2023
Implementing Programs to Initiate Buprenorphine for Opioid Use Disorder Treatment in High-Need, Low-Resource Emergency Departments: A Nonrandomized Controlled Trial
McCormack R, Rotrosen J, Gauthier P, D'Onofrio G, Fiellin D, Marsch L, Novo P, Liu D, Edelman E, Farkas S, Matthews A, Mulatya C, Salazar D, Wolff J, Knight R, Goodman W, Williams J, Hawk K. Implementing Programs to Initiate Buprenorphine for Opioid Use Disorder Treatment in High-Need, Low-Resource Emergency Departments: A Nonrandomized Controlled Trial. Annals Of Emergency Medicine 2023, 82: 272-287. PMID: 37140493, PMCID: PMC10524047, DOI: 10.1016/j.annemergmed.2023.02.013.Peer-Reviewed Original ResearchConceptsBuprenorphine programImplementation facilitationEmergency departmentMedical recordsOpioid use disorder treatmentMain secondary outcomesMore treatment visitsPrimary implementation outcomeNonrandomized Controlled TrialPatient-level outcomesPatients' medical recordsUse disorder treatmentTreatment 30 daysBuprenorphine administrationOpioid useSecondary outcomesControlled TrialsTreatment visitsED settingUnique patientsClinicians' readinessEligibility criteriaClinical protocolsDisorder treatmentOverdose eventsPerspectives 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 disordersImplementation Facilitation to Promote Emergency Department–Initiated Buprenorphine for Opioid Use Disorder
D’Onofrio G, Edelman E, Hawk K, Chawarski M, Pantalon M, Owens P, Martel S, Rothman R, Saheed M, Schwartz R, Cowan E, Richardson L, Salsitz E, Lyons M, Freiermuth C, Wilder C, Whiteside L, Tsui J, Klein J, Coupet E, O’Connor P, Matthews A, Murphy S, Huntley K, Fiellin D. Implementation Facilitation to Promote Emergency Department–Initiated Buprenorphine for Opioid Use Disorder. JAMA Network Open 2023, 6: e235439. PMID: 37017967, PMCID: PMC10077107, DOI: 10.1001/jamanetworkopen.2023.5439.Peer-Reviewed Original ResearchConceptsOpioid use disorderRate of patientsOUD treatmentImplementation facilitationED visitsObservational cohortED cliniciansX-waiverUse disordersEmergency Department-Initiated BuprenorphineUntreated opioid use disorderEvaluation periodHybrid type 3Provision of buprenorphineBaseline periodGrand roundsRates of EDPrimary outcomeWhite patientsAcademic EDBlack patientsED patientsEmergency departmentCommunity cliniciansMAIN OUTCOMEHomelessness and Treatment Outcomes Among Black Adults With Opioid Use Disorder: A Secondary Analysis of X:BOT
Justen M, Scodes J, Pavlicova M, Choo T, Gopaldas M, Haeny A, Opara O, Rhee T, Rotrosen J, Nunes E, Hawk K, Edelman E. Homelessness and Treatment Outcomes Among Black Adults With Opioid Use Disorder: A Secondary Analysis of X:BOT. Journal Of Addiction Medicine 2023, 17: 463-467. PMID: 37579110, PMCID: PMC10323031, DOI: 10.1097/adm.0000000000001125.Peer-Reviewed Original ResearchConceptsClinical trialsTreatment outcomesSecondary analysisOpioid use disorder treatmentBlack individualsExtended-release naltrexoneOpioid use disorderAdditional clinical supportBlack participantsUse disorder treatmentBuprenorphine-naloxoneStudy medicationWeeks postrandomizationMedication initiationClinical characteristicsOpioid useTrial entryUrine toxicologyBlack patientsSedative useExtramedical useUse disordersClinical supportDisorder treatmentBlack adults
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 ClassificationAll-cause mortality among males living with and without HIV initiating long-term opioid therapy, and its association with opioid dose, opioid interruption and other factors
Gordon K, Manhapra A, Crystal S, Dziura J, Edelman E, Skanderson M, Kerns R, Justice A, Tate J, Becker W. All-cause mortality among males living with and without HIV initiating long-term opioid therapy, and its association with opioid dose, opioid interruption and other factors. Drug And Alcohol Dependence 2020, 216: 108291. PMID: 33011662, PMCID: PMC7644145, DOI: 10.1016/j.drugalcdep.2020.108291.Peer-Reviewed Original ResearchConceptsMorphine equivalent daily doseCause mortalityLong-term opioid therapyTime-updated Cox regressionStrong dose-response relationshipUnnatural deathsEquivalent daily doseDose-response relationshipOpioid doseOpioid therapyUninfected patientsOpioid useDaily doseCox regressionMortality outcomesTherapy doseHigh doseMale veteransOverdose fatalitiesOverdose mortalityPLWHMortalityHIVPatientsDose
2019
Marijuana Use Is Not Associated With Changes in Opioid Prescriptions or Pain Severity Among People Living With HIV and Chronic Pain.
Merlin JS, Long D, Becker WC, Cachay ER, Christopolous KA, Claborn KR, Crane HM, Edelman E, Lovejoy TI, Mathews WC, Morasco BJ, Napravnik S, OʼCleirigh C, Saag MS, Starrels JL, Gross R, Liebschutz JM. Marijuana Use Is Not Associated With Changes in Opioid Prescriptions or Pain Severity Among People Living With HIV and Chronic Pain. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2019, 81: 231-237. PMID: 30865181, PMCID: PMC6522289, DOI: 10.1097/qai.0000000000001998.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidChronic PainFemaleFollow-Up StudiesHIV InfectionsHumansLogistic ModelsMaleMarijuana SmokingMarijuana UseMedical MarijuanaMiddle AgedMultivariate AnalysisOpioid-Related DisordersPrescription DrugsProspective StudiesSelf ReportSurveys and QuestionnairesTreatment OutcomeUnited StatesConceptsChronic painPain severityIndex visitOpioid useMultivariable binary logistic regression modelMarijuana useDiscontinuation of opioidsImproved pain outcomesMedian pain severityAIDS Research NetworkPrescription opioid usePrescribed opioid useIntegrated Clinical SystemsLogistic regression modelsBinary logistic regression modelOpioid discontinuationOpioid initiationOpioid prescribingOpioid prescriptionsPain outcomesClinical systemsHigher oddsLower oddsPainPLWHUnhealthy Alcohol Use in Primary Care-The Elephant in the Examination Room.
Edelman EJ, Tetrault JM. Unhealthy Alcohol Use in Primary Care-The Elephant in the Examination Room. JAMA Internal Medicine 2019, 179: 9-10. PMID: 30422276, DOI: 10.1001/jamainternmed.2018.6125.Peer-Reviewed Original Research
2018
“No more falling through the cracks”: A qualitative study to inform measurement of integration of care of HIV and opioid use disorder
Oldfield BJ, Muñoz N, Boshnack N, Leavitt R, McGovern MP, Villanueva M, Tetrault JM, Edelman E. “No more falling through the cracks”: A qualitative study to inform measurement of integration of care of HIV and opioid use disorder. Journal Of Substance Use And Addiction Treatment 2018, 97: 28-40. PMID: 30577897, DOI: 10.1016/j.jsat.2018.11.007.Peer-Reviewed Original ResearchConceptsOpioid use disorderIntegration of HIVUse disordersClinical staffCare of HIVCommunity-based participatory research principlesBehavioral health integrationImproved patient outcomesEvidence-based treatmentsDiverse care settingsParticipatory research principlesPrimary carePatient outcomesPatient-centered policiesCare settingsHealth integrationHIVQualitative studyStages of changeClinic leadershipCare instrumentIntegrated carePatientsBehavioral healthMeasures of quality
2016
Primary Care Physicians’ Willingness to Prescribe HIV Pre-exposure Prophylaxis for People who Inject Drugs
Edelman EJ, Moore BA, Calabrese SK, Berkenblit G, Cunningham C, Patel V, Phillips K, Tetrault JM, Shah M, Fiellin DA, Blackstock O. Primary Care Physicians’ Willingness to Prescribe HIV Pre-exposure Prophylaxis for People who Inject Drugs. AIDS And Behavior 2016, 21: 1025-1033. PMID: 27896552, PMCID: PMC5344709, DOI: 10.1007/s10461-016-1612-6.Peer-Reviewed Original ResearchConceptsPrimary care physiciansPre-exposure prophylaxisCare physiciansHIV pre-exposure prophylaxisHIV risk groupMore HIVClinic patientsRisk groupsGeneral internistsPWIDAcademic general internistsPractice characteristicsDisease preventionHIVPrEPProphylaxisPatientsPhysiciansCareDrugsOnline surveyInternistsHigher willingnessLower willingnessCentral roleA Cross-Sectional Online Survey of HIV Pre-Exposure Prophylaxis Adoption Among Primary Care Physicians
Blackstock OJ, Moore BA, Berkenblit GV, Calabrese SK, Cunningham CO, Fiellin DA, Patel VV, Phillips KA, Tetrault JM, Shah M, Edelman EJ. A Cross-Sectional Online Survey of HIV Pre-Exposure Prophylaxis Adoption Among Primary Care Physicians. Journal Of General Internal Medicine 2016, 32: 62-70. PMID: 27778215, PMCID: PMC5215171, DOI: 10.1007/s11606-016-3903-z.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnti-HIV AgentsCross-Sectional StudiesFemaleHealth Knowledge, Attitudes, PracticeHealth PersonnelHealth Risk BehaviorsHIV InfectionsHumansMaleMiddle AgedMultivariate AnalysisOdds RatioPractice Patterns, Physicians'Pre-Exposure ProphylaxisPrimary Health CareSurveys and QuestionnairesConceptsPrimary care physiciansHIV care experienceCare physiciansPrEP adoptionPrEP awarenessPractice characteristicsHIV pre-exposure prophylaxisCare experiencesAcademic primary care physiciansHIV-positive patientsPre-exposure prophylaxisHealth care providersResultsThe survey response rateSectional Online SurveyPCP adoptionHIV careKey ResultsThe survey response ratePercent of respondentsRisk compensationSurvey response ratePrEP knowledgePrEP useSelf-rated knowledgeMultivariable analysisClinical championsThe impact of prescribed opioids on CD4 cell count recovery among HIV‐infected patients newly initiating antiretroviral therapy
Edelman E, Gordon K, Tate J, Becker W, Bryant K, Crothers K, Gaither, Gibert C, Gordon A, Marshall B, Rodriguez‐Barradas M, Samet J, Skanderson M, Justice A, Fiellin D. The impact of prescribed opioids on CD4 cell count recovery among HIV‐infected patients newly initiating antiretroviral therapy. HIV Medicine 2016, 17: 728-739. PMID: 27186715, PMCID: PMC5053822, DOI: 10.1111/hiv.12377.Peer-Reviewed Original ResearchConceptsCD4 cell countBaseline CD4 cell countCell countPrescribed opioidsImmunosuppressive propertiesVeterans Aging Cohort Study (VACS) dataCD4 cell count recoveryAntiretroviral therapy responseCell count recoveryShort-term opioidsViral load suppressionCohort study dataOverall disease severityYear of initiationPrimary independent variableOpioid durationAntiretroviral therapyCount recoveryComorbid conditionsPharmacy dataOpioid propertiesTherapy responseOpioidsPatientsHIVHepatic Safety of Buprenorphine in HIV-Infected and Uninfected Patients With Opioid Use Disorder: The Role of HCV-Infection
Tetrault JM, Tate JP, Edelman EJ, Gordon AJ, Re V, Lim JK, Rimland D, Goulet J, Crystal S, Gaither JR, Gibert CL, Rodriguez-Barradas MC, Fiellin LE, Bryant K, Justice AC, Fiellin DA. Hepatic Safety of Buprenorphine in HIV-Infected and Uninfected Patients With Opioid Use Disorder: The Role of HCV-Infection. Journal Of Substance Use And Addiction Treatment 2016, 68: 62-67. PMID: 27431048, PMCID: PMC4976086, DOI: 10.1016/j.jsat.2016.06.002.Peer-Reviewed Original ResearchConceptsLiver enzyme elevationAlcohol use disorderUninfected patientsHepatotoxic medicationsHCV infectionUse disordersComposite endpointLiver injuryHIV/HCV co-infected patientsHCV co-infected patientsHIV/HCV statusPre-existing liver injuryCo-infected patientsCohort of HIVHepatitis C infectionHIV/HCVOpioid use disorderRisk of hepatotoxicityHCV statusHepatic safetyMedian ALTC infectionChart reviewEnzyme elevationHIV infection
2012
Combining Rapid HIV Testing and a Brief Alcohol Intervention in Young Unhealthy Drinkers in the Emergency Department: A Pilot Study
Edelman EJ, Dinh A, Radulescu R, Lurie B, D'Onofrio G, Tetrault JM, Fiellin DA, Fiellin LE. Combining Rapid HIV Testing and a Brief Alcohol Intervention in Young Unhealthy Drinkers in the Emergency Department: A Pilot Study. The American Journal Of Drug And Alcohol Abuse 2012, 38: 539-543. PMID: 22794939, PMCID: PMC3522092, DOI: 10.3109/00952990.2012.701359.Peer-Reviewed Original ResearchConceptsSexual risk reduction counselingSexual risk behaviorsRisk reduction counselingRapid HIV testingEmergency departmentRisk behaviorsReduction counselingHIV testingAlcohol useUnhealthy drinkersAlcohol consumptionMean age 26 yearsAverage weekly drinksImportant preventive servicesAlcohol Use Disorders Identification Test (AUDIT) scoresUnknown HIV statusRapid HIV testsUnhealthy alcohol useAge 26 yearsBrief alcohol interventionHIV testHIV statusRegular doctorPreventive servicesRisk populations