2012
Opioid Detoxification and Naltrexone Induction Strategies: Recommendations for Clinical Practice
Sigmon SC, Bisaga A, Nunes EV, O'Connor PG, Kosten T, Woody G. Opioid Detoxification and Naltrexone Induction Strategies: Recommendations for Clinical Practice. The American Journal Of Drug And Alcohol Abuse 2012, 38: 187-199. PMID: 22404717, PMCID: PMC4331107, DOI: 10.3109/00952990.2011.653426.Peer-Reviewed Original ResearchConceptsΜ-opioid receptor antagonist naltrexoneSignificant public health problemDose of buprenorphinePublic health problemLevel of careOral naltrexoneOpioid detoxificationAntagonist naltrexoneOpioid dependencePatient selectionOpioid agonistsAgonist maintenanceAncillary medicationsFavorable outcomeHigh riskTarget doseClinical practiceHealth problemsNaltrexoneExpert cliniciansTreatmentDoseMore researchUseful alternativeBest approach
2003
Initial and Maintenance Naltrexone Treatment for Alcohol Dependence Using Primary Care vs Specialty Care: A Nested Sequence of 3 Randomized Trials
O'Malley SS, Rounsaville BJ, Farren C, Namkoong K, Wu R, Robinson J, O'Connor PG. Initial and Maintenance Naltrexone Treatment for Alcohol Dependence Using Primary Care vs Specialty Care: A Nested Sequence of 3 Randomized Trials. JAMA Internal Medicine 2003, 163: 1695-1704. PMID: 12885685, DOI: 10.1001/archinte.163.14.1695.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAlanine TransaminaseAlcoholismAspartate AminotransferasesCognitive Behavioral TherapyCombined Modality TherapyConnecticutFemaleGamma-GlutamyltransferaseHumansMaleMedicineMiddle AgedNaltrexoneNarcotic AntagonistsPatient CompliancePatient ParticipationPrimary Health CareSpecializationTimeTreatment OutcomeConceptsPrimary care managementCognitive behavior therapyPlacebo-controlled studyAlcohol dependenceNaltrexone treatmentPersistent heavy drinkingPrimary care treatmentWeeks of treatmentMaintenance of responseMaintenance of improvementCBT armCBT patientsPlacebo groupNaltrexone maintenanceRandomized trialsCare treatmentPrimary careSpecialty carePCM patientsDays abstinentNaltrexoneInitial courseCare managementCBT respondersPatients
1999
Measurement of compliance with naltrexone in the treatment of alcohol dependence: research and clinical implications.
Namkoong K, Farren CK, O'Connor PG, O'Malley SS. Measurement of compliance with naltrexone in the treatment of alcohol dependence: research and clinical implications. The Journal Of Clinical Psychiatry 1999, 60: 449-53. PMID: 10453799, DOI: 10.4088/jcp.v60n0706.Peer-Reviewed Original ResearchConceptsMedication Event Monitoring SystemMedication compliancePill countAlcohol dependenceOpen-label studyPill-taking behaviorSample of patientsEvent Monitoring SystemMeasurement of complianceEstimates of complianceCompliant groupPharmacotherapy researchTreatment outcomesClinical utilityCompliance rateNaltrexoneClinical implicationsOverall outcomeDrinking outcomesPatientsMEMS dataOutcomesCountTreatmentCompliance
1997
A Preliminary Investigation of the Management of Alcohol Dependence With Naltrexone by Primary Care Providers
O’Connor P, Farren C, Rounsaville B, O’Malley S. A Preliminary Investigation of the Management of Alcohol Dependence With Naltrexone by Primary Care Providers. The American Journal Of Medicine 1997, 103: 477-482. PMID: 9428830, DOI: 10.1016/s0002-9343(97)00271-4.Peer-Reviewed Original ResearchConceptsPrimary care providersCare providersGamma-glutamyl transferaseAlcohol dependenceDays abstinentHeavy drinkingSerum gamma-glutamyl transferaseCare treatment modelCompletion of treatmentPercent days abstinentAlcohol-dependent subjectsAlcohol-dependent individualsNaltrexone therapyNumber of drinksPrimary outcomeLiver enzymesPatient ratingsNew patientsGlutamyl transferaseNaltrexoneProvider ratingsBaselineTreatment modelTreatmentDrinking behaviorThree methods of opioid detoxification in a primary care setting. A randomized trial.
O'Connor PG, Carroll KM, Shi JM, Schottenfeld RS, Kosten TR, Rounsaville BJ. Three methods of opioid detoxification in a primary care setting. A randomized trial. Annals Of Internal Medicine 1997, 127: 526-30. PMID: 9313020, DOI: 10.7326/0003-4819-127-7-199710010-00004.Peer-Reviewed Original ResearchConceptsPrimary care settingOpioid detoxificationCare settingsBuprenorphine groupWithdrawal symptomsDouble-blind clinical trialOpioid-dependent patientsHeroin-dependent patientsPrimary care clinicsWithdrawal symptom scoresSevere withdrawal symptomsDrug treatment programsSubstance abuse treatmentNaltrexone groupCare clinicsSymptom scoresPharmacologic protocolClinical trialsTreatment protocolClonidineTreatment retentionBuprenorphineNaltrexoneTreatment programAbuse treatmentPHARMACOTHERAPY FOR OPIOID AND COCAINE ABUSE
Warner E, Kosten T, O'Connor P. PHARMACOTHERAPY FOR OPIOID AND COCAINE ABUSE. Medical Clinics Of North America 1997, 81: 909-925. PMID: 9222260, DOI: 10.1016/s0025-7125(05)70555-1.Peer-Reviewed Original Research
1995
Primary care-based ambulatory opioid detoxification
O’Connor P, Waugh M, Carroll K, Rounsaville B, Diagkogiannis I, Schottenfeld R. Primary care-based ambulatory opioid detoxification. Journal Of General Internal Medicine 1995, 10: 255-260. PMID: 7616334, DOI: 10.1007/bf02599882.Peer-Reviewed Original ResearchConceptsInjection drug usersClonidine/naltrexoneOpioid detoxificationDrug treatmentProspective nonrandomized clinical trialMedical clinicsPrimary care medical clinicFirst heroin useOngoing drug treatmentNonrandomized clinical trialPrimary care providersWithdrawal symptom scoresSubstance abuse treatmentMuscle crampsSymptom scoresClinical trialsClonidineNurse practitionersCare providersDetoxified patientsHeroin useTreatment groupsNaltrexoneDrug usersMedical units
1994
SPECT regional cerebral blood flow alterations in naltrexone-precipitated withdrawal from buprenorphine
van Dyck C, Rosen M, Thomas H, McMahon T, Wallace E, O'Connor P, Sullivan M, Krystal J, Hoffer P, Woods S, Kosten T. SPECT regional cerebral blood flow alterations in naltrexone-precipitated withdrawal from buprenorphine. Psychiatry Research 1994, 55: 181-191. PMID: 7701033, DOI: 10.1016/0925-4927(94)90013-2.Peer-Reviewed Original ResearchConceptsRegional cerebral blood flowRegional cerebral blood flow alterationsCerebral blood flow alterationsHexamethyl propylene amine oximeOpiate-induced analgesiaBlood flow alterationsSeverity of withdrawalCerebral blood flowOpiate-dependent patientsAnterior cingulate regionsAnterior cingulate cortexSingle photon emissionPlacebo administrationAmine oximeOpiate withdrawalRCBF ratiosWithdrawal severityBlood flowCingulate cortexCingulate regionsSignificant negative correlationBuprenorphineNaltrexonePlaceboPatients
1992
Ambulatory opiate detoxification and primary care
O’Connor P, Waugh M, Schottenfeld R, Diakogiannis I, Rounsaville B. Ambulatory opiate detoxification and primary care. Journal Of General Internal Medicine 1992, 7: 532-534. PMID: 1403211, DOI: 10.1007/bf02599459.Peer-Reviewed Original Research