University of Washington, provides information and online
trainings about preventing and reversing opioid overdoses (including instructions on how to
obtain and use naloxone).

PROJECT BUDGET
ProposaI TitIe
PrincipaI Investigator Beatriz CarIini
AppIicant Organization University of Washington
AppIicant UW Department AIcohoI and Drug Abuse Institute
Project start date
Project end date

SaIaries/Benefits Base Salary Benefits Salary Benefits
Months Effort Salary Year 1 Year 1 Year 2 Year 2 Total
Beatriz Carlini, P 18 0.25 86,520 21,630 7,354 11,139 3,787 43,911
Jennifer Velotta, Outreach Specialist 6 0.10 51,912 2,596 883 0 0 3,478
TBN, Project Coordinator 18 0.35 43,680 15,288 2,523 7,873 1,299 26,983
Roger Roffman, Collaborator 12 0.02 166,584 2,563 423 0 0 2,986
42,076 11,182 19,013 5,087 77,358
Goods and Services 22,144
Crisis Clinic 2,500
Washington Poison Center 2,500
Consultant, Gregory Carter 3,000
CME accreditation fee, 2 years 750
Printing, 5,000 brochures 2,745
Graphic Design Services 3,000
UW Webinar facilities 396
Software, Articulate 1,398
Office lease, P and project coordinator 5,516
Phone, conference call number for advisory group 75
Phone, P and project coordinator 263
TraveI 770
Travel, local mileage, parking 770
TotaI UW Direct Costs 100,272
UW Administrative/Overhead 10% 10,027
TotaI UW Funding Request 110,299
March 31, 2015
October 1, 2013
Chronic Pain Management and Marijuana Use: Science-Based
Education in Times of LegaIization