B. Edlin: Treatment of Drug Abusers
Brian R. Edlin, M.D. serves as Professor of Medicine at the State University of New York (SUNY) Downstate College of Medicine, Adjunct Associate Professor of Medicine and Public Health at Weill Medical College of Cornell University, and Epidemiologist for the Center for the Study of Hepatitis C in New York. He is an Attending Physician at the University Hospital of Brooklyn and an Associate Attending Physician at NewYork-Presbyterian Hospital. Dr. Edlin's research focuses on the epidemiology and primary and secondary prevention of viral hepatitis, human immunodeficiency virus (HIV) infection, and other conditions affecting drug users.
An internist with training in infectious diseases and epidemiology, Dr. Edlin joined the Epidemic Intelligence Service at the Centers for Disease Control and Prevention and served for eight years in the Division of HIV/AIDS Prevention, first as a medical epidemiologist and then as its Assistant Director for Science. In 1997, Dr. Edlin was recruited to join the faculty of the University of California, San Francisco to direct the Urban Health Study, the longest running longitudinal study of injection drug users (IDUs) in the world. In 2003, Dr. Edlin joined the faculty of Weill Cornell Medical College (WCMC) to serve as Epidemiologist for the Center for the Study of Hepatitis C, a multidisciplinary center at the Rockefeller University, WCMC and NewYork-Presbyterian Hospital. In 2008, Dr. Edlin joined the Special Treatment and Research (STAR) Program at SUNY Downstate, the primary provider of HIV/AIDS care in Brooklyn, while continuing his work as at the Center for the Study of Hepatitis C as an adjunct faculty member at Cornell.
Dr. Edlin has conducted research on emerging issues in infectious diseases for 20 years. His initial research focused on multidrug-resistant tuberculosis and HIV. His work with drug users documented the connections between the crack cocaine and HIV epidemics in inner-city communities. Subsequent studies have examined social, structural, behavioral, and biological factors associated with health conditions among IDUs. These conditions include HIV, hepatitis B, hepatitis C, other viral infections, tuberculosis, abscesses, and heroin overdose. Dr. Edlin's research has examined the effectiveness of pioneering interventions including needle exchange, street-based hepatitis B vaccination, street-based abscess care, and naloxone distribution to prevent fatal heroin overdose.
Community-based studies currently underway in New York include the Swan Project, a study of young, predominantly homeless street-recruited IDUs on the Lower East Side of Manhattan. Epidemiologic analyses examine the prevalence, incidence, and predictors of new HCV infection, to identify the specific injection practices and contexts that are responsible for continued HCV transmission among IDUs despite access to needle exchange. Clinical, virologic, and immunologic studies characterize the features of acute HCV infection, examining HCV-specific immune responses in relation to viral kinetics in these rarely observed infections in order to characterize the components of an effective immune response. A novel community-based, integrated, multidisciplinary program developed in collaboration with needle exchange programs offers expert, subspecialty care for hepatitis C to active illicit drug users. Through this program, active drug users recruited from community settings receive effective treatment for hepatitis C.
In the policy arena, Dr. Edlin has been at the forefront of efforts to win access to hepatitis C treatment for illicit drug users. In 2001 he became the first to publicly and prominently challenge the National Institutes of Health (NIH) recommendation to withhold hepatitis C treatment from active illicit drug users. The following year, the NIH asked him to address its Consensus Development Conference on the Management of Hepatitis C as the expert speaker on hepatitis C in injection drug users. The Consensus Panel adopted his recommendations, rescinding its previous recommendation and advocating hepatitis C prevention, screening, and treatment for injection drug users and incarcerated persons.
Dr. Edlin's has published more than 80 articles in scientific journals, including the New England Journal of Medicine, Lancet, Annals of Internal Medicine, Journal of Infectious Diseases, and others. He received the Donald C. Mackel Memorial Award, the Alexander D. Langmuir Award, and the Charles C. Shepard Science Award for his research on nosocomial transmission of multidrug-resistant tuberculosis. Dr. Edlin is a fellow of the Infectious Diseases Society of America and a member of the American Association for the Study of Liver Disease and serves on the NIH HIV Prevention Trials Network Substance Use Working Group. He has served on several NIH study sections and has received numerous research grants including 7 NIH R-01 awards. Dr. Edlin currently serves on the New York State Hepatitis C Advisory Council and the Center for Substance Abuse Treatment's Viral Hepatitis Expert Consensus Panel.