Featured Publications
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 ClassificationPerspectives About Emergency Department Care Encounters Among Adults With Opioid Use Disorder
Hawk K, McCormack R, Edelman EJ, Coupet E, Toledo N, Gauthier P, Rotrosen J, Chawarski M, Martel S, Owens P, Pantalon MV, O’Connor P, Whiteside LK, Cowan E, Richardson LD, Lyons MS, Rothman R, Marsch L, Fiellin DA, D’Onofrio G. Perspectives About Emergency Department Care Encounters Among Adults With Opioid Use Disorder. JAMA Network Open 2022, 5: e2144955. PMID: 35076700, PMCID: PMC8790663, DOI: 10.1001/jamanetworkopen.2021.44955.Peer-Reviewed Original ResearchConceptsUntreated opioid use disorderOpioid use disorderEmergency departmentED visitsOUD treatmentUse disordersPublic safety-net hospitalRural critical access hospitalsEmergency department careSafety-net hospitalUrban academic centerLife-saving treatmentCritical access hospitalsImplementation science frameworkPatient factorsTreatment initiationED careUS patientsStaff trainingDemand treatmentPatient readinessNet hospitalPatient's perspectivePromoting ActionImproved careBarriers 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 cliniciansEarly emergency department experience with 7‐day extended‐release injectable buprenorphine for opioid use disorder
D'Onofrio G, Perrone J, Hawk K, Cowan E, McCormack R, Coupet E, Owens P, Martel S, Huntley K, Walsh S, Lofwall M, Herring A, Investigators T. Early emergency department experience with 7‐day extended‐release injectable buprenorphine for opioid use disorder. Academic Emergency Medicine 2023, 30: 1264-1271. PMID: 37501652, PMCID: PMC10822018, DOI: 10.1111/acem.14782.Peer-Reviewed Original ResearchConceptsOpioid use disorderEmergency departmentUse disordersSevere opioid use disorderOngoing clinical trialsEuropean Medicines AgencyEmergency department experienceInjectable buprenorphineClinician barriersED patientsED settingEmergency cliniciansInsurance statusClinical trialsReferral sitesDrug AdministrationMedicines AgencyBuprenorphine preparationsMedicationsU.S. FoodTreatment innovationsBuprenorphineDepartment's experienceEarly experienceDisorders
2024
Cost-Effectiveness of Implementation Facilitation to Promote Emergency Department-Initiated Buprenorphine for Opioid Use Disorder
Lu T, Ryan D, Cadet T, Chawarski M, Coupet E, Edelman E, Hawk K, Huntley K, Jalali A, O'Connor P, Owens P, Martel S, Fiellin D, D'Onofrio G, Murphy S. Cost-Effectiveness of Implementation Facilitation to Promote Emergency Department-Initiated Buprenorphine for Opioid Use Disorder. Annals Of Emergency Medicine 2024 PMID: 39570250, DOI: 10.1016/j.annemergmed.2024.10.001.Peer-Reviewed Original ResearchHealth care sector perspectiveImplementation facilitatorsOpioid use disorder careIncremental cost-effectiveness ratioCost-effectiveness ratioHealth care sector costsEducational strategiesImplementation facilitation strategyCost-effectiveness acceptability curvesLikelihood of cost-effectivenessCost-effectiveOpioid use disorderQuality-adjusted life yearsUse disorderPatient engagementAcademic EDED visitsAcceptability curvesStandard educationEmergency departmentLife yearsFacilitation strategiesMeasures of effectivenessHealthBuprenorphineAn Urgent Need to Promote Equitable Buprenorphine Administration for Opioid Use Disorder in the Emergency Department.
Coupet E, Edelman E. An Urgent Need to Promote Equitable Buprenorphine Administration for Opioid Use Disorder in the Emergency Department. Journal Of Addiction Medicine 2024 PMID: 39514893, DOI: 10.1097/adm.0000000000001409.Peer-Reviewed Original ResearchBuprenorphine administrationOpioid use disorder treatmentOpioid use disorderUse disorderAddiction treatmentDisorder treatmentEmergency departmentED patientsCross-sectional study of ED patientsTreatment accessBuprenorphineStudy of ED patientsOpioidOpioid overdose deathsOpioid misuseOverdose deathsCross-sectional studyLatinosAddiction403EMF Barriers and Facilitators to Addiction Treatment Access From the Emergency Department Among Black Individuals With Opioid Use Disorder
Coupet E, Chawarski M, Hercules K, Williams J, Murphy A, Owens P, D'Onofrio G. 403EMF Barriers and Facilitators to Addiction Treatment Access From the Emergency Department Among Black Individuals With Opioid Use Disorder. Annals Of Emergency Medicine 2024, 84: s182-s183. DOI: 10.1016/j.annemergmed.2024.08.403.Peer-Reviewed Original Research
2023
National Institute on Drug Abuse Clinical Trials Network Meeting Report: Advancing Emergency Department Initiation of Buprenorphine for Opioid Use Disorder
Cowan E, Perrone J, Bernstein S, Coupet E, Fiellin D, Hawk K, Herring A, Huntley K, McCormack R, Venkatesh A, D'Onofrio G. National Institute on Drug Abuse Clinical Trials Network Meeting Report: Advancing Emergency Department Initiation of Buprenorphine for Opioid Use Disorder. Annals Of Emergency Medicine 2023, 82: 326-335. PMID: 37178101, PMCID: PMC10524880, DOI: 10.1016/j.annemergmed.2023.03.025.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsOpioid use disorderEmergency departmentUse disordersDrug Abuse Clinical Trials NetworkEffective evidence-based treatmentsEmergency department initiationStandard emergency careMajor public health crisisClinical Trials NetworkEvidence of efficacyNational InstituteEvidence-based treatmentsOpioid overdose deathsTechnology-based interventionsBuprenorphine dosingBuprenorphine initiationPeer-based interventionsPublic health crisisPatient outcomesED staffOverdose deathsEmergency careBuprenorphineTrials NetworkUniversal uptakePerspectives on and experiences of emergency department–initiated buprenorphine among clinical pharmacists: A multi-site qualitative study
Justen M, Edelman E, Chawarski M, Coupet E, Cowan E, Lyons M, Owens P, Martel S, Richardson L, Rothman R, Whiteside L, O'Connor P, Zahn E, D'Onofrio G, Fiellin D, Hawk K. Perspectives on and experiences of emergency department–initiated buprenorphine among clinical pharmacists: A multi-site qualitative study. Journal Of Substance Use And Addiction Treatment 2023, 155: 209058. PMID: 37149149, DOI: 10.1016/j.josat.2023.209058.Peer-Reviewed Original ResearchConceptsOpioid use disorderClinical pharmacistsED careEmergency department-initiated buprenorphineEffective OUD treatmentEffectiveness-implementation studyHealth Services frameworkFocus groups/interviewsMulti-site qualitative studyFuture implementation effortsOUD treatmentUrban EDGroups/interviewsEmergency departmentPromoting ActionUnique pharmacologyED staffBuprenorphinePharmacist participantsUse disordersED contextPharmacistsPractice changePharmacy resourcesSuccessful program implementationPerspectives 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 OUTCOME
2022
Models for Implementing Emergency Department–Initiated Buprenorphine With Referral for Ongoing Medication Treatment at Emergency Department Discharge in Diverse Academic Centers
Whiteside LK, D'Onofrio G, Fiellin DA, Edelman EJ, Richardson L, O'Connor P, Rothman RE, Cowan E, Lyons MS, Fockele CE, Saheed M, Freiermuth C, Punches BE, Guo C, Martel S, Owens PH, Coupet E, Hawk KF. Models for Implementing Emergency Department–Initiated Buprenorphine With Referral for Ongoing Medication Treatment at Emergency Department Discharge in Diverse Academic Centers. Annals Of Emergency Medicine 2022, 80: 410-419. PMID: 35752520, PMCID: PMC9588652, DOI: 10.1016/j.annemergmed.2022.05.010.Peer-Reviewed Original ResearchConceptsOpioid use disorderUse disordersEmergency Department-Initiated BuprenorphineEmergency department dischargeEmergency department patientsElectronic medical record integrationAcademic medical centerBuprenorphine programDepartment patientsTreatment initiationMedication treatmentEmergency physiciansMedical CenterAmerican CollegeClinical practiceImplementation facilitationQuality improvement processBuprenorphineCommon facilitatorsRecord integrationPatientsReferralED cultureEducational disseminationDisorders
2021
Emergency Department Treatment of Opioid Use Disorder
Samuels E, Coupet E, D’Onofrio G. Emergency Department Treatment of Opioid Use Disorder. 2021, 57-75. DOI: 10.1007/978-3-030-80818-1_5.ChaptersOpioid use disorderED visitsUse disordersUntreated opioid use disorderDrug-related emergency department visitsNonfatal opioid overdoseUS ED visitsEmergency department treatmentFirst-line treatmentLow-dose ketamineEmergency department visitsIllicit opioid useDosage of medicationRegional nerve blocksAddiction treatment medicationsHarm reduction servicesTake-home naloxoneCost-effective treatmentAcute painOpioid useDepartment visitsOUD treatmentTreatment medicationsNerve blockOpioid agonistsThe design and conduct of a randomized clinical trial comparing emergency department initiation of sublingual versus a 7-day extended-release injection formulation of buprenorphine for opioid use disorder: Project ED Innovation
D'Onofrio G, Hawk KF, Herring AA, Perrone J, Cowan E, McCormack RP, Dziura J, Taylor RA, Coupet E, Edelman EJ, Pantalon MV, Owens PH, Martel SH, O'Connor PG, Van Veldhuisen P, DeVogel N, Huntley K, Murphy SM, Lofwall MR, Walsh SL, Fiellin DA. The design and conduct of a randomized clinical trial comparing emergency department initiation of sublingual versus a 7-day extended-release injection formulation of buprenorphine for opioid use disorder: Project ED Innovation. Contemporary Clinical Trials 2021, 104: 106359. PMID: 33737199, PMCID: PMC9153252, DOI: 10.1016/j.cct.2021.106359.Peer-Reviewed Original ResearchConceptsOpioid use disorderRandomized clinical trialsPrimary outcomeFormal addiction treatmentOpioid withdrawalClinical trialsAncillary studiesUse disordersSelf-reported opioid useAddiction treatmentEmergency department initiationIncremental cost-effectiveness ratioReceipt of medicationEmergency department studyHealth service utilizationCost-effectiveness ratioOpioid useSecondary outcomesService utilizationTreatment accessEligibility criteriaImplementation facilitationBuprenorphineOverdose eventsDepartment study
2020
Use 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 use