Daniel Ciccarone, MD, MPH
Professor
Family Community Medicine
School of Medicine

My research is centered on the contextual issues of treatment and prevention of HIV/AIDS, and related diseases, in socially marginalized populations. My long-term objective is to combine ethnographic and epidemiological research to explore the intricate socio-behavioral-medical issues of medication adherence, access to care and risk taking behaviors, particularly related to drug use and drug users. My work, including collaborations, has been published in JAMA, NEJM, PLoS Medicine, AJPH, JAIDS and other peer-reviewed journals.

My recent research is in exploring the different medical consequences of use of various sources and forms of heroin. The US has recently entered a new heroin epidemic, this time fueled by the recent opioid pill epidemic. My team is exploring the economic, anthropological, historical, clinical and public health dimensions of this crisis.

Teaching: In my activities as a medical educator, I have largely worked towards improving the social, behavioral and prevention science content within the undergraduate medical school curriculum. In 2009, I became Co-Director for the Foundations of Patient Care (FPC) course. In this role, I design and administrate FPC during the Organs Block of the Essential Core course. I am also Director of the Transitional Clerkship, a two-week immersion into the clinical wards for finishing second year medical students transitioning to their clinical training years. In these roles, I am responsible for designing extensive curricula, editing syllabi, recruiting faculty, hosting sessions and direct teaching, as well as, designing and leading assessment activities.

• Innovation and adaptation: The rise of a fentanyl smoking culture in San Francisco.
  PloS one 2024 Ciccarone D, Holm N, Ondocsin J, Schlosser A, Fessel J, Cowan A, Mars SG
• How do we understand the value of drug checking as a component of harm reduction services? A qualitative exploration of client and provider perspectives.
  Harm reduction journal 2024 Moran L, Ondocsin J, Outram S, Ciccarone D, Werb D, Holm N, Arnold EA
• National and regional trends in fentanyl seizures in the United States, 2017-2023.
  The International journal on drug policy 2024 Palamar JJ, Fitzgerald N, Carr TH, Cottler LB, Ciccarone D
• Estimating changes in overdose death rates from increasing methamphetamine supply in Ohio: Evidence from crime lab data.
  Drug and alcohol dependence reports 2024 Rosenblum D, Ondocsin J, Mars SG, Cauchon D, Ciccarone D
• The influence of transformations in supply on methamphetamine initiation among people injecting opioids in the United States.
  Harm reduction journal 2024 Mars S, Ondocsin J, Holm N, Ciccarone D
• Testing the test strips: laboratory performance of fentanyl test strips.
  Harm reduction journal 2024 Halifax JC, Lim L, Ciccarone D, Lynch KL
• The motives and methods of methamphetamine and 'heroin' co-use in West Virginia.
  Harm reduction journal 2023 Ondocsin J, Holm N, Mars SG, Ciccarone D
• Insights from Drug Checking Programs: Practicing Bootstrap Public Health Whilst Tailoring to Local Drug User Needs.
  International journal of environmental research and public health 2023 Ondocsin J, Ciccarone D, Moran L, Outram S, Werb D, Thomas L, Arnold EA
• Harm reduction behaviors are associated with carrying naloxone among patients on methadone treatment.
  Harm reduction journal 2023 Kozak Z, Ciccarone D, Thrul J, Cole TO, Pappas AL, Greenblatt AD, Welsh C, Yoon M, Gann D, Artigiani EE, Wish ED, Belcher AM
• The Opioid Industry Documents Archive: A Living Digital Repository.
  American journal of public health 2022 Caleb Alexander G, Mix LA, Choudhury S, Taketa R, Tomori C, Mooghali M, Fan A, Mars S, Ciccarone D, Patton M, Apollonio DE, Schmidt L, Steinman MA, Greene J, Ling PM, Seymour AK, Glantz S, Tasker K
• Trends in characteristics of fentanyl-related poisonings in the United States, 2015-2021.
  The American journal of drug and alcohol abuse 2022 Palamar JJ, Cottler LB, Goldberger BA, Severtson SG, Grundy DJ, Iwanicki JL, Ciccarone D
• Trends in seizures of powders and pills containing illicit fentanyl in the United States, 2018 through 2021.
  Drug and alcohol dependence 2022 Palamar JJ, Ciccarone D, Rutherford C, Keyes KM, Carr TH, Cottler LB
• 'The High Five Club': Social Relations and Perspectives on HIV-Related Stigma During an HIV Outbreak in West Virginia.
  Culture, medicine and psychiatry 2022 Mars SG, Koester KA, Ondocsin J, Mars V, Mars G, Ciccarone D
• Understanding Stimulant Use and Use Disorders in a New Era.
  The Medical clinics of North America 2022 Ciccarone D, Shoptaw S
• Prevalence and factors associated with chronic venous insufficiency, leg ulceration and deep-vein thrombosis among people who inject drugs in London, UK.
  Drug and alcohol review 2021 Doran J, Hope V, Wright T, Scott J, Ciccarone D, Harris M
• Correction to: Hostility, compassion and role reversal in West Virginia's long opioid overdose emergency.
  Harm reduction journal 2021 Ondocsin J, Mars SG, Howe M, Ciccarone D
• The rise of illicit fentanyls, stimulants and the fourth wave of the opioid overdose crisis.
  Current opinion in psychiatry 2021 Ciccarone D
• Identifying counties at risk of high overdose mortality burden during the emerging fentanyl epidemic in the USA: a predictive statistical modelling study.
  The Lancet. Public health 2021 Marks C, Abramovitz D, Donnelly CA, Carrasco-Escobar G, Carrasco-Hernández R, Ciccarone D, González-Izquierdo A, Martin NK, Strathdee SA, Smith DM, Bórquez A
• Methodological approaches for the prediction of opioid use-related epidemics in the United States: a narrative review and cross-disciplinary call to action.
  Translational research : the journal of laboratory and clinical medicine 2021 Marks C, Carrasco-Escobar G, Carrasco-Hernández R, Johnson D, Ciccarone D, Strathdee SA, Smith D, Bórquez A
• Responding to the Opioid Epidemic: Educational Competencies for Pain and Substance Use Disorder from the Medical Schools of the University of California.
  Pain medicine (Malden, Mass.) 2021 Servis M, Fishman SM, Wallace MS, Henry SG, Ziedonis D, Ciccarone D, Knight KR, Shoptaw S, Dowling P, Suchard JR, Shah S, Singh N, Cedarquist LC, Alem N, Copenhaver DJ, Westervelt M, Willis BC
• Rise in Presence of Methamphetamine in Oral Fluid Toxicology Tests Among Outpatients in a Large Healthcare Setting in the Northeast.
  Journal of addiction medicine 2021 Wakeman S, Flood J, Ciccarone D
• Hostility, compassion and role reversal in West Virginia's long opioid overdose emergency.
  Harm reduction journal 2020 Ondocsin J, Mars SG, Howe M, Ciccarone D
• Prevalence and severity of abscesses and cellulitis, and their associations with other health outcomes, in a community-based study of people who inject drugs in London, UK.
  PloS one 2020 Wright T, Hope V, Ciccarone D, Lewer D, Scott J, Harris M
• Correction to: Navigating environmental constraints to injection preparation: the use of saliva and other alternatives to sterile water among unstably housed PWID in London.
  Harm reduction journal 2020 Harris M, Scott J, Hope V, Wright T, McGowan C, Ciccarone D
• High prevalence of albuminuria amongst people who inject drugs: A cross-sectional study.
  Scientific reports 2020 McGowan CR, Wright T, Nitsch D, Lewer D, Brathwaite R, Scott J, Hope V, Ciccarone D, Dunn J, Gillmore J, Story A, Harris M
• Navigating environmental constraints to injection preparation: the use of saliva and other alternatives to sterile water among unstably housed PWID in London.
  Harm reduction journal 2020 Harris M, Scott J, Hope V, Wright T, McGowan C, Ciccarone D
• Frequency of health-care utilization by adults who use illicit drugs: a systematic review and meta-analysis.
  Addiction (Abingdon, England) 2020 Lewer D, Freer J, King E, Larney S, Degenhardt L, Tweed EJ, Hope VD, Harris M, Millar T, Hayward A, Ciccarone D, Morley KI
• The Rapidly Changing US Illicit Drug Market and the Potential for an Improved Early Warning System: Evidence from Ohio Drug Crime Labs.
  Drug and alcohol dependence 2020 Rosenblum D, Unick J, Ciccarone D
• Heroin type, injecting behavior, and HIV transmission. A simulation model of HIV incidence and prevalence.
  PloS one 2019 Bobashev G, Mars S, Murphy N, Dreisbach C, Zule W, Ciccarone D
• Injecting-related health harms and overuse of acidifiers among people who inject heroin and crack cocaine in London: a mixed-methods study.
  Harm reduction journal 2019 Harris M, Scott J, Wright T, Brathwaite R, Ciccarone D, Hope V
• Heroin Smoking Is Not Common in the United States.
  JAMA neurology 2019 Ciccarone D
• Fentanyl: the many challenges ahead.
  Addiction (Abingdon, England) 2019 Mars SG, Rosenblum D, Ciccarone D
• The triple wave epidemic: Supply and demand drivers of the US opioid overdose crisis.
  The International journal on drug policy 2019 Ciccarone D
• Illicit fentanyls in the opioid street market: desired or imposed?
  Addiction (Abingdon, England) 2018 Mars SG, Rosenblum D, Ciccarone D
• Fentanyl test strips as an opioid overdose prevention strategy: Findings from a syringe services program in the Southeastern United States.
  The International journal on drug policy 2018 Peiper NC, Clarke SD, Vincent LB, Ciccarone D, Kral AH, Zibbell JE
• Drawing attention to a neglected injecting-related harm: a systematic review of AA amyloidosis among people who inject drugs.
  Addiction (Abingdon, England) 2018 Harris M, Brathwaite R, Scott J, Gilchrist G, Ciccarone D, Hope V, McGowan CR
• Toots, tastes and tester shots: user accounts of drug sampling methods for gauging heroin potency.
  Harm reduction journal 2018 Mars SG, Ondocsin J, Ciccarone D
• 'Care and Prevent': rationale for investigating skin and soft tissue infections and AA amyloidosis among people who inject drugs in London.
  Harm reduction journal 2018 Harris M, Brathwaite R, McGowan CR, Ciccarone D, Gilchrist G, McCusker M, O'Brien K, Dunn J, Scott J, Hope V
• Opioid Crisis: No Easy Fix to Its Social and Economic Determinants.
  American journal of public health 2017 Dasgupta N, Beletsky L, Ciccarone D
• Sold as Heroin: Perceptions and Use of an Evolving Drug in Baltimore, MD.
  Journal of psychoactive drugs 2017 Mars SG, Ondocsin J, Ciccarone D
• Fentanyl in the US heroin supply: A rapidly changing risk environment.
  The International journal on drug policy 2017 Ciccarone D
• Heroin uncertainties: Exploring users' perceptions of fentanyl-adulterated and -substituted 'heroin'.
  The International journal on drug policy 2017 Ciccarone D, Ondocsin J, Mars SG
• US regional and demographic differences in prescription opioid and heroin-related overdose hospitalizations.
  The International journal on drug policy 2017 Unick GJ, Ciccarone D
• The Textures of Heroin: User Perspectives on "Black Tar" and Powder Heroin in Two U.S. Cities.
  Journal of psychoactive drugs 2016 Mars SG, Bourgois P, Karandinos G, Montero F, Ciccarone D
• Nationwide increase in hospitalizations for heroin-related soft tissue infections: Associations with structural market conditions.
  Drug and alcohol dependence 2016 Ciccarone D, Unick GJ, Cohen JK, Mars SG, Rosenblum D
• Injecting drugs in tight spaces: HIV, cocaine and collinearity in the Downtown Eastside, Vancouver, Canada.
  The International journal on drug policy 2016 Ciccarone D, Bourgois P
• Heroin-related overdose: The unexplored influences of markets, marketing and source-types in the United States.
  Social science & medicine (1982) 2015 Mars SG, Fessel JN, Bourgois P, Montero F, Karandinos G, Ciccarone D
• Fire in the vein: Heroin acidity and its proximal effect on users' health.
  The International journal on drug policy 2015 Ciccarone D, Harris M
• The relationship between US heroin market dynamics and heroin-related overdose, 1992-2008.
  Addiction (Abingdon, England) 2014 Unick G, Rosenblum D, Mars S, Ciccarone D
• Urban segregation and the US heroin market: a quantitative model of anthropological hypotheses from an inner-city drug market.
  The International journal on drug policy 2013 Rosenblum D, Castrillo FM, Bourgois P, Mars S, Karandinos G, Unick GJ, Ciccarone D
• "Every 'never' I ever said came true": transitions from opioid pills to heroin injecting.
  The International journal on drug policy 2013 Mars SG, Bourgois P, Karandinos G, Montero F, Ciccarone D
• The entry of Colombian-sourced heroin into the US market: the relationship between competition, price, and purity.
  The International journal on drug policy 2013 Rosenblum D, Unick GJ, Ciccarone D
• The good-enough science-and-politics of anthropological collaboration with evidence-based clinical research: Four ethnographic case studies.
  Social science & medicine (1982) 2013 Messac L, Ciccarone D, Draine J, Bourgois P
• Intertwined epidemics: national demographic trends in hospitalizations for heroin- and opioid-related overdoses, 1993-2009.
  PloS one 2013 Unick GJ, Rosenblum D, Mars S, Ciccarone D
• Saying goodbye to high-dead-space syringes.
  The International journal on drug policy 2012 Ciccarone D
• A technology-enhanced medical note-writing workshop.
  Medical education 2012 Ciccarone D, Yu T, Nye H, Chang A
• A SBIRT curriculum for medical residents: development of a performance feedback tool to build learner confidence.
  Substance abuse 2012 Hettema JE, Ratanawongsa N, Manuel JK, Ciccarone D, Coffa D, Jain S, Lum PJ
• Review of The World Heroin Market: Can Supply Be Cut? (Oxford, 2009) by Letizia Paoli, Victoria A. Greenfield and Peter Reuter
  Asian Journal of Criminology 2012 Ciccarone D.
• Henceforth harm reduction?
  The International journal on drug policy 2011 Ciccarone D
• Stimulant abuse: pharmacology, cocaine, methamphetamine, treatment, attempts at pharmacotherapy.
  Primary care 2011 Ciccarone D
• Impact of South American heroin on the US heroin market 1993-2004.
  The International journal on drug policy 2009 Ciccarone D, Unick GJ, Kraus A
• Heroin in brown, black and white: structural factors and medical consequences in the US heroin market.
  The International journal on drug policy 2008 Ciccarone D
• Improving medical student communication skills through improvisational theatre.
  Medical education 2008 Hoffman A, Utley B, Ciccarone D
• Understanding illicit substance use in the real world.
  Medical education 2008 Ciccarone D, Jain S, Bourgois P
• Interactive "Video Doctor" counseling reduces drug and sexual risk behaviors among HIV-positive patients in diverse outpatient settings.
  PloS one 2008 Gilbert P, Ciccarone D, Gansky SA, Bangsberg DR, Clanon K, McPhee SJ, Calderón SH, Bogetz A, Gerbert B
• Nationwide increase in the number of hospitalizations for illicit injection drug use-related infective endocarditis.
  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2007 Cooper HL, Brady JE, Ciccarone D, Tempalski B, Gostnell K, Friedman SR
• Reinterpreting ethnic patterns among white and African American men who inject heroin: a social science of medicine approach.
  PLoS medicine 2006 Bourgois P, Martinez A, Kral A, Edlin BR, Schonberg J, Ciccarone D
• The CASE adherence index: A novel method for measuring adherence to antiretroviral therapy.
  AIDS care 2006 Mannheimer SB, Mukherjee R, Hirschhorn LR, Dougherty J, Celano SA, Ciccarone D, Graham KK, Mantell JE, Mundy LM, Eldred L, Botsko M, Finkelstein R
• Correlates of sex without serostatus disclosure among a national probability sample of HIV patients.
  AIDS and behavior 2006 Duru OK, Collins RL, Ciccarone DH, Morton SC, Stall R, Beckman R, Miu A, Kanouse DE
• Reframing "prevention with positives": incorporating counseling techniques that improve the health of HIV-positive patients.
  AIDS patient care and STDs 2006 Gerbert B, Danley DW, Herzig K, Clanon K, Ciccarone D, Gilbert P, Allerton M
• Naloxone distribution and cardiopulmonary resuscitation training for injection drug users to prevent heroin overdose death: a pilot intervention study.
  Journal of urban health : bulletin of the New York Academy of Medicine 2005 Seal KH, Thawley R, Gee L, Bamberger J, Kral AH, Ciccarone D, Downing M, Edlin BR
• HIV prevalence and risk behaviors among men who have sex with men and inject drugs in San Francisco.
  Journal of urban health : bulletin of the New York Academy of Medicine 2005 Kral AH, Lorvick J, Ciccarone D, Wenger L, Gee L, Martinez A, Edlin BR
• The Political Economy of Heroin: Regional Markets, Practices and Consequences
  Int J Drug Policy 2005 Ciccarone D
• The cost of HIV medication adherence support interventions: Results of a cross-site evaluation
  AIDS Care 2005 Schackman BR, Finkelstein R, Neukermans CP, Lewis L, Eldred L, Ciccarone D et al.
• Integrating HIV risk reduction into the medical curriculum.
  Medical education 2004 Ciccarone D, Coffin P, Preer G
• Origins of community strains of methicillin-resistant Staphylococcus aureus.
  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2004 Charlebois ED, Perdreau-Remington F, Kreiswirth B, Bangsberg DR, Ciccarone D, Diep BA, Ng VL, Chansky K, Edlin BR, Edlin B, Chambers HF
• Explaining the geographical variation of HIV among injection drug users in the United States.
  Substance use & misuse 2003 Ciccarone D, Bourgois P
• Attitudes about prescribing take-home naloxone to injection drug users for the management of heroin overdose: a survey of street-recruited injectors in the San Francisco Bay Area.
  Journal of urban health : bulletin of the New York Academy of Medicine 2003 Seal KH, Downing M, Kral AH, Singleton-Banks S, Hammond JP, Lorvick J, Ciccarone D, Edlin BR
• Sex without disclosure of positive HIV serostatus in a US probability sample of persons receiving medical care for HIV infection.
  American journal of public health 2003 Ciccarone DH, Kanouse DE, Collins RL, Miu A, Chen JL, Morton SC, Stall R
• With Both Eyes Open: Notes on a Disciplinary Dialogue between Ethnographic and Epidemiological Research among Injection Drug Users
  Int J Drug Policy 2003 Ciccarone D.
• Is it justifiable to withhold treatment for hepatitis C from illicit-drug users?
  The New England journal of medicine 2001 Edlin BR, Seal KH, Lorvick J, Kral AH, Ciccarone DH, Moore LD, Lo B
• Risk factors for skin and soft-tissue abscesses among injection drug users: a case-control study.
  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2001 Murphy EL, DeVita D, Liu H, Vittinghoff E, Leung P, Ciccarone DH, Edlin BR
• Provider assessment of adherence to HIV antiretroviral therapy.
  Journal of acquired immune deficiency syndromes (1999) 2001 Bangsberg DR, Hecht FM, Clague H, Charlebois ED, Ciccarone D, Chesney M, Moss A
• Soft Tissue Infections Among Injection Drug Users - San Francisco, California, 1996-2000
  JAMA 2001 Ciccarone D, Bamberger J, Kral A, Hobart CJ, Moon A, Edlin BR, Harris HW, Young DM, Bourgois P, Murphy EL.
• The cost-effectiveness of voluntary counseling and testing of hospital inpatients for HIV infection.
  JAMA 1994 Lurie P, Avins AL, Phillips KA, Kahn JG, Lowe RA, Ciccarone D
• The cost-effectiveness of HIV testing of physicians and dentists in the United States.
  JAMA 1994 Phillips KA, Lowe RA, Kahn JG, Lurie P, Avins AL, Ciccarone D
• Undiagnosed HIV infection in acute care hospitals.
  The New England journal of medicine 1992 Lurie P, Lowe RA, Avins AL, Phillips KA, Kahn JG, Franks PE, Ciccarone DH