Huiru Dong joined the ITA as a postdoctoral fellow in 2021 and the faculty of the ITA in November, 2024.
Dr. Dong received her PhD in Population and Public Health from the University of British Columbia and holds an MS in Epidemiology from the University of Alberta. The overarching goal of her research is to improve health and social outcomes for people living with substance use disorders through rigorous data science methodologies. Prior to joining the lab, Dr. Dong was a senior statistician and investigator at the British Columbia Centre on Substance Use, where she spent the last eight years working on the development and implementation of novel statistical methods, investigation of the determinants of health and drug use outcomes, and evaluation of drug policies and services. Dr. Dong is currently working with Dr. Mohammad Jalali (“MJ”) on projects using machine learning models and system dynamics models to understand polysubstance use during the opioid crisis.
Selected Publications
Dong, Huiru; Stringfellow, Erin J; Jalali, Mohammad S
State-level racial and ethnic disparities in buprenorphine treatment duration in the United States Journal Article
In: Am J Addict, vol. 34, no. 1, pp. 69-74, 2025, ISSN: 1521-0391.
@article{pmid39107678,
title = {State-level racial and ethnic disparities in buprenorphine treatment duration in the United States},
author = {Huiru Dong and Erin J Stringfellow and Mohammad S Jalali},
doi = {10.1111/ajad.13638},
issn = {1521-0391},
year = {2025},
date = {2025-01-01},
urldate = {2024-08-01},
journal = {Am J Addict},
volume = {34},
number = {1},
pages = {69-74},
abstract = {BACKGROUND AND OBJECTIVES: National trends reveal a concerning escalation in racial and ethnic disparities in buprenorphine treatment duration for opioid use disorder. However, the extent of such disparities at the state level remains largely unexplored. This study aims to examine such disparities at the state level.nnMETHODS: We analyzed 9,040,620 buprenorphine prescriptions dispensed between January 2011 and December 2020 from IQVIA Longitudinal Prescription data. The primary outcome was the difference in median treatment duration between White people and racial and ethnic minorities. We also included a second outcome measurement to quantify the difference in median treatment duration among episodes lasting ≥180 days. Using quantile regressions, we examined racial and ethnic disparities in treatment duration, adjusting for the patient\'s age, sex, payment type, and calendar year of the treatment episode. All analyses were conducted at the state level.nnRESULTS: Our study revealed substantial statewide variations in racial and ethnic disparities. Specifically, 21 states showed longer treatment durations for White people across all episodes, and eight states displayed similar trends among episodes lasting ≥180 days. Five states exhibited longer treatment durations for White people in both overall and long-term episodes. Fifteen states showed no racial and ethnic disparities.nnCONCLUSION AND SCIENTIFIC SIGNIFICANCE: These results are among the first to indicate substantial statewide variations in racial and ethnic disparities in buprenorphine treatment episode duration, providing a critical foundation for targeted interventions to enhance buprenorphine treatment, especially in states confronting such pronounced racial and ethnic disparities.},
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BACKGROUND AND OBJECTIVES: National trends reveal a concerning escalation in racial and ethnic disparities in buprenorphine treatment duration for opioid use disorder. However, the extent of such disparities at the state level remains largely unexplored. This study aims to examine such disparities at the state level.nnMETHODS: We analyzed 9,040,620 buprenorphine prescriptions dispensed between January 2011 and December 2020 from IQVIA Longitudinal Prescription data. The primary outcome was the difference in median treatment duration between White people and racial and ethnic minorities. We also included a second outcome measurement to quantify the difference in median treatment duration among episodes lasting ≥180 days. Using quantile regressions, we examined racial and ethnic disparities in treatment duration, adjusting for the patient's age, sex, payment type, and calendar year of the treatment episode. All analyses were conducted at the state level.nnRESULTS: Our study revealed substantial statewide variations in racial and ethnic disparities. Specifically, 21 states showed longer treatment durations for White people across all episodes, and eight states displayed similar trends among episodes lasting ≥180 days. Five states exhibited longer treatment durations for White people in both overall and long-term episodes. Fifteen states showed no racial and ethnic disparities.nnCONCLUSION AND SCIENTIFIC SIGNIFICANCE: These results are among the first to indicate substantial statewide variations in racial and ethnic disparities in buprenorphine treatment episode duration, providing a critical foundation for targeted interventions to enhance buprenorphine treatment, especially in states confronting such pronounced racial and ethnic disparities.
Lee, Hannah; Otero-Leon, Daniel; Dong, Huiru; Stringfellow, Erin J; Jalali, Mohammad S
Uncovering Patterns in Overdose Deaths: An Analysis of Spike Identification in Fatal Drug Overdose Data in Massachusetts, 2017-2023 Journal Article
In: Public Health Rep, pp. 333549241299613, 2024, ISSN: 1468-2877.
@article{pmid39717009,
title = {Uncovering Patterns in Overdose Deaths: An Analysis of Spike Identification in Fatal Drug Overdose Data in Massachusetts, 2017-2023},
author = {Hannah Lee and Daniel Otero-Leon and Huiru Dong and Erin J Stringfellow and Mohammad S Jalali},
doi = {10.1177/00333549241299613},
issn = {1468-2877},
year = {2024},
date = {2024-12-01},
journal = {Public Health Rep},
pages = {333549241299613},
abstract = {OBJECTIVES: Yearly rolling aggregate trends or rates are commonly used to analyze trends in overdose deaths, but focusing on long-term trends can obscure short-term fluctuations (eg, daily spikes). We analyzed data on spikes in daily fatal overdoses and how various spike detection thresholds influence the identification of spikes.nnMATERIALS AND METHODS: We used a spike detection algorithm to identify spikes among 16 660 drug-related overdose deaths (from any drug) reported in Massachusetts' vital statistics from 2017 through 2023. We adjusted the parameters of the algorithm to define spikes in 3 distinct scenarios: deaths exceeding 2 adjusted moving SDs above the 7-, 30-, and 90-day adjusted moving average.nnRESULTS: Our results confirmed the on-the-ground observation that there are days when many more people die of overdoses than would be expected based on fluctuations due to differences among people alone. We identified spikes on 5.8% to 20.6% of the days across the 3 scenarios, annually, constituting 11.1% to 31.6% of all overdose deaths. The absolute difference in percentage points of days identified as spikes varied from 5.2 to 11.5 between 7- and 30-day lags and from 0 to 4.6 between 30- and 90-day lags across years. When compared with the adjusted moving average across the 3 scenarios, in 2017 an average of 3.9 to 5.5 additional deaths occurred on spike days, while in 2023 the range was 3.7 to 6.0.nnPRACTICE IMPLICATIONS: A substantial percentage of deaths occurred annually on spike days, highlighting the need for effectively monitoring short-term overdose trends. Moreover, our study serves as a foundational analysis for future research into exogenous events that may contribute to spikes in overdose deaths, aiming to prevent future deaths.},
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OBJECTIVES: Yearly rolling aggregate trends or rates are commonly used to analyze trends in overdose deaths, but focusing on long-term trends can obscure short-term fluctuations (eg, daily spikes). We analyzed data on spikes in daily fatal overdoses and how various spike detection thresholds influence the identification of spikes.nnMATERIALS AND METHODS: We used a spike detection algorithm to identify spikes among 16 660 drug-related overdose deaths (from any drug) reported in Massachusetts' vital statistics from 2017 through 2023. We adjusted the parameters of the algorithm to define spikes in 3 distinct scenarios: deaths exceeding 2 adjusted moving SDs above the 7-, 30-, and 90-day adjusted moving average.nnRESULTS: Our results confirmed the on-the-ground observation that there are days when many more people die of overdoses than would be expected based on fluctuations due to differences among people alone. We identified spikes on 5.8% to 20.6% of the days across the 3 scenarios, annually, constituting 11.1% to 31.6% of all overdose deaths. The absolute difference in percentage points of days identified as spikes varied from 5.2 to 11.5 between 7- and 30-day lags and from 0 to 4.6 between 30- and 90-day lags across years. When compared with the adjusted moving average across the 3 scenarios, in 2017 an average of 3.9 to 5.5 additional deaths occurred on spike days, while in 2023 the range was 3.7 to 6.0.nnPRACTICE IMPLICATIONS: A substantial percentage of deaths occurred annually on spike days, highlighting the need for effectively monitoring short-term overdose trends. Moreover, our study serves as a foundational analysis for future research into exogenous events that may contribute to spikes in overdose deaths, aiming to prevent future deaths.
Lim, Tse Yang; Dong, Huiru; Stringfellow, Erin; Hasgul, Zeynep; Park, Ju; Glos, Lukas; Kazemi, Reza; Jalali, Mohammad S.
Temporal and spatial trends of fentanyl co-occurrence in the illicit drug supply in the United States: a serial cross-sectional analysis Journal Article
In: The Lancet Regional Health - Americas, vol. 39, 2024, ISSN: 2667-193X.
@article{Lim2024,
title = {Temporal and spatial trends of fentanyl co-occurrence in the illicit drug supply in the United States: a serial cross-sectional analysis},
author = {Tse Yang Lim and Huiru Dong and Erin Stringfellow and Zeynep Hasgul and Ju Park and Lukas Glos and Reza Kazemi and Mohammad S. Jalali},
doi = {10.1016/j.lana.2024.100898},
issn = {2667-193X},
year = {2024},
date = {2024-11-00},
journal = {The Lancet Regional Health - Americas},
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Dong, Huiru; Stringfellow, Erin J; Russell, Alton; Jalali, Mohammad S
State Mandates On Naloxone Coprescribing Associated With Short-Term Increase In Naloxone Codispensing Journal Article
In: Health Aff (Millwood), vol. 43, no. 9, pp. 1319–1328, 2024, ISSN: 2694-233X.
@article{pmid39226505,
title = {State Mandates On Naloxone Coprescribing Associated With Short-Term Increase In Naloxone Codispensing},
author = {Huiru Dong and Erin J Stringfellow and Alton Russell and Mohammad S Jalali},
doi = {10.1377/hlthaff.2023.01667},
issn = {2694-233X},
year = {2024},
date = {2024-09-01},
journal = {Health Aff (Millwood)},
volume = {43},
number = {9},
pages = {1319--1328},
abstract = {In the midst of the opioid crisis in the US, efforts to mitigate overdose risks have become paramount, leading some states to introduce mandates for coprescribing the life-saving overdose reversal drug naloxone. These mandates were designed to specifically address people receiving opioid analgesics who had an elevated risk for overdose. This included people receiving high opioid dosages, those concurrently using benzodiazepines, or those with a history of substance use disorder or overdose. Using a nationally representative, multipayer cohort of patients receiving prescription opioids, we investigated how naloxone codispensing rates changed at the state level from 2016 to 2021 among patients with an elevated risk for overdose. Then we used controlled interrupted time series analyses to assess mandates' longitudinal impact on naloxone codispensing in ten states that implemented mandates. We observed an immediate and significant increase in the naloxone codispensing rates in eight states after the implementation of mandates. Nevertheless, in five of these states, the codispensing rates exhibited a subsequent downward trend after the initial increase. State mandates show potential for improving naloxone codispensing; however, mandates alone might not be adequate for sustained change. Further research is needed to identify strategies complementing and enhancing the impact of mandates in combating the overdose crisis.},
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In the midst of the opioid crisis in the US, efforts to mitigate overdose risks have become paramount, leading some states to introduce mandates for coprescribing the life-saving overdose reversal drug naloxone. These mandates were designed to specifically address people receiving opioid analgesics who had an elevated risk for overdose. This included people receiving high opioid dosages, those concurrently using benzodiazepines, or those with a history of substance use disorder or overdose. Using a nationally representative, multipayer cohort of patients receiving prescription opioids, we investigated how naloxone codispensing rates changed at the state level from 2016 to 2021 among patients with an elevated risk for overdose. Then we used controlled interrupted time series analyses to assess mandates' longitudinal impact on naloxone codispensing in ten states that implemented mandates. We observed an immediate and significant increase in the naloxone codispensing rates in eight states after the implementation of mandates. Nevertheless, in five of these states, the codispensing rates exhibited a subsequent downward trend after the initial increase. State mandates show potential for improving naloxone codispensing; however, mandates alone might not be adequate for sustained change. Further research is needed to identify strategies complementing and enhancing the impact of mandates in combating the overdose crisis.
Dong, Huiru; Stringfellow, Erin J; Russell, W Alton; Bearnot, Benjamin; Jalali, Mohammad S
Impact of Alternative Ways to Operationalize Buprenorphine Treatment Duration on Understanding Continuity of Care for Opioid Use Disorder Journal Article
In: Int J Ment Health Addict, vol. 22, no. 4, pp. 2285–2290, 2024, ISSN: 1557-1874.
@article{pmid39629044,
title = {Impact of Alternative Ways to Operationalize Buprenorphine Treatment Duration on Understanding Continuity of Care for Opioid Use Disorder},
author = {Huiru Dong and Erin J Stringfellow and W Alton Russell and Benjamin Bearnot and Mohammad S Jalali},
doi = {10.1007/s11469-022-00985-w},
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Dong, Huiru; Stringfellow, Erin J; Russell, W Alton; Bearnot, Benjamin; Jalali, Mohammad S
Impact of Alternative Ways to Operationalize Buprenorphine Treatment Duration on Understanding Continuity of Care for Opioid Use Disorder Journal Article
In: Int J Ment Health Addict, vol. 22, no. 4, pp. 2285–2290, 2024, ISSN: 1557-1874.
@article{pmid39629044b,
title = {Impact of Alternative Ways to Operationalize Buprenorphine Treatment Duration on Understanding Continuity of Care for Opioid Use Disorder},
author = {Huiru Dong and Erin J Stringfellow and W Alton Russell and Benjamin Bearnot and Mohammad S Jalali},
doi = {10.1007/s11469-022-00985-w},
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Stringfellow, Erin J; Lim, Tse Yang; Dong, Huiru; Zhang, Ziyuan; Jalali, Mohammad S
In: Addiction, vol. 118, no. 11, pp. 2215-2219, 2023, ISSN: 1360-0443.
@article{pmid37434347b,
title = {The association between longitudinal trends in receipt of buprenorphine for opioid use disorder and buprenorphine-waivered providers in the United States},
author = {Erin J Stringfellow and Tse Yang Lim and Huiru Dong and Ziyuan Zhang and Mohammad S Jalali},
doi = {10.1111/add.16291},
issn = {1360-0443},
year = {2023},
date = {2023-11-01},
urldate = {2023-07-01},
journal = {Addiction},
volume = {118},
number = {11},
pages = {2215-2219},
abstract = {AIMS, DESIGN AND SETTING: We sought to describe longitudinal trends in buprenorphine receipt and buprenorphine-waivered providers in the United States from 2003 to 2021 and measure whether the relationship between the two differed after capacity-building strategies were enacted nationally in 2017. This was a retrospective study of two separate cohorts covering the years 2003-21, testing whether the association between two trends in these cohorts changed comparing 2003 to 2016 and from 2017 to 2021, among buprenorphine providers in the United States, regardless of treatment setting. Patients receiving dispensed buprenorphine at retail pharmacies.nnPARTICIPANTS: All providers who have obtained a waiver to prescribe buprenorphine in the United States, and an estimate of the annual number of patients who had buprenorphine for opioid use disorder (OUD) dispensed to them at a retail pharmacy.nnMEASUREMENTS: We synthesized and summarized data from multiple sources to assess the cumulative number of buprenorphine-waivered providers over time. We used national-level prescription data from IQVIA to estimate annual buprenorphine receipt for OUD.nnFINDINGS: From 2003 to 2021, the number of buprenorphine-waivered providers in the United States increased from fewer than 5000 in the first 2 years of Food and Drug Administration (FDA) approval to more than 114 000 in 2021, while patients receiving buprenorphine products for OUD increased from approximately 19 000 to more than 1.4 million. The strength of association between waivered providers and patients is significantly different before and after 2017 (P \< 0.001). From 2003 to 2016, for each additional provider, there was an average increase of 32.1 [95% confidence interval (CI) = 28.7-35.6] patients, but an increase of only 4.6 (95% CI= 3.5-5.7) patients for each additional provider, beginning in 2017.nnCONCLUSIONS: In the United States, the relationship between the rates of growth in buprenorphine providers and patients became weaker after 2017. While efforts to increase buprenorphine-waivered providers were successful, there was less success in translating that into significant increases in buprenorphine receipt.},
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AIMS, DESIGN AND SETTING: We sought to describe longitudinal trends in buprenorphine receipt and buprenorphine-waivered providers in the United States from 2003 to 2021 and measure whether the relationship between the two differed after capacity-building strategies were enacted nationally in 2017. This was a retrospective study of two separate cohorts covering the years 2003-21, testing whether the association between two trends in these cohorts changed comparing 2003 to 2016 and from 2017 to 2021, among buprenorphine providers in the United States, regardless of treatment setting. Patients receiving dispensed buprenorphine at retail pharmacies.nnPARTICIPANTS: All providers who have obtained a waiver to prescribe buprenorphine in the United States, and an estimate of the annual number of patients who had buprenorphine for opioid use disorder (OUD) dispensed to them at a retail pharmacy.nnMEASUREMENTS: We synthesized and summarized data from multiple sources to assess the cumulative number of buprenorphine-waivered providers over time. We used national-level prescription data from IQVIA to estimate annual buprenorphine receipt for OUD.nnFINDINGS: From 2003 to 2021, the number of buprenorphine-waivered providers in the United States increased from fewer than 5000 in the first 2 years of Food and Drug Administration (FDA) approval to more than 114 000 in 2021, while patients receiving buprenorphine products for OUD increased from approximately 19 000 to more than 1.4 million. The strength of association between waivered providers and patients is significantly different before and after 2017 (P < 0.001). From 2003 to 2016, for each additional provider, there was an average increase of 32.1 [95% confidence interval (CI) = 28.7-35.6] patients, but an increase of only 4.6 (95% CI= 3.5-5.7) patients for each additional provider, beginning in 2017.nnCONCLUSIONS: In the United States, the relationship between the rates of growth in buprenorphine providers and patients became weaker after 2017. While efforts to increase buprenorphine-waivered providers were successful, there was less success in translating that into significant increases in buprenorphine receipt.
Vivas-Valencia, Carolina; Dong, Huiru; Stringfellow, Erin J; Russell, W Alton; Morgan, Jake R; Tadrous, Mina; Jalali, Mohammad S
Factors Associated With Abrupt Discontinuation of Long-Term High-Dose Opioid Treatment Journal Article
In: JAMA Netw Open, vol. 6, no. 11, pp. e2341416, 2023, ISSN: 2574-3805.
@article{pmid37921772,
title = {Factors Associated With Abrupt Discontinuation of Long-Term High-Dose Opioid Treatment},
author = {Carolina Vivas-Valencia and Huiru Dong and Erin J Stringfellow and W Alton Russell and Jake R Morgan and Mina Tadrous and Mohammad S Jalali},
doi = {10.1001/jamanetworkopen.2023.41416},
issn = {2574-3805},
year = {2023},
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Dong, Huiru; Stringfellow, Erin J; Russell, W Alton; Jalali, Mohammad S
Racial and Ethnic Disparities in Buprenorphine Treatment Duration in the US Journal Article
In: JAMA Psychiatry, vol. 80, iss. 1, pp. 93-95, 2023, ISSN: 2168-6238.
@article{pmid36350592,
title = {Racial and Ethnic Disparities in Buprenorphine Treatment Duration in the US},
author = {Huiru Dong and Erin J Stringfellow and W Alton Russell and Mohammad S Jalali},
doi = {10.1001/jamapsychiatry.2022.3673},
issn = {2168-6238},
year = {2023},
date = {2023-01-01},
urldate = {2023-01-01},
journal = {JAMA Psychiatry},
volume = {80},
issue = {1},
pages = {93-95},
abstract = {Buprenorphine is used to treat opioid use disorder (OUD) and reduce overdose risk.1 Duration of buprenorphine treatment is a measure of quality of care; longer retention is associated with superior clinical outcomes. Racial and ethnic minority patients are more likely to discontinue buprenorphine treatment earlier than White patients. To our knowledge, no nationally representative studies have examined buprenorphine treatment duration over time across racial and ethnic groups. This information is needed to close the racial and ethnic gap in treatment retention for OUD.},
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Buprenorphine is used to treat opioid use disorder (OUD) and reduce overdose risk.1 Duration of buprenorphine treatment is a measure of quality of care; longer retention is associated with superior clinical outcomes. Racial and ethnic minority patients are more likely to discontinue buprenorphine treatment earlier than White patients. To our knowledge, no nationally representative studies have examined buprenorphine treatment duration over time across racial and ethnic groups. This information is needed to close the racial and ethnic gap in treatment retention for OUD.
Dong, Huiru; Hayashi, Kanna; Fairbairn, Nadia; Milloy, MJ; DeBeck, Kora; Wood, Evan; Kerr, Thomas
Long term pre-treatment opioid use trajectories in relation to opioid agonist therapy outcomes among people who use drugs in a Canadian setting Journal Article
In: Addictive Behaviors, vol. 112, pp. 106655, 2021, ().
@article{dong2021long,
title = {Long term pre-treatment opioid use trajectories in relation to opioid agonist therapy outcomes among people who use drugs in a Canadian setting},
author = {Huiru Dong and Kanna Hayashi and Nadia Fairbairn and MJ Milloy and Kora DeBeck and Evan Wood and Thomas Kerr},
url = {https://pubmed.ncbi.nlm.nih.gov/32977270/},
doi = {10.1016/j.addbeh.2020.106655 },
year = {2021},
date = {2021-01-01},
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