2022
Missed Opportunities for HIV and Hepatitis C Screening Among Emergency Department Patients With Untreated Opioid Use Disorder
Lyons MS, Chawarski MC, Rothman R, Whiteside L, Cowan E, Richardson LD, Hawk K, Tsui JI, Schwartz RP, O’Connor P, D’Onofrio G, Fiellin DA, Edelman EJ. Missed Opportunities for HIV and Hepatitis C Screening Among Emergency Department Patients With Untreated Opioid Use Disorder. Journal Of Addiction Medicine 2022, 17: 210-214. PMID: 36170184, PMCID: PMC10023471, DOI: 10.1097/adm.0000000000001074.Peer-Reviewed Original ResearchConceptsUntreated opioid use disorderOpioid use disorderRecent injection drug useEmergency department HIVInjection drug useHCV screeningED patientsUse disordersEnrollment periodDrug useHepatitis C screeningStructured screening programmeUnknown HCV statusUnknown HIV statusHigh-risk cohortMedical care providersHCV statusC screeningHepatitis CED visitsAcademic EDHIV statusEmergency departmentCohort 2Cohort 1
2018
Decriminalization of drug use
Vicknasingam B, Narayanan S, Singh D, Chawarski M. Decriminalization of drug use. Current Opinion In Psychiatry 2018, 31: 300-305. PMID: 29746420, DOI: 10.1097/yco.0000000000000429.Peer-Reviewed Original Research
2017
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
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 disordersEmergency Department-Initiated Buprenorphine for Opioid Dependence with Continuation in Primary Care: Outcomes During and After Intervention
D’Onofrio G, Chawarski MC, O’Connor P, Pantalon MV, Busch SH, Owens PH, Hawk K, Bernstein SL, Fiellin DA. Emergency Department-Initiated Buprenorphine for Opioid Dependence with Continuation in Primary Care: Outcomes During and After Intervention. Journal Of General Internal Medicine 2017, 32: 660-666. PMID: 28194688, PMCID: PMC5442013, DOI: 10.1007/s11606-017-3993-2.Peer-Reviewed Original ResearchConceptsIllicit opioid useOpioid usePrimary careHIV riskBrief interventionAddiction treatmentBuprenorphine groupEmergency Department-Initiated BuprenorphineCohort of patientsLong-term followLong-term outcomesFormal addiction treatmentSignificant differencesMain MeasuresSelfStudy entryUrine toxicologyBuprenorphine/Opioid dependenceED interventionsUrine resultsBuprenorphineTreatment engagementDrug useReferralPatients
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
Evaluation 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 disordersBuprenorphine/naloxone treatment practices in Malaysia: Results of national surveys of physicians and patients
Vicknasingam B, Dazali MN, Singh D, Schottenfeld RS, Chawarski MC. Buprenorphine/naloxone treatment practices in Malaysia: Results of national surveys of physicians and patients. Drug And Alcohol Dependence 2015, 152: 164-169. PMID: 25935736, DOI: 10.1016/j.drugalcdep.2015.04.007.Peer-Reviewed Original ResearchConceptsBUP/NXNX treatmentGeneral practitionersPast monthOpiate positive urine testsOptimal treatment effectivenessRoutine toxicology testingToxicology testingBuprenorphine/naloxonePositive urine testUrine toxicology testingIllicit opiate useInjection of heroinInjection of drugsCross-sectional surveyMaintenance treatmentPatient surveyUrine testingUrine testsTreatment responseOpiate usePatient experiencePatientsDispensing practicesDrug useHepatitis C seroconversion in methadone maintenance treatment programs in Wuhan, China
Zhou W, Wang X, Zhou S, Xie N, Liu P, Luo L, Peng J, Liu M, Desrosiers A, Schottenfeld R, Chawarski MC. Hepatitis C seroconversion in methadone maintenance treatment programs in Wuhan, China. Addiction 2015, 110: 796-802. PMID: 25529103, PMCID: PMC4598328, DOI: 10.1111/add.12836.Peer-Reviewed Original ResearchConceptsMethadone maintenance treatmentInjection drug useHCV seroconversionPatients HCVSeroconversion ratesDrug useOpiate positive urine testsHepatitis C virus infectionRisk behaviorsMethadone maintenance treatment patientsMethadone maintenance treatment programHepatitis C seroconversionC virus infectionUrine toxicology resultsHepatitis C virusMaintenance treatment programPotential risk factorsOpiate-dependent individualsCross-sectional surveyHCV seroprevalenceMMT clinicsMaintenance treatmentTreatment patientsC virusUrine tests
2012
Cost-Effectiveness of Buprenorphine and Naltrexone Treatments for Heroin Dependence in Malaysia
Ruger JP, Chawarski M, Mazlan M, Ng N, Schottenfeld R. Cost-Effectiveness of Buprenorphine and Naltrexone Treatments for Heroin Dependence in Malaysia. PLOS ONE 2012, 7: e50673. PMID: 23226534, PMCID: PMC3514172, DOI: 10.1371/journal.pone.0050673.Peer-Reviewed Original ResearchConceptsHeroin dependenceCost-effectiveness ratioSecondary outcomesOutcome measuresDrug usePlacebo-controlled clinical trialFirst heroin useIncremental cost-effectiveness ratioSocietal costsInjection drug useSecondary outcome measuresPrimary outcome measureIllicit opiate useIncremental treatment costNaltrexone treatmentPrimary outcomeMedication costsPlacebo interventionClinical trialsHeroin abstinenceOpiate useHeroin useBuprenorphineTreatment retentionNaltrexoneDrug 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 problem
2008
Long‐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 levelsPercent
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 proportionBuprenorphine/naloxone treatment in primary care is associated with decreased human immunodeficiency virus risk behaviors
Sullivan LE, Moore BA, Chawarski MC, Pantalon MV, Barry D, O'Connor PG, Schottenfeld RS, Fiellin DA. Buprenorphine/naloxone treatment in primary care is associated with decreased human immunodeficiency virus risk behaviors. Journal Of Substance Use And Addiction Treatment 2007, 35: 87-92. PMID: 17933486, PMCID: PMC2587397, DOI: 10.1016/j.jsat.2007.08.004.Peer-Reviewed Original ResearchConceptsBuprenorphine/naloxone treatmentNaloxone treatmentHIV risk behaviorsHIV riskRisk behaviorsHuman immunodeficiency virus (HIV) risk behaviorsDrug-related HIV riskHuman immunodeficiency virus (HIV) riskSex-related HIV risk behaviorsBuprenorphine/naloxoneIntravenous drug useOpioid-dependent personsPrimary care clinicsInconsistent condom useBuprenorphine/Care clinicsMethadone treatmentPrimary careDrug useSteady partnerCondom useBaselineWeeksTreatmentPatientsUtility of sweat patch testing for drug use monitoring in outpatient treatment for opiate dependence
Chawarski MC, Fiellin DA, O'Connor PG, Bernard M, Schottenfeld RS. Utility of sweat patch testing for drug use monitoring in outpatient treatment for opiate dependence. Journal Of Substance Use And Addiction Treatment 2007, 33: 411-415. PMID: 17512157, PMCID: PMC3632440, DOI: 10.1016/j.jsat.2007.03.004.Peer-Reviewed Original ResearchConceptsOutpatient clinical settingPatch testingDrug useClinical settingSweat testingEfficacy of buprenorphinePrimary care settingRandomized clinical trialsSelf-reported drug usePositive urine resultsSweat test resultsDrug use monitoringUrine toxicologyOpioid dependenceOutpatient treatmentUrine testingClinical trialsCare settingsOpiate useOpiate dependenceUrine resultsStudy participantsLevel of agreementToxicology testsLow acceptability
2006
ASIA PACIFIC COLUMN: New challenges and opportunities in managing substance abuse in Malaysia
MAZLAN M, SCHOTTENFELD RS, CHAWARSKI MC. ASIA PACIFIC COLUMN: New challenges and opportunities in managing substance abuse in Malaysia. Drug And Alcohol Review 2006, 25: 473-478. PMID: 16939945, DOI: 10.1080/09595230600883354.Peer-Reviewed Original ResearchConceptsStimulant abuseDrug useRelated disordersAgonist maintenance treatmentInjection drug useHealth careHigh HIV prevalenceHeroin-dependent individualsOpiate-dependent patientsSevere drug problemsInfectious disease ratesAgonist medicationsHIV casesMaintenance treatmentHIV prevalenceCountry's health careHeroin abusersMedical treatmentHeroin usersTreatment approachesDrug abusersDrug usersAdult populationDisease ratesSubstance abuseHeroin dependence and HIV infection in Malaysia
Chawarski MC, Mazlan M, Schottenfeld RS. Heroin dependence and HIV infection in Malaysia. Drug And Alcohol Dependence 2006, 82: s39-s42. PMID: 16769444, DOI: 10.1016/s0376-8716(06)80007-4.Peer-Reviewed Original ResearchConceptsInjection drug useCurrent injection drug useLifetime injection drug useHIV infectionNeedle sharingHepatitis CHeroin dependenceHigh prevalenceDrug useMajor risk factorChest X-rayHeroin-dependent individualsHIV risk behaviorsHeroin-dependent subjectsConsistent condom useAddiction Severity IndexDrug abuse treatmentRadiological evidenceHepatitis BMean ageRisk factorsClinical trialsMalay ethnicityBaseline assessmentHIV
2005
The practice of office-based buprenorphine treatment of opioid dependence: is it associated with new patients entering into treatment?
Sullivan LE, Chawarski M, O’Connor P, Schottenfeld RS, Fiellin DA. The practice of office-based buprenorphine treatment of opioid dependence: is it associated with new patients entering into treatment? Drug And Alcohol Dependence 2005, 79: 113-116. PMID: 15943950, DOI: 10.1016/j.drugalcdep.2004.12.008.Peer-Reviewed Original ResearchConceptsPrimary care clinicsInjection drug useOpioid treatment programsMethadone treatmentOpioid dependenceClinical trialsTreatment outcomesHistory of IDUOffice-based buprenorphine treatmentOffice-based buprenorphineBuprenorphine/naloxoneOffice-based treatmentLower ratesHepatitis CClinical characteristicsBuprenorphine treatmentCare clinicsMethadone maintenancePCC patientsNew patientsTreatment retentionPatientsDrug useTreatment programBuprenorphine
2001
Methadone Maintenance in Primary Care: A Randomized Controlled Trial
Fiellin DA, O'Connor PG, Chawarski M, Pakes JP, Pantalon MV, Schottenfeld RS. Methadone Maintenance in Primary Care: A Randomized Controlled Trial. JAMA 2001, 286: 1724-1731. PMID: 11594897, DOI: 10.1001/jama.286.14.1724.Peer-Reviewed Original ResearchConceptsOpioid-dependent patientsNarcotic treatment programsOffice-based careStable opioid-dependent patientsIllicit drug usePrimary care physiciansMethadone maintenanceUse of healthDrug useNTP patientsCare physiciansClinical instabilityFunctional statusPrimary care physician's officeMethadone maintenance therapyPrimary care internistsMethadone maintenance patientsOpen clinical trialIllicit opiate useToxicology test resultsQuality of careMaintenance therapyUsual careControlled TrialsOpioid dependence
2000
Thrice-weekly versus daily buprenorphine maintenance
Schottenfeld R, Pakes J, O’Connor P, Chawarski M, Oliveto A, Kosten T. Thrice-weekly versus daily buprenorphine maintenance. Biological Psychiatry 2000, 47: 1072-1079. PMID: 10862807, DOI: 10.1016/s0006-3223(99)00270-x.Peer-Reviewed Original ResearchConceptsSublingual buprenorphineMaintenance treatmentSelf-reported illicit drug useDrug useOpioid agonist maintenance treatmentOpioid-positive urine testsAgonist maintenance treatmentDaily clinic attendanceDaily sublingual buprenorphineThrice-weekly dosingOpioid-dependent patientsUrine toxicology testsSignificant differencesIllicit drug useSelf-reported numberBuprenorphine maintenanceClinic attendanceWeekly doseIllicit opioidsMedication complianceThrice weeklyUrine testsOutcome measuresBuprenorphineCounseling attendanceCommunity reinforcement approach for combined opioid and cocaine dependence Patterns of engagement in alternate activities
Schottenfeld R, Pantalon M, Chawarski M, Pakes J, M.Ed. Community reinforcement approach for combined opioid and cocaine dependence Patterns of engagement in alternate activities. Journal Of Substance Use And Addiction Treatment 2000, 18: 255-261. PMID: 10742639, DOI: 10.1016/s0740-5472(99)00062-8.Peer-Reviewed Original ResearchConceptsCommunity Reinforcement ApproachNondrug-related activitiesDrug useGroup drug counselingClinical trialsDrug counselingReinforcement approachCocaine dependenceCurrent trialOpioidsAbstinenceSignificant differencesPatientsTrialsAlternate activitiesAverage hoursEffective overallTotal numberHoursRecreational activitiesActivityWeeksCocaine