{"id":710,"date":"2026-02-23T16:55:59","date_gmt":"2026-02-23T21:55:59","guid":{"rendered":"https:\/\/sites.bu.edu\/ctmh\/?p=710"},"modified":"2026-02-23T16:55:59","modified_gmt":"2026-02-23T21:55:59","slug":"affiliate-spotlight-rachel-sayko-adams-phd-mph","status":"publish","type":"post","link":"https:\/\/sites.bu.edu\/ctmh\/2026\/02\/23\/affiliate-spotlight-rachel-sayko-adams-phd-mph\/","title":{"rendered":"Affiliate Spotlight: Rachel Sayko Adams, PhD, MPH"},"content":{"rendered":"

Each newsletter we feature a CTMH affiliate to learn a bit more about their work. This month we speak with Dr. Rachel Sayko Adams<\/a>, Research Associate Professor in <\/span>Health Law, Policy & Management<\/span><\/span>. Click to listen to the audio interview:<\/h4>\n

\"Audio<\/a><\/h4>\n

In the interview, Dr. Adams describes her path from a BU MPH student to a substance use researcher, explaining how she came to focus on health disparities in access to care and long-term outcomes at the intersection of traumatic brain injury\u00a0(TBI), mental health, and addiction in both military and civilian populations.<\/span>\u00a0<\/span><\/p>\n

She\u00a0outlines how she and her colleagues developed the model, “the perfect storm” which describes a cascade of vulnerabilities for people with TBI\u00a0elevating\u00a0risk for\u00a0opioid\u00a0overdose and suicide.\u00a0<\/span>\u00a0<\/span>Dr. Adams\u2019s\u00a0team\u00a0recently\u00a0received a second\u00a0INROADS<\/a> (Intersecting Research on Opioid Misuse, Addiction, and Disability Services)\u00a0grant from\u00a0the National Institute on Alcohol Abuse and Alcoholism:<\/span>\u00a0<\/span><\/p>\n

“Now, we’re really thinking about the broad community of people with disabilities, including people with TBI…\u00a0and\u00a0if they’re experiencing alcohol-related problems in the same manner and scope as people without disabilities…\u00a0We’re\u00a0really trying to discover if there are disparities in care for people with disabilities with alcohol problems… We are partnering with people with lived experience. We think that this is an area where, unfortunately, there’s been not much research done to focus on these specific needs, and we’re really excited to continue to do this work.”<\/span>\u00a0<\/span><\/p>\n

Transcript: <\/u><\/strong><\/p>\n

(The audio transcript of this interview has been edited for clarity)<\/em><\/p>\n

Claire Dillenbeck: Welcome to the Affiliate Spotlight with the Center for Trauma and Mental Health.\u00a0I’m\u00a0Claire Dillenbeck, and today\u00a0I’m\u00a0talking to\u00a0Dr.\u00a0Rachel\u00a0Sayko\u00a0Adams, Research Associate Professor with the Health Law,\u00a0Policy, and Management Department at BUSPH. Welcome, Rachel.<\/p>\n

Rachel Sayko Adams: Thanks for having me, Claire.<\/p>\n

Claire Dillenbeck:\u00a0Can\u00a0you start by telling us a little bit about yourself and how you arrived at public health and mental health?<\/strong><\/p>\n

Rachel Sayko Adams:\u00a0One of the first things I want to share is that\u00a0I’m\u00a0an alum of the BU School of Public Health MPH program.\u00a0I did my MPH here, graduating in 2008, in Health Policy and Management. Then I went on to get a PhD\u00a0focusing on behavioral health services, and I trained\u00a0as a substance use researcher, and learned a lot about\u00a0addiction. A\u00a0lot of my work focuses on\u00a0big populations using healthcare claims and trying to understand what happens to people and how the care that they receive and the treatment that they receive\u00a0relates\u00a0to their long-term health outcomes.\u00a0I’m\u00a0very focused\u00a0on addiction and mental health and how that relates to trauma.<\/p>\n

Claire Dillenbeck: Excellent. That is great to hear, especially as a BU\u00a0MPH student myself!<\/p>\n

01:30<\/p>\n

Claire Dillenbeck:\u00a0A lot of your current research focuses on military members, veterans, and people with disabilities. How has working with these groups shaped how you think about trauma and recovery?<\/strong><\/p>\n

Rachel Sayko Adams: Yes, so\u00a0that’s\u00a0how\u00a0I’ll\u00a0make the\u00a0initial\u00a0connection from addiction to trauma. I think\u00a0there’s\u00a0a lot of\u00a0connections;\u00a0for\u00a0people who experience addiction,\u00a0there’s\u00a0a higher risk of having a\u00a0trauma\u00a0prior to addiction, but also,\u00a0addiction increases your risk for\u00a0experiencing\u00a0different types\u00a0of traumatic events.<\/p>\n

The way I came to learn about this connection\u00a0was\u00a0when I was doing my PhD;\u00a0it was around the time of intense deployments associated with the Afghanistan and Iraq conflicts that were happening.\u00a0I\u00a0was\u00a0asked to join a research project focusing on\u00a0the impacts\u00a0of deployment\u00a0for\u00a0military\u00a0families. I was studying to be an addiction researcher, and\u00a0I started learning about military culture more. Having been someone who\u00a0doesn’t\u00a0come from a military family,\u00a0at least my immediate family,\u00a0I\u00a0didn’t\u00a0know a lot about it.\u00a0I started\u00a0to learn specifically\u00a0about\u00a0the predominant culture of heavy alcohol use that happens in military environments.\u00a0I was thinking about that in relation to\u00a0all\u00a0these deployments\u00a0and military members coming back.<\/p>\n

At the same time, I also was paying attention to what they were calling the new signature injury of those conflicts, which was traumatic brain injury, or blast-related head injuries,\u00a0that were happening during these deployments.\u00a0I started meeting TBI researchers and learning a lot about it.\u00a0I started to think,\u00a0what’s\u00a0going to\u00a0happen with these military members who have these head injuries, and then come back from\u00a0deployment?\u00a0They resume their alcohol use that they were engaging in prior to deployment.\u00a0It\u2019s\u00a0very common to binge-drink in the military,\u00a0multiple\u00a0times a month, and\u00a0how is that\u00a0going to\u00a0impact their overall well-being?<\/p>\n

I ended up doing a dissertation\u00a0really\u00a0digging into the association between experiencing a military-related traumatic brain injury or head injury in relation to future at-risk drinking behaviors and consequences of drinking.\u00a0I found\u00a0that people with a history of deployment-related TBI were at risk for engaging in more frequent binge drinking when they\u00a0got\u00a0back, so it was increasing the risk of that behavior\u00a0and\u00a0risk of higher,\u00a0negative consequences from that drinking behavior.<\/p>\n

That work really\u00a0set\u00a0me on a path of continuing to do work in\u00a0the traumatic\u00a0brain injury or concussion space.\u00a0Thinking a lot about\u00a0different types\u00a0of addiction following\u00a0TBI,\u00a0and\u00a0I continue to do that work with both military members and veterans, as well as with civilian populations.<\/p>\n

04:43<\/p>\n

Claire Dillenbeck:\u00a0It’s\u00a0very interesting.\u00a0One part of this\u00a0work\u00a0is that\u00a0you’ve\u00a0developed a model, the\u00a0<\/strong>Perfect Storm<\/strong><\/a>,\u00a0regarding\u00a0how people with a history of traumatic brain injury are at risk for opioid use and the devastating consequences of\u00a0addiction.\u00a0Can you tell us a little bit about The Perfect Storm?<\/strong><\/p>\n

Rachel Sayko Adams: I think all of you are familiar and have heard that in the United States, we had a very severe overdose and opioid crisis. Around 2018,\u00a0my colleagues and I received a grant to look at how the disability community was\u00a0impacted\u00a0by this opioid or overdose epidemic, because they had been really, not\u00a0been paid attention\u00a0to\u00a0as much in that work.\u00a0Through that work, we ended up doing more investigations specifically about individuals with a history of traumatic brain injury.<\/p>\n

We\u00a0put\u00a0together a lot of information from different literature and studies that people were doing, and we\u00a0came up with\u00a0a model that\u00a0suggested that people with a history of TBI, first\u00a0in Phase 1,\u00a0are more susceptible to receiving prescription opioids, and that has to do with the fact that\u00a0they’re\u00a0much more likely to have pain following head injury.\u00a0Chronic pain is\u00a0a very common\u00a0consequence of TBI, or concussion, and\u00a0during the opioid crisis, pain was really a driver of receiving opioids in our country as a prescription, at least in the early years.\u00a0Then people with TBI are also more likely to have mental health consequences and psychiatric problems, which sometimes do lead to opioid\u00a0receipt\u00a0as well.<\/p>\n

In the second phase of that Perfect Storm\u00a0model\u00a0is that\u00a0we suggested that once individuals with TBI receive prescription opioids or start using opioids,\u00a0they’re\u00a0more likely to advance to using opioids long-term or to developing opioid use disorder or experiencing opioid misuse than people without TBI.\u00a0A\u00a0lot of our research studies since then,\u00a0and others in the\u00a0field,\u00a0have provided evidence to support that phase as well.\u00a0There’re\u00a0now studies that have been done with\u00a0civilian\u00a0populations, with college students with concussion history, and with\u00a0military members\u00a0that\u00a0demonstrate\u00a0that\u00a0individuals with TBI who start using opioids are more likely to advance to problematic opioid use.<\/p>\n

In the third phase of the model, we hypothesize that if individuals with TBI develop opioid use disorder(addiction)that they might face greater barriers accessing substance use disorder treatment, or they might receive\u00a0worse quality care when in that treatment. At the time,\u00a0we\u00a0developed\u00a0this model around 2018-2019,\u00a0there\u00a0wasn’t\u00a0a lot of research\u00a0actually looking\u00a0at\u00a0that\u00a0specific\u00a0piece of the model. There\u00a0weren’t\u00a0a lot of studies looking at substance use treatment to see if people with TBI had the same experience, the same access, or quality care. But since then, there have been several studies, and what we have seen through the work\u00a0we’ve\u00a0done with\u00a0colleagues\u00a0and some other researchers is that\u00a0people with TBI,\u00a0who\u00a0have opioid use disorder are less likely to receive medications for opioid use disorder, such as buprenorphine or methadone.\u00a0They’re\u00a0less likely to start using those evidence-based medications.\u00a0Other studies have also shown that they are also less likely to\u00a0continue on\u00a0them for a certain\u00a0period of time, which is really\u00a0an indication\u00a0of\u00a0quality care.<\/p>\n

My\u00a0colleagues and I have done a lot of thinking about this, and\u00a0just,\u00a0the implications for substance use treatment providers, about\u00a0understanding\u00a0the population of people in their practice who have history of TBI or concussion, and how\u00a0they may need to provide more\u00a0accommodations\u00a0or more tailored care\u00a0to\u00a0acknowledge the potential cognitive deficits that these individuals may have, or, increase targeted care to make treatment more appealing, more accessible, and more\u00a0effective for these individuals.<\/p>\n

There’s\u00a0a last piece of that model is that\u00a0we\u00a0acknowledge that both\u00a0developing opioid use disorder, or having opioid use disorder, but not getting quality substance use disorder treatment increases risk for really devastating outcomes, like overdose, or as well as death by suicide.\u00a0These are\u00a0very critical, critically\u00a0important issues\u00a0for the field.<\/p>\n

Claire Dillenbeck:\u00a0As\u00a0you’re\u00a0talking,\u00a0I’m\u00a0thinking\u00a0from\u00a0my clinical experience, and it just feels so important to understand how all these things are coming together\u00a0to affect these folks.<\/p>\n

10:12<\/p>\n

Claire Dillenbeck:\u00a0From your work, what are\u00a0you\u00a0excited about or\u00a0feel\u00a0hopeful about in terms of research directions in trauma and mental health?<\/p>\n

Rachel Sayko Adams:\u00a0My colleague Sharon Reef, at Brandeis, as well as\u00a0my\u00a0colleagues I have here at BU School of Public Health,\u00a0have a grant funded by the National Institute on Alcohol Abuse and Alcoholism that we call\u00a0INROADS,<\/a>\u00a0which\u00a0stands\u00a0for\u00a0Intersecting Research on Opioid Misuse, Addiction, and Disability Services.\u00a0This is the second INROADS\u00a0grant we received. The first one was focused on opioids, and\u00a0that’s\u00a0where a lot of\u00a0this work came that supported the development of the Perfect Storm model.\u00a0Now,\u00a0we’re\u00a0also really thinking\u00a0about\u00a0the broad community of people with disabilities, including people with\u00a0TBI,\u00a0as well as\u00a0people with other types of disabilities\u00a0and\u00a0if\u00a0they’re\u00a0experiencing alcohol-related problems in the same manner and scope as people without disabilities, if\u00a0they\u00a0have\u00a0the same access to appropriate\u00a0substance use disorder treatment,\u00a0if they do develop problems with alcohol, and if they receive the same quality care.\u00a0We’re\u00a0really trying to\u00a0discover\u00a0if there are disparities in care\u00a0for\u00a0people with disabilities with alcohol problems.<\/p>\n

We’re\u00a0very excited\u00a0about that work. We are partnering\u00a0with\u00a0people with\u00a0lived\u00a0experience.\u00a0We\u00a0think that this is an area where, unfortunately,\u00a0there’s\u00a0been not much research done to focus on these specific needs,\u00a0and\u00a0we’re\u00a0really\u00a0excited\u00a0to continue to do this work.<\/p>\n

12:02<\/p>\n

Claire Dillenbeck: Great.\u00a0Thank you so much for taking the time to speak with us today, and\u00a0I’m\u00a0looking forward to hearing what comes out of that work in the future.<\/p>\n

Rachel Sayko Adams: My pleasure.\u00a0Thanks, Claire.<\/p>\n","protected":false},"excerpt":{"rendered":"

Each newsletter we feature a CTMH affiliate to learn a bit more about their work. This month we speak with Dr. Rachel Sayko Adams, Research Associate Professor in Health Law, Policy & Management. Click to listen to the audio interview: In the interview, Dr. Adams describes her path from a BU MPH student to a […]<\/p>\n","protected":false},"author":25441,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/sites.bu.edu\/ctmh\/wp-json\/wp\/v2\/posts\/710"}],"collection":[{"href":"https:\/\/sites.bu.edu\/ctmh\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/sites.bu.edu\/ctmh\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/sites.bu.edu\/ctmh\/wp-json\/wp\/v2\/users\/25441"}],"replies":[{"embeddable":true,"href":"https:\/\/sites.bu.edu\/ctmh\/wp-json\/wp\/v2\/comments?post=710"}],"version-history":[{"count":4,"href":"https:\/\/sites.bu.edu\/ctmh\/wp-json\/wp\/v2\/posts\/710\/revisions"}],"predecessor-version":[{"id":725,"href":"https:\/\/sites.bu.edu\/ctmh\/wp-json\/wp\/v2\/posts\/710\/revisions\/725"}],"wp:attachment":[{"href":"https:\/\/sites.bu.edu\/ctmh\/wp-json\/wp\/v2\/media?parent=710"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/sites.bu.edu\/ctmh\/wp-json\/wp\/v2\/categories?post=710"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/sites.bu.edu\/ctmh\/wp-json\/wp\/v2\/tags?post=710"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}