Center to Improve Veteran Involvement in Care (CIVIC)
Investigator Story: Jessica Wyse, PhD
Written by Noah Jacobson
Dr. Jessica Wyse’s start at CIVIC signified a return to her roots. She grew up in the adjacent Hillsdale neighborhood and attended Ida B Wells High School, both a short walk from CIVIC. Her studies took her to Connecticut for college and later to the Midwest, where she earned a doctorate in Sociology and Public Policy from the University of Michigan and completed a postdoctoral fellowship at their Institute for Social Research, both in Ann Arbor.
Dr. Wyse applies qualitative methods to uncover how systems and policies might better meet people’s needs. “I like hearing people’s stories and how they think, and identifying social patterns across the experiences of individuals,” explains Wyse. Through this lens, Dr. Wyse explored US poverty policy, issues around prisoner reentry, and most recently, medications for opioid use disorder.
Prior to CIVIC, Dr. Wyse focused on the criminal justice system and justice-involved individuals, working with Multnomah County. She interviewed individuals with untreated substance use disorders, as part of an initiative to provide injectable naltrexone, a medication for opioid use disorder (MOUD) to residents of the Multnomah County jail.
“I was surprised to learn that there were effective medications that were incredibly underutilized,” Dr. Wyse remarked. She continued, “in fact, the only time I had heard about buprenorphine (an opioid use disorder medication) previously was from an interview subject who bought the medication from her drug dealer.” This experience sparked her curiosity into the cultural and system-level barriers that were preventing patients from accessing these medications.
In 2016, Dr. Wyse arrived at CIVIC as a postdoctoral fellow and continued gaining momentum. She documented the development of a primary care buprenorphine clinic at the Portland VA. This study provides a narrative account, which Dr Wyse feels can uniquely benefit other clinics as they build their own programs. In 2020, she received a Career Development Award to expand buprenorphine access in rural primary care settings. As a result, Dr. Wyse and her colleagues discovered that in the past five years, VA and national initiatives expanded access to treatment broadly with no disparities in the proportion of patients receiving MOUD between urban and rural health systems.
While MOUD halves the risk of death, nationally, less than half of patients receive medication. She believes VA could serve as a model for other health care systems looking to expand access to MOUD.
Moving forward, Dr. Wyse plans to expand upon this timely body of research surrounding opioid treatment. The direct connections between research and clinical care through VA and OHSU result in many outlets to share and learn about new findings and engage with colleagues. She points to Dr. Katherine Mackey as an example of a collaborator spreading awareness and best practices surrounding MOUD in primary care. She also highlights resources like HSR&D Cyberseminars, the Evidence Synthesis Program, and various newsletters as “a great way to keep abreast of current research that can inform clinical care.” In fact, Dr. Wyse recently shared her next project, a proposal on the predictors and processes of buprenorphine discontinuation, in a CIVIC Cyberseminar.
Dr. Wyse has found a home at CIVIC. She cherishes the community a learning health system affords, and the opportunity to give voice to Veterans’ experiences. In the future, she envisions a larger scale investigation into buprenorphine discontinuation outcomes, and a return to criminal justice research, particularly around access to substance use disorder treatment. She is also interested in studying innovations in methadone delivery or potentially the new psilocybin therapy. Outside of the lab, you’ll likely find Dr. Wyse tending her garden, coaching basketball, or diving into a mystery novel. Regardless of where her journey continues, Dr. Wyse remains eager to solve the puzzles in her path.
