Dr. Merlin is a Professor with Tenure in the Division of General Internal Medicine and Director of the CHAllenges in Managing and Preventing Pain (CHAMPP) clinical research center. She is a physician and is board certified in internal medicine, infectious diseases, palliative care, and addiction medicine. She is also a PhD-trained behavioral scientist and NIH-funded clinician-investigator. Her large, NIH-funded program of research focuses on the intersection of chronic pain and opioid misuse/use disorder across populations and settings. To that end, among other NIH-funded studies, she is the MPI of the NIH-funded Tailored Retention and Engagement for Equitable Treatment of Opioid Use Disorder and Pain (TREETOP) clinical research center, one of four NIH-funded centers focusing on the intersection of pain and opioid use disorder in the US. Her work is widely published in prominent journals, and she serves as a scientific mentor to many PhD students, post-doctoral fellows, and faculty with similar interests. She is an active clinician, including as co-director of a palliative care program for individuals with serious illness who also have a substance use disorder. She has been recognized nationally with numerous prestigious research, leadership, and mentorship awards.
Dr. Merlin is a native Pittsburgher and is a graduate of Taylor Allderdice High School. She enjoys taking epic road trips with her husband and two children that involve amazing food, friends, and hiking.
Education & Training
- BS (Biology & History and Policy), Carnegie Mellon University, 2000
- MD, University of Pennsylvania, 2005
- MBA (Health Policy and Management), The Wharton School, University of Pennsylvania, 2005
- Residency (Internal Medicine), Hospital of the University of Pennsylvania, 2008
- Fellowship (Infectious Diseases), Hospital of the University of Pennsylvania, 2010
- Fellowship (Palliative Care), Mt. Sinai School of Medicine, 2011
- PhD (Health Education and Promotion), University of Alabama at Birmingham, 2017
Representative Publications
Fitzgerald Jones K*, Khodyakkov D, Arnold R, Bulls H, Dao E, Kapo J, Meier D, Paice J, Liebschutz J, Ritchie C, Merlin J. Consensus-based guidance on opioid management in individuals with advanced cancer-related pain and opioid misuse or use disorder. JAMA Oncol. 2022 Sug 1;8(8):1107-1114.
Key Delphi results include: For a patient with untreated OUD, regardless of prognosis, it was deemed inappropriate to begin treatment with buprenorphine/naloxone and inappropriate to refer to a methadone clinic; beginning split-dose methadone was deemed appropriate for patients with shorter prognoses and of uncertain appropriateness for those with longer prognoses; beginning a full opioid agonist was deemed of uncertain appropriateness for those with a short prognosis and inappropriate for those with a longer prognosis.
Ho J*, Jones KF**, Sager Z, Neale K, Childers JW, Loggers E, Merlin JS. Barriers to buprenorphine prescribing for opioid use disorder in hospice and palliative care. J Pain Symptom Manage. 2022 Aug;64(2):119-127.
Among hospice and palliative care clinicians, important barriers included discomfort managing concurrent pain, buprenorphine, and OUD; concerns about impacts on practice; unsupportive practice culture; insufficient practice support; patient facing challenges; and cumbrsome regulatory policies.
Merlin JS, Althouse A, Feldman R, Arnsten JH, Bulls HW, Liebschutz JM, Nugent SM, Orris SR, Rohac R, Starrels JL, Morasco BJ, Kansagara D. Analysis of state cannabis laws and dispensary staff recommendations to adults purchasing medical cannabis. JAMA Netw Open. 2021 Sep 1;4(9):e2124511.
In this nationwide cross-sectional study of 434 employees from 351 unique dispensaries, most respondents reported basing customer recommendations on the customer's medical condition, the experiences of other customers, the customer's prior experience with cannabis, and the respondent's personal experience; few counseled customers about important risks, including cannabis use disorder, withdrawal, motor vehicle collision risk, or psychotic reactions.
Merlins JS, Khodyakov D, Arnold R, Bulls HW*, Dao E, Kapo J, King C*, Meier D, Paice J, Ritchie C, Liebschutz JM. Expert panel consensus on managment of advanced cancer-related pain in individuals with opioid use disorder. JAMA Netw Open. 2021 Dec 1;4(12):e2139968.
Key Delphi results include: For a patient with OUD taking buprenorphine-naloxone, continuing buprenorphine-naloxone and adding a full-agonist opioid was deemed to be appropriate for patients with a prognosis of weeks to months and of uncertain appropriateness for patients with a prognosis of months to years; for a patient with OUD taking methadone dispensed at a methadone clinic, it was deemed appropriate to take over prescribing and dose twice or thrice daily.
Click here for a more complete bibliography of Dr. Merlin's works.
Research Interests
- Pain and opioid misuse/use disorder
- Including in people with serious illnesses such as HIV, cancer
- Randomized behavioral trials
- Delphi methodology
- Medical cannabis-related decision-making