2023
Perspectives of Clinicians and Staff at Community-Based Opioid Use Disorder Treatment Settings on Linkages With Emergency Department–Initiated Buprenorphine Programs
Sue K, Chawarski M, Curry L, McNeil R, Coupet E, Schwartz R, Wilder C, Tsui J, Hawk K, D’Onofrio G, O’Connor P, Fiellin D, Edelman E. Perspectives of Clinicians and Staff at Community-Based Opioid Use Disorder Treatment Settings on Linkages With Emergency Department–Initiated Buprenorphine Programs. JAMA Network Open 2023, 6: e2312718. PMID: 37163263, PMCID: PMC10173026, DOI: 10.1001/jamanetworkopen.2023.12718.Peer-Reviewed Original ResearchConceptsCommunity-based cliniciansOpioid use disorderEmergency departmentOUD treatmentMedication treatmentSubstance use disorders trainingUrban academic emergency departmentEffectiveness-implementation studyAcademic emergency departmentDisorder treatment settingsPerspectives of cliniciansCommunity-based treatmentCommunity-based treatment programsStaff perspectivesImplementation science frameworkBuprenorphine programTreatment cliniciansPeer navigatorsReferral sitesPromoting ActionMAIN OUTCOMEED staffBuprenorphineFocus groupsUse disorders
2020
Emergency department patients with untreated opioid use disorder: A comparison of those seeking versus not seeking referral to substance use treatment
Coupet E, D’Onofrio G, Chawarski M, Edelman E, O’Connor P, Owens P, Martel S, Fiellin DA, Cowan E, Richardson L, Huntley K, Whiteside LK, Lyons MS, Rothman RE, Pantalon M, Hawk K. Emergency department patients with untreated opioid use disorder: A comparison of those seeking versus not seeking referral to substance use treatment. Drug And Alcohol Dependence 2020, 219: 108428. PMID: 33307301, PMCID: PMC8110210, DOI: 10.1016/j.drugalcdep.2020.108428.Peer-Reviewed Original ResearchConceptsUntreated opioid use disorderOpioid use disorderEmergency department patientsDepartment patientsUse disordersTenth Revision diagnosis codesSevere opioid use disorderConclusions Most patientsInjection-related infectionsRevision diagnosis codesHealth insurance statusSubstance use treatmentCross-sectional analysisOpioid withdrawalClinical characteristicsED visitsMost patientsTreatment initiationUrine toxicologyClinical correlatesDiagnosis codesInsurance statusUnivariate analysisBackground LittleInternational ClassificationUse of Amphetamine-Type Stimulants Among Emergency Department Patients With Untreated Opioid Use Disorder
Chawarski MC, Hawk K, Edelman EJ, O'Connor P, Owens P, Martel S, Coupet E, Whiteside L, Tsui JI, Rothman R, Cowan E, Richardson L, Lyons MS, Fiellin DA, D'Onofrio G. Use of Amphetamine-Type Stimulants Among Emergency Department Patients With Untreated Opioid Use Disorder. Annals Of Emergency Medicine 2020, 76: 782-787. PMID: 32782084, PMCID: PMC8048036, DOI: 10.1016/j.annemergmed.2020.06.046.Peer-Reviewed Original ResearchConceptsUntreated opioid use disorderOpioid use disorderAmphetamine-type stimulant useUse disordersStimulant useAmphetamine-type stimulantsStudy admissionEmergency departmentEmergency department patientsImplementation science studyUrine test resultsFalse discovery rate correctionSubstance use problemsHepatitis CED visitsDepartment patientsReferral protocolsED patientsUrine testsDrug injectionOverdose riskPatientsHealth factorsUnstable housingConcurrent useBarriers and Facilitators to Clinician Readiness to Provide Emergency Department–Initiated Buprenorphine
Hawk KF, D’Onofrio G, Chawarski MC, O’Connor P, Cowan E, Lyons MS, Richardson L, Rothman RE, Whiteside LK, Owens PH, Martel SH, Coupet E, Pantalon M, Curry L, Fiellin DA, Edelman EJ. Barriers and Facilitators to Clinician Readiness to Provide Emergency Department–Initiated Buprenorphine. JAMA Network Open 2020, 3: e204561. PMID: 32391893, PMCID: PMC7215257, DOI: 10.1001/jamanetworkopen.2020.4561.Peer-Reviewed Original ResearchConceptsOpioid use disorderEmergency departmentAdvanced practice cliniciansED cliniciansClinicians' readinessOngoing treatmentTreatment of OUDEmergency Department-Initiated BuprenorphineUntreated opioid use disorderDrug Addiction Treatment ActDecrease opioid useVisual analog scaleHealth Services frameworkAcademic emergency departmentMixed-methods formative evaluationQuality of careSubset of participantsBuprenorphine initiationClinician typeOpioid useED patientsAnalog scaleOngoing careDepartmental protocolPractice clinicians
2018
Atomoxetine for amphetamine-type stimulant dependence during buprenorphine treatment: A randomized controlled trial
Schottenfeld RS, Chawarski MC, Sofuoglu M, Chooi WT, Zaharim NM, M Yasin MA, Ahmad I, Syed Jaapar SZ, Vicknasingam BK. Atomoxetine for amphetamine-type stimulant dependence during buprenorphine treatment: A randomized controlled trial. Drug And Alcohol Dependence 2018, 186: 130-137. PMID: 29573648, PMCID: PMC5911201, DOI: 10.1016/j.drugalcdep.2018.01.017.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic Uptake InhibitorsAdultAmphetamine-Related DisordersAtomoxetine HydrochlorideBehavior TherapyBuprenorphineBuprenorphine, Naloxone Drug CombinationDepressionDouble-Blind MethodHumansMaleMiddle AgedNarcotic AntagonistsOpioid-Related DisordersPilot ProjectsTreatment OutcomeYoung AdultConceptsATS use disorderPlacebo-treated participantsUse disordersAdverse eventsUrine testsPotential efficacyAmphetamine-type stimulant dependenceAmphetamine-type stimulant useSerious adverse eventsBuprenorphine/naloxoneBetween-group differencesATS dependenceClinical tolerabilityMedication discontinuationBuprenorphine treatmentPrimary outcomeOpioid dependenceClinical trialsITT sampleTreat sampleBehavioral counselingDepressive symptomsDays abstinentAtomoxetineStimulant dependence
2017
Past‐year Prescription Drug Monitoring Program Opioid Prescriptions and Self‐reported Opioid Use in an Emergency Department Population With Opioid Use Disorder
Hawk K, D'Onofrio G, Fiellin DA, Chawarski MC, O'Connor PG, Owens PH, Pantalon MV, Bernstein SL. Past‐year Prescription Drug Monitoring Program Opioid Prescriptions and Self‐reported Opioid Use in an Emergency Department Population With Opioid Use Disorder. Academic Emergency Medicine 2017, 25: 508-516. PMID: 29165853, PMCID: PMC5963969, DOI: 10.1111/acem.13352.Peer-Reviewed Original ResearchConceptsPrescription drug monitoring programsOpioid use disorderNonmedical prescription opioid usePrescription opioid useAberrant drug-related behaviorsOpioid useOpioid prescriptionsUse disordersED patientsDrug-related behaviorsPrescription recordsState prescription drug monitoring programStatistical Manual IV criteriaNonmedical opioid useRandomized clinical trialsEmergency department assessmentEmergency department populationDrug monitoring programsCharacteristics of participantsUrban EDOpioid dependencePrescription opioidsPDMP dataTreatment trialsClinical historyEarly Initiation of Amphetamine-Type Stimulants (ATS) Use Associated with Lowered Cognitive Performance among Individuals with Co-Occurring Opioid and ATS Use Disorders in Malaysia
Chooi WT, Zaharim N, Desrosiers A, Ahmad I, Yasin MAM, Jaapar S, Schottenfeld RS, Vicknasingam BK, Chawarski MC. Early Initiation of Amphetamine-Type Stimulants (ATS) Use Associated with Lowered Cognitive Performance among Individuals with Co-Occurring Opioid and ATS Use Disorders in Malaysia. Journal Of Psychoactive Drugs 2017, 49: 326-332. PMID: 28661714, PMCID: PMC6218246, DOI: 10.1080/02791072.2017.1342152.Peer-Reviewed Original ResearchConceptsCognitive performanceStandard Progressive MatricesRey-Osterrieth Complex Figure TestSymbol digit substitution taskCognitive performance groupsComplex Figure TestRaven's Standard Progressive MatricesATS use disorderATS useDigit spanTrail MakingCognitive functioningFigures TestAmphetamine-type stimulant useSubstitution taskProgressive MatricesFunctioning profilesDrug useCo-occurring opioidGroup differencesCurrent study findingsStimulant useClusters of individualsATS dependenceUse disordersPsychiatric symptoms, quality of life, and HIV status among people using opioids in Saint Petersburg, Russia
Desrosiers A, Blokhina E, Krupitsky E, Zvartau E, Schottenfeld R, Chawarski M. Psychiatric symptoms, quality of life, and HIV status among people using opioids in Saint Petersburg, Russia. Drug And Alcohol Dependence 2017, 172: 60-65. PMID: 28130990, PMCID: PMC5408353, DOI: 10.1016/j.drugalcdep.2016.12.007.Peer-Reviewed Original ResearchConceptsQuality of lifeOpioid use disorderPsychiatric symptomsUse disordersCo-occurring opioid use disordersBaseline psychiatric symptomsPsychiatric symptom presentationsWorld Health Organization QualityPsychiatric symptom profilesRandomized clinical trialsHealth Organization QualityPsychiatric symptom levelsLife indicatorsHIV individualsHIV infectionNaltrexone treatmentHIV statusBrief Symptom InventoryOutpatient treatmentClinical trialsDrug treatmentLife-BREFBSI anxietyOrganization QualitySymptom profiles
2016
Emerging Drug Use Trends in Kelantan, Malaysia
Desrosiers A, Chooi WT, Zaharim NM, Ahmad I, Yasin M, Jaapar S, Schottenfeld RS, Vicknasingam B, Chawarski MC. Emerging Drug Use Trends in Kelantan, Malaysia. Journal Of Psychoactive Drugs 2016, 48: 218-226. PMID: 27224011, DOI: 10.1080/02791072.2016.1185553.Peer-Reviewed Original ResearchConceptsDrug useAmphetamine-type stimulant useDrug use initiationTreatment optionsHigh prevalenceTreatment needsDrug use trendsTreatment servicesYounger ageStimulant useUse initiationPrevention effortsUnique sociocultural factorsTreatment seekingFGD participantsRural areasHigh rateEarly agePrevalencePWUDDrugsAgeSociocultural factorsParticipantsMajor contributor
2015
Aripiprazole and Risperidone for Treatment of Methamphetamine-Associated Psychosis in Chinese Patients
Wang G, Zhang Y, Zhang S, Chen H, Xu Z, Schottenfeld RS, Hao W, Chawarski MC. Aripiprazole and Risperidone for Treatment of Methamphetamine-Associated Psychosis in Chinese Patients. Journal Of Substance Use And Addiction Treatment 2015, 62: 84-88. PMID: 26733277, PMCID: PMC4724444, DOI: 10.1016/j.jsat.2015.11.009.Peer-Reviewed Original ResearchConceptsRisperidone-treated patientsSimpson-Angus ScaleVisual analog scalePsychotic symptomsRisperidone groupSelf-reported adverse effectsClinical Global Impressions-SeverityKaplan-Meier survival analysisAdverse effectsAripiprazole-treated patientsEfficacy of aripiprazoleMethamphetamine-Associated PsychosisExtra-pyramidal symptomsInpatient hospital stayTreatment of methamphetamineNegative Syndrome ScaleGreater methamphetamineHospital stayAripiprazole groupEntire studyAngus ScaleAnalog scaleAcute methamphetamineChinese patientsIllness ScaleEvaluation of an implementation of methadone maintenance treatment in China
Marienfeld C, Liu P, Wang X, Schottenfeld R, Zhou W, Chawarski MC. Evaluation of an implementation of methadone maintenance treatment in China. Drug And Alcohol Dependence 2015, 157: 60-67. PMID: 26601934, PMCID: PMC4663107, DOI: 10.1016/j.drugalcdep.2015.10.001.Peer-Reviewed Original ResearchConceptsInjection drug useMethadone maintenance treatmentMMT exposureDrug useMaintenance treatmentUrine testsPositive testOpiate positive urine testsDaily methadone dosesPositive urine testHigher adherence ratesOpioid use disorderNegative urine testsSelf-reported drug useElectronic medical recordsPriority improvement areasMonth drug useMethadone dosesMethadone dosingDose adjustmentAdherence ratesDaily dosesMedical recordsTreatment daysUse disorders
2013
Randomized clinical trial of disulfiram for cocaine dependence or abuse during buprenorphine treatment
Schottenfeld RS, Chawarski MC, Cubells JF, George TP, Lappalainen J, Kosten TR. Randomized clinical trial of disulfiram for cocaine dependence or abuse during buprenorphine treatment. Drug And Alcohol Dependence 2013, 136: 36-42. PMID: 24462581, DOI: 10.1016/j.drugalcdep.2013.12.007.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAlcohol DeterrentsAlcoholismAllelesBuprenorphineCocaine-Related DisordersData Interpretation, StatisticalDisulfiramDNADouble-Blind MethodDrug Therapy, CombinationFemaleGenotypeHumansMaleMiddle AgedNarcotic AntagonistsOpioid-Related DisordersPharmacogeneticsPolymerase Chain ReactionSample SizeTreatment OutcomeYoung AdultConceptsUrine testsCocaine useMechanism of actionCocaine dependenceClinical trialsWeeks abstinencePlacebo-controlled clinical trialEfficacy of disulfiramPharmacogenetics of responseDouble-blind treatmentBuprenorphine maintenance treatmentRandomized clinical trialsOpioid-dependent participantsT allele carriersFrequent cocaine useDopamine β-hydroxylaseBuprenorphine treatmentPrimary outcomeTreat comparisonMaintenance treatmentPharmacogenetic interactionsTreatment responseTT genotypeCocaine abstinenceConsecutive weeksImpulsivity, cognitive function, and their relationship in heroin-dependent individuals
Zeng H, Lee TM, Waters JH, So KF, Sham PC, Schottenfeld RS, Marienfeld C, Chawarski MC. Impulsivity, cognitive function, and their relationship in heroin-dependent individuals. Journal Of Clinical And Experimental Neuropsychology 2013, 35: 897-905. PMID: 24040894, DOI: 10.1080/13803395.2013.828022.Peer-Reviewed Original ResearchConceptsCognitive functionAbstinent heroin-dependent individualsHeroin-dependent individualsSelf-reported impulsivitySelf-report measuresCognitive abilitiesMotor impulsivityImpulsivityExperience seekingComputerized assessmentMixed evidenceHeroin dependenceIndividualsFunctional weaknessDistractibilityMemorySeekingTherapeutic interventionsInterventionImplicationsMeasuresAbilityRelationshipDecisions
2012
Drug use in rural China: a preliminary investigation in Hunan Province
Deng Q, Tang Q, Schottenfeld RS, Hao W, Chawarski MC. Drug use in rural China: a preliminary investigation in Hunan Province. Addiction 2012, 107: 610-613. PMID: 21906200, PMCID: PMC4596718, DOI: 10.1111/j.1360-0443.2011.03648.x.Peer-Reviewed Original ResearchConceptsRural drug usersDrug usersDrug abusersDrug useHuman immunodeficiency virusDrug treatment participationSubstance abuse treatmentImmunodeficiency virusNeedle sharingLow prevalencePrimary drugRural areasDrug abuse patternsAbuse treatmentEarly onsetTreatment participationDrug abuseAbuse patternsTreatment pointsTreatment penetrationHigher proportionLower proportionAbusersAbuseSubstantial problemLifetime ATS use and increased HIV risk among not-in-treatment opiate injectors in Malaysia
Chawarski MC, Vicknasingam B, Mazlan M, Schottenfeld RS. Lifetime ATS use and increased HIV risk among not-in-treatment opiate injectors in Malaysia. Drug And Alcohol Dependence 2012, 124: 177-180. PMID: 22266088, PMCID: PMC4641448, DOI: 10.1016/j.drugalcdep.2011.12.024.Peer-Reviewed Original ResearchConceptsOpiate injectorsHIV infectionHIV statusATS useLifetime historyAmphetamine-type stimulantsHIV-negative participantsHIV transmission riskHIV-positive participantsDrug use historyPublic health prevention measuresHigh-risk behaviorsHealth prevention measuresTreatment IDUsVs. 75HIV transmissionRisk factorsPositive participantsHIV riskHigh riskRisk behaviorsDrug abuse problemsTransmission riskDrug abuseIDUs
2010
Injection of buprenorphine and buprenorphine/naloxone tablets in Malaysia
Vicknasingam B, Mazlan M, Schottenfeld RS, Chawarski MC. Injection of buprenorphine and buprenorphine/naloxone tablets in Malaysia. Drug And Alcohol Dependence 2010, 111: 44-49. PMID: 20478668, DOI: 10.1016/j.drugalcdep.2010.03.014.Peer-Reviewed Original ResearchConceptsBuprenorphine/naloxone tabletsInjection of buprenorphineInjection drug usersMisuse of buprenorphineFirst wave participantsBuprenorphine maintenanceOpioid dependenceBenzodiazepine abuseBuprenorphineDrug usersSecond-wave surveyIDUsFocus group participantsCombination tabletGroup participantsPreliminary dataSurvey participantsParticipantsFocus groupsWithdrawalAbuseDiversionSecond waveKuala Lumpur
2008
Doubts about the role of cannabis in causing lung cancer
Sewell RA, Cohn AJ, Chawarski MC. Doubts about the role of cannabis in causing lung cancer. European Respiratory Journal 2008, 32: 815-816. PMID: 18757709, DOI: 10.1183/09031936.00051108.Peer-Reviewed Original ResearchLong‐Term Treatment with Buprenorphine/Naloxone in Primary Care: Results at 2–5 Years
Fiellin DA, Moore BA, Sullivan LE, Becker WC, Pantalon MV, Chawarski MC, Barry DT, O'Connor PG, Schottenfeld RS. Long‐Term Treatment with Buprenorphine/Naloxone in Primary Care: Results at 2–5 Years. American Journal On Addictions 2008, 17: 116-120. PMID: 18393054, DOI: 10.1080/10550490701860971.Peer-Reviewed Original ResearchMeSH KeywordsAdultBuprenorphineCombined Modality TherapyCounselingCross-Sectional StudiesDose-Response Relationship, DrugDrug Administration ScheduleDrug Therapy, CombinationFemaleFollow-Up StudiesHeroin DependenceHumansLong-Term CareMaleMiddle AgedNaloxoneNarcotic AntagonistsOpioid-Related DisordersPatient DropoutsPrimary Health CareSubstance Abuse DetectionTreatment OutcomeConceptsOpioid-dependent patientsAdverse eventsSerum transaminasesBuprenorphine/naloxone treatmentSerious adverse eventsBuprenorphine/naloxoneLong-term outcomesOffice-based treatmentIllicit drug useOpioid useClinical stabilityNaloxone treatmentPrimary outcomePatient satisfactionPrimary careTerm treatmentDrug useUrine samplesPatientsTreatmentTransaminaseOutcomesYearsModerate levelsPercentResearch‐ and Community‐Based Clinicians' Attitudes on Treatment Manuals
Barry DT, Fulgieri MD, Lavery ME, Chawarski MC, Najavits LM, Schottenfeld RS, Pantalon MV. Research‐ and Community‐Based Clinicians' Attitudes on Treatment Manuals. American Journal On Addictions 2008, 17: 145-148. PMID: 18393058, DOI: 10.1080/10550490701860880.Peer-Reviewed Original Research
2007
Behavioral drug and HIV risk reduction counseling (BDRC) with abstinence-contingent take-home buprenorphine: A pilot randomized clinical trial
Chawarski MC, Mazlan M, Schottenfeld RS. Behavioral drug and HIV risk reduction counseling (BDRC) with abstinence-contingent take-home buprenorphine: A pilot randomized clinical trial. Drug And Alcohol Dependence 2007, 94: 281-284. PMID: 18164145, DOI: 10.1016/j.drugalcdep.2007.11.008.Peer-Reviewed Original ResearchConceptsBuprenorphine maintenance treatmentOpioid-negative urine testsHIV risk reduction counselingRisk reduction counselingHIV risk behaviorsBehavioral drugReduction counselingUrine testsClinical trialsDrug counselingRisk behaviorsSelf-reported HIV risk behaviorsTake-home dosesUrine toxicology testsHeroin-dependent individualsIndividual drug counselingSelf-reported drug useMaintenance treatmentMedication adherenceLimited counselingBuprenorphineDrug useConsecutive abstinenceToxicology testsOverall proportion