Tell us about your clinical and research background. What led you to study substance use?<\/strong><\/p>\nI completed residency in combined internal medicine and pediatrics and then an addiction medicine fellowship after that at BU. During my fellowship, I did my research training at the BU School of Public Health and got a Master of Science in Epidemiology, and then I had ongoing research training after receiving a career development award from NIDA. Before I was even drawn to medicine, I was always interested in public health and wanting to work with populations in communities that were vulnerable or didn\u2019t have access to not just health care, but health too. I started as pre-med, but took a break in college because I wasn\u2019t sure it was what I wanted to do and I really wanted to focus on public health. It was actually during that experience where I spent some time working at AIDS Project Rhode Island and started learning more about HIV and, as a result, learning more about substance use.<\/p>\n
During that time when I worked between college and medical school, I spent some time in upstate New York working in a shelter with women and children who were affected by drug use. I started medical school and realized, \u201cIsn\u2019t there more in medicine that we can be offering to people who use drugs and alcohol?\u00a0<\/span>And yet it\u2019s just so poorly integrated into health care settings.<\/em>\u201d This was 2004, when there were no fellowship programs. It was not standardized as part of the medical school curriculum and no one was really talking about it, but I was fortunate enough to have mentors throughout medical school and residency who did teach me how to integrate treatment of substance use disorders into medical settings or health care settings, and how they can have an impact on individuals and communities.<\/p>\nI feel privileged to be in this field where there are so many unanswered questions and work to do, and yet also so many opportunities because we have a lot of effective treatments and strategies for harm reduction that we can already offer, and they\u2019re just poorly implemented. It\u2019s just unbelievably gratifying, too, and I just think anyone who\u2019s worked with people who use drugs or in recovery or trying to be in recovery \u2026 it\u2019s really a joy and a privilege. The final thing is there is something \u2013 also because I really am interested in public health \u2013 in being able to focus on something where there is this intersection of policy, public health, medical care, opportunity for advocacy, research, and education. It all collides or intersects.<\/p>\n
In what ways did your involvement with the RAMS Program assist you with your research career?<\/strong><\/p>\nRAMS is so great. I was in the 1st cohort of RAMS scholars. <\/span>When I began fellowship, I had no<\/u> research experience when I was starting so it was actually this fundamental grounding experience for me, both because it connected me with peers in my cohort who were also in a similar stage and the connections with Jeffrey and Patrick and Michael Stein were also important. RAMS provided a platform for me to learn about how you think about research questions, design research projects, and then implement or execute a research project. The experience was really fundamental, as it provided support for the first research project that I completed and started me on this career and gave me the confidence to also think that I could pursue a career in addiction medicine and research, which if you had told me a year before all of this had happened, I don\u2019t think I would have believed you.<\/p>\nAnd now we\u2019re in our tenth cohort\u2026<\/em><\/strong><\/p>\nYeah, it\u2019s pretty amazing. I finished fellowship. I\u2019m almost done with my K. It\u2019s really amazing.<\/p>\n
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Did you move institutions post-fellowship? If so, what was the most challenging about this transition?<\/strong><\/p>\nI did not. I looked a little bit but I stayed at BMC. I had really strong mentorship and was so fortunate to be able to be offered a position.<\/p>\n
So you have been at BU\/BMC\u2026<\/em><\/strong><\/p>\nSince 2012\u2026 I was at Brown for residency, so I came in 2012. So it\u2019s been a really long time \u2013 July will be 10 years. It\u2019s amazing. I was pregnant when I started fellowship so my daughter turns ten next year in September, and I guess that\u2019s how long I can mark that I have been at BMC.<\/p>\n
What would you consider an interesting or surprising finding from your research so far?<\/strong><\/p>\nI think one thing that has become increasingly clear to me over the years is the importance in partnering with people in the community who are affected by substance use. I have learned a lot of humility over the years about partnering and the amount of time and effort that I need to put in, in order to build trust with people and ask them to participate and join as collaborators. I think that\u2019s been pretty humbling to be honest, and I\u2019ve learned a lot and changed my approaches to thinking about how to partner and how to develop projects.<\/p>\n
I think similarly in my clinical work, too, just trying to think about everything that I do \u2013 Are there ways for me to involve patient\u2019s families or just simply be responsive to the questions they may have too? On one hand, we actually do know so much about how to improve outcomes related to substance use, but yet it\u2019s so poorly implemented and engagement is poor. So really taking a step back and being \u201cWhy is that?,\u201d<\/em> and maybe one of the reasons is we don\u2019t have <\/span>enough patient involvement in the clinical and research work that we do. So I am left with the question of how can we change that so that whatever work we are doing is relevant to lives of the people or the communities that we are trying to hopefully make a difference.<\/p>\nTell us about some directions you see your research going in.<\/strong><\/p>\nOne thing that has been on my mind is thinking about how there\u2019s been an increased attention to post-overdose care. There are programs that have emerged all over the country providing post-overdose care, and they are, in general, public health responses to a public health problem but aren\u2019t vigorously evaluated in terms of understanding their effectiveness. I\u2019ve therefore been fortunate to be part of some research teams at BMC that are trying to look at that. So, I think that because of my background and interests in thinking about youth, I see taking that next step as thinking about post-overdose care for youth and the different settings and different kinds of teams that need to be developed and implemented in communities in order to care for youth who are impacted by overdose. This would include younger children \u2013 both thinking about teenagers who might have had the overdose but also younger children who might be exposed to the overdose of a parent or grandparent or other family member. So, then what\u2019s the right intervention to mitigate the harms? I think that\u2019s one direction that I\u2019m really interested in.<\/p>\n
I think another direction is about different interventions for families that can be offered in treatment settings, because families are often left out of treatment planning both for youth and adults. What are the effective interventions that can be implemented in health care settings that support family members, and that both improve treatment outcomes for people with substance use disorders, but also for family members themselves who have higher rates of anxiety and depression and sort of control their chronic illnesses.<\/p>\n
What has been a particularly challenging IRB issue you have had recently?<\/strong><\/p>\nI haven\u2019t had any recently. I haven\u2019t been putting in super complicated studies, and I work with a really great research staff, so I think they probably deal with a lot of the things before it becomes an issue. There may be things, but I never hear about them because the people I work with are so great!<\/p>\n
Have you ever had an experience with a revise and resubmit decision and\/or a rejection, and if so, what errors did you make and what would you have changed\/what did you change?<\/strong><\/p>\nYeah, plenty of all of those. I think with thinking about revise and resubmits for manuscripts, one thing that I have learned is the importance of being really respectful in my responses and remembering that people who are doing reviews are volunteering their time. So, even as an author, if you don\u2019t totally agree with what the comment is, it doesn\u2019t mean that we can\u2019t be respectful in our response and gracious in how we think about how we want to answer their question or query. I think that the one thing that I\u2019m still learning about rejections \u2013 I\u2019m thinking about a paper and a grant that have both been rejected in the last year \u2013 is finding ways to be motivated to go back to the idea. For a paper, making sure you resubmit it, and if there are helpful comments that you maybe got in the rejection, that you make some changes. Don\u2019t just let it sit on your desk. I remember Patrick talking about that actually, pretty clearly in RAMS.<\/p>\n
Similarly for grants, if your grant isn\u2019t discussed or isn\u2019t going to be funded, I think needing to take a little time away from it is important because it\u2019s emotionally exhausting. It happens to everyone and it never feels great. Then, try to take a step back and think \u201cIs this still an idea that I am excited to work on?\u201d <\/em>which the answer has to be \u201cyes\u201d otherwise it doesn\u2019t make sense to do it. Then thinking, \u201cOkay this is something that I still think is important.\u201d<\/em> If so, then I need to find other funding mechanisms or other ways to think about trying to do this work.<\/p>\nA very human response in this line of work where that happens all the time\u2026<\/em><\/strong><\/p>\nIt happens all the time, but then you hear about all the acceptances\u2026 like you know when your colleague is published and you know when they get a grant. The reality is, you have to do a lot of that (i.e., rejection, revision, and resubmission) and there\u2019s a lot of pain that goes along with it.<\/p>\n
How has COVID-19 inspired you to focus on new work?<\/strong><\/p>\nI think one really important impact of COVID has sort of been a real worsening and exacerbation of teen mental health. Interestingly, the substance use data from Monitoring the Future that was released last month actually showed that there were decreases in substance use among teens, which doesn\u2019t make sense in terms of what we are seeing clinically. I think, it has for me anyway, highlighted the need for the highest risk youth who have sort of more severe mental illness and substance use disorders, like the need for more high-quality data to understand how we should be treating them. Actually, there\u2019s very limited data to guide us on those questions, in what to do. So, I\u2019m just more inspired to focus on this really high-risk group. <\/span><\/span><\/p>\nTell us one thing about yourself that readers might find interesting.<\/strong><\/p>\nI spent some time during residency helping to build a kayak.<\/p>\n
Interview conducted by Sophia Ly, MS<\/em><\/strong><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"In February 2022, Dr. Sarah Bagley from the 1st RAMS Cohort (2012-2014) graciously answered several questions about herself and her work since completing the RAMS Program. Sarah Bagley, MD is currently an Assistant Professor of Medicine and Pediatrics at the Boston University School of Medicine and a primary care physician at Boston Medical Center. She […]<\/p>\n","protected":false},"author":20007,"featured_media":0,"parent":12291,"menu_order":8,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/www.bumc.bu.edu\/care\/wp-json\/wp\/v2\/pages\/12688"}],"collection":[{"href":"https:\/\/www.bumc.bu.edu\/care\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.bumc.bu.edu\/care\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/care\/wp-json\/wp\/v2\/users\/20007"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/care\/wp-json\/wp\/v2\/comments?post=12688"}],"version-history":[{"count":21,"href":"https:\/\/www.bumc.bu.edu\/care\/wp-json\/wp\/v2\/pages\/12688\/revisions"}],"predecessor-version":[{"id":13215,"href":"https:\/\/www.bumc.bu.edu\/care\/wp-json\/wp\/v2\/pages\/12688\/revisions\/13215"}],"up":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/care\/wp-json\/wp\/v2\/pages\/12291"}],"wp:attachment":[{"href":"https:\/\/www.bumc.bu.edu\/care\/wp-json\/wp\/v2\/media?parent=12688"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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In February 2022, Dr. Sarah Bagley from the 1st RAMS Cohort (2012-2014) graciously answered several questions about herself and her work since completing the RAMS Program.<\/p>\n