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 historyCost‐effectiveness of emergency department‐initiated treatment for opioid dependence
Busch SH, Fiellin DA, Chawarski MC, Owens PH, Pantalon MV, Hawk K, Bernstein SL, O'Connor PG, D'Onofrio G. Cost‐effectiveness of emergency department‐initiated treatment for opioid dependence. Addiction 2017, 112: 2002-2010. PMID: 28815789, PMCID: PMC5657503, DOI: 10.1111/add.13900.Peer-Reviewed Original ResearchConceptsCost-effectiveness acceptability curvesOpioid dependenceCommunity-based treatmentBrief interventionAcceptability curvesPast weekHealth care system costsHealth care system perspectiveAddiction treatmentOpioid-dependent patientsPatient time costsHealth care useFormal addiction treatmentBuprenorphine treatmentUrban EDEmergency departmentPrimary carePatient engagementTreatment engagementPatientsReferralSecondary analysisBuprenorphineNumber of daysInterventionEmergency 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
2015
A randomized clinical trial of emergency department initiated treatment for opioid dependence: Two and six month outcomes
D’Onofrio G, O’Connor P, Pantalon M, Chawarski M, Busch S, Owens P, Bernstein S, Fiellin D. A randomized clinical trial of emergency department initiated treatment for opioid dependence: Two and six month outcomes. Drug And Alcohol Dependence 2015, 156: e53. DOI: 10.1016/j.drugalcdep.2015.07.1062.Peer-Reviewed Original ResearchHealth service use in a randomized clinical trial comparing three methods of emergency department interventions for opioid dependence
Busch S, Hawk K, Fiellin D, O’Connor P, Chawarski M, Owens P, Pantalon M, Bernstein S, D’Onofrio G. Health service use in a randomized clinical trial comparing three methods of emergency department interventions for opioid dependence. Drug And Alcohol Dependence 2015, 156: e32. DOI: 10.1016/j.drugalcdep.2015.07.1005.Peer-Reviewed Original ResearchEmergency Department–Initiated Buprenorphine/Naloxone Treatment for Opioid Dependence: A Randomized Clinical Trial
D’Onofrio G, O’Connor P, Pantalon MV, Chawarski MC, Busch SH, Owens PH, Bernstein SL, Fiellin DA. Emergency Department–Initiated Buprenorphine/Naloxone Treatment for Opioid Dependence: A Randomized Clinical Trial. JAMA 2015, 313: 1636-1644. PMID: 25919527, PMCID: PMC4527523, DOI: 10.1001/jama.2015.3474.Peer-Reviewed Original ResearchConceptsBrief intervention groupOpioid-dependent patientsIllicit opioid useAddiction treatment servicesPercent of patientsBuprenorphine groupEmergency departmentIntervention groupReferral groupOpioid useTreatment servicesBrief interventionOpioid dependenceClinical trialsHIV riskUrban teaching hospital emergency departmentBuprenorphine/naloxone treatmentHuman immunodeficiency virus (HIV) riskTeaching hospital emergency departmentAddiction treatmentBuprenorphine treatment groupUrine samplesBuprenorphine/naloxoneRandomized clinical trialsCommunity-based treatment services
2014
Primary Care–Based Buprenorphine Taper vs Maintenance Therapy for Prescription Opioid Dependence: A Randomized Clinical Trial
Fiellin DA, Schottenfeld RS, Cutter CJ, Moore BA, Barry DT, O’Connor P. Primary Care–Based Buprenorphine Taper vs Maintenance Therapy for Prescription Opioid Dependence: A Randomized Clinical Trial. JAMA Internal Medicine 2014, 174: 1947-1954. PMID: 25330017, PMCID: PMC6167926, DOI: 10.1001/jamainternmed.2014.5302.Peer-Reviewed Original ResearchConceptsPrescription opioid dependenceOngoing maintenance therapyIllicit opioid useMaintenance therapyOpioid dependenceBuprenorphine taperBuprenorphine therapyTaper groupMaintenance groupOpioid usePrimary careClinical trialsPrimary care-based treatmentSignificant public health burdenBuprenorphine maintenance therapyOngoing maintenance treatmentPrimary care physiciansEvidence-based guidelinesPrimary care sitesPublic health burdenWeeks of stabilizationHydrochloride therapyOpioid withdrawalBuprenorphine treatmentNaltrexone treatmentThe impact of buprenorphine/naloxone treatment on HIV risk behaviors among HIV-infected, opioid-dependent patients
Edelman EJ, Chantarat T, Caffrey S, Chaudhry A, O’Connor P, Weiss L, Fiellin DA, Fiellin LE. The impact of buprenorphine/naloxone treatment on HIV risk behaviors among HIV-infected, opioid-dependent patients. Drug And Alcohol Dependence 2014, 139: 79-85. PMID: 24726429, PMCID: PMC4029496, DOI: 10.1016/j.drugalcdep.2014.03.006.Peer-Reviewed Original ResearchConceptsBuprenorphine/naloxone treatmentOpioid-dependent patientsHIV risk behaviorsBuprenorphine/naloxoneNon-condom useNaloxone treatmentRisk behaviorsTreatment initiationViral loadHIV-1 RNA viral loadCocaine/amphetaminesTime-updated variablesRNA viral loadMajor risk factorOpioid-dependent populationsCochran-Armitage trend testSexual risk behaviorsOlder patientsHIV infectionOpioid dependenceRisk factorsHeroin useHIVPatientsTargeted interventions
2013
A Randomized Trial of Cognitive Behavioral Therapy in Primary Care-based Buprenorphine
Fiellin DA, Barry DT, Sullivan LE, Cutter CJ, Moore BA, O'Connor PG, Schottenfeld RS. A Randomized Trial of Cognitive Behavioral Therapy in Primary Care-based Buprenorphine. The American Journal Of Medicine 2013, 126: 74.e11-74.e17. PMID: 23260506, PMCID: PMC3621718, DOI: 10.1016/j.amjmed.2012.07.005.Peer-Reviewed Original ResearchConceptsCognitive behavioral therapyPhysician managementBehavioral therapyOpioid useOpioid dependencePrimary careSelf-reported frequencyBuprenorphine/naloxone treatmentConsecutive weeksOpioid-dependent patientsIllicit opioid usePrimary care clinicsPrimary outcome measureWeeks of treatmentNaloxone treatmentOpioid abstinenceBuprenorphine/Care clinicsIllicit opioidsRandomized trialsUrine toxicologyClinical trialsStudy completionOutcome measuresCocaine use
2012
Brief versus extended counseling along with buprenorphine/naloxone for HIV-infected opioid dependent patients
Tetrault JM, Moore BA, Barry DT, O'Connor PG, Schottenfeld R, Fiellin DA, Fiellin LE. Brief versus extended counseling along with buprenorphine/naloxone for HIV-infected opioid dependent patients. Journal Of Substance Use And Addiction Treatment 2012, 43: 433-439. PMID: 22938914, DOI: 10.1016/j.jsat.2012.07.011.Peer-Reviewed Original ResearchMeSH KeywordsAdultBuprenorphineBuprenorphine, Naloxone Drug CombinationCounselingDelivery of Health Care, IntegratedFeasibility StudiesFemaleFollow-Up StudiesHIV InfectionsHumansMaleMiddle AgedNaloxoneNarcotic AntagonistsOpioid-Related DisordersPsychotherapy, BriefSubstance Abuse DetectionTime FactorsTreatment OutcomeViral LoadConceptsEnhanced medical managementPhysician managementDetectable HIV viral loadHIV treatment settingsOpioid-negative urinesBuprenorphine/naloxoneHIV viral loadOpioid-dependent patientsPercentage of subjectsUntreated opioid dependenceExtended counselingHIV clinicHIV outcomesBuprenorphine/Medical managementOpioid dependenceViral loadDependent patientsExtensive counselingClinical trialsContinuous abstinenceNegative urineTreatment settingsGroup differencesCounselingOpioid 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
2011
Drug Treatment Outcomes Among HIV-Infected Opioid-Dependent Patients Receiving Buprenorphine/Naloxone
Fiellin DA, Weiss L, Botsko M, Egan JE, Altice FL, Bazerman LB, Chaudhry A, Cunningham CO, Gourevitch MN, Lum PJ, Sullivan LE, Schottenfeld RS, O'Connor PG. Drug Treatment Outcomes Among HIV-Infected Opioid-Dependent Patients Receiving Buprenorphine/Naloxone. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2011, 56: s33-s38. PMID: 21317592, PMCID: PMC3863630, DOI: 10.1097/qai.0b013e3182097537.Peer-Reviewed Original ResearchConceptsBuprenorphine/naloxoneBuprenorphine/naloxone treatmentOpioid-dependent patientsDrug useOpioid useNaloxone treatmentHIV treatment settingsIllicit opioid useOngoing drug useDrug treatment outcomesNaloxone dosesIllicit opioidsOpioid dependenceOffice visitsProspective studyHIV treatmentRetained patientsTreatment outcomesTreatment retentionPatientsTreatment settingsAddiction treatment processNaloxoneTreatment populationHIV
2009
The Association between Cocaine Use and Treatment Outcomes in Patients Receiving Office‐Based Buprenorphine/Naloxone for the Treatment of Opioid Dependence
Sullivan LE, Moore BA, O'Connor PG, Barry DT, Chawarski MC, Schottenfeld RS, Fiellin DA. The Association between Cocaine Use and Treatment Outcomes in Patients Receiving Office‐Based Buprenorphine/Naloxone for the Treatment of Opioid Dependence. American Journal On Addictions 2009, 19: 53-58. PMID: 20132122, PMCID: PMC3107713, DOI: 10.1111/j.1521-0391.2009.00003.x.Peer-Reviewed Original ResearchConceptsOpioid-negative urinesBuprenorphine/naloxoneUrine toxicology testsWeeks of treatmentWorse treatment outcomesTreatment outcomesCocaine useTreatment retentionMean weekBuprenorphine/naloxone maintenanceGreater percentageToxicology testsUrine toxicology resultsOpioid dependenceToxicology resultsPatientsTargeted interventionsWeeksNaloxoneOutcomesTreatmentBaselineUrineAssociationPercentage
2008
Integrating Buprenorphine Treatment into Office-based Practice: a Qualitative Study
Barry DT, Irwin KS, Jones ES, Becker WC, Tetrault JM, Sullivan LE, Hansen H, O’Connor P, Schottenfeld RS, Fiellin DA. Integrating Buprenorphine Treatment into Office-based Practice: a Qualitative Study. Journal Of General Internal Medicine 2008, 24: 218-225. PMID: 19089500, PMCID: PMC2628993, DOI: 10.1007/s11606-008-0881-9.Peer-Reviewed Original ResearchConceptsBuprenorphine maintenance treatmentOffice-based practicePhysicians' perceptionsPatient-related barriersOffice-based physiciansLack of remunerationBuprenorphine treatmentOpioid dependenceMaintenance treatmentPhysician barriersMethadone maintenancePrimary careResultsEighty percentLow prevalenceClinical practiceMedical providersMultidisciplinary teamPatient careInternal medicinePhysician facilitatorsInfectious diseasesAddiction medicinePhysiciansQualitative software programDesignQualitative studyCost analysis of clinic and office-based treatment of opioid dependence: Results with methadone and buprenorphine in clinically stable patients
Jones ES, Moore BA, Sindelar JL, O’Connor P, Schottenfeld RS, Fiellin DA. Cost analysis of clinic and office-based treatment of opioid dependence: Results with methadone and buprenorphine in clinically stable patients. Drug And Alcohol Dependence 2008, 99: 132-140. PMID: 18804923, PMCID: PMC2646001, DOI: 10.1016/j.drugalcdep.2008.07.013.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultBuprenorphineCohort StudiesCost of IllnessCosts and Cost AnalysisData Interpretation, StatisticalFemaleHealth PersonnelHumansMaleMethadoneMiddle AgedNarcoticsOpioid-Related DisordersPhysicians' OfficesSocioeconomic FactorsSubstance Abuse DetectionSubstance Abuse Treatment CentersTreatment OutcomeYoung AdultConceptsOffice-based treatmentOpioid dependencePatient costsClinical contactMonthly medication costsOffice-based buprenorphineOffice-based methadoneMonths of treatmentAnalysis of treatmentTotal monthly costsChi-square testMonths of maintenanceStable patientsMedication costsPatientsMethadoneMonthly costBuprenorphineTreatmentMonthsStatistical comparisonCost estimatesClinic
2007
Utility 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 acceptabilityPrimary Care Office-based Buprenorphine Treatment: Comparison of Heroin and Prescription Opioid Dependent Patients
Moore BA, Fiellin DA, Barry DT, Sullivan LE, Chawarski MC, O’Connor P, Schottenfeld RS. Primary Care Office-based Buprenorphine Treatment: Comparison of Heroin and Prescription Opioid Dependent Patients. Journal Of General Internal Medicine 2007, 22: 527-530. PMID: 17372805, PMCID: PMC1829433, DOI: 10.1007/s11606-007-0129-0.Peer-Reviewed Original ResearchConceptsPrescription opioid useOpioid useOnly patientsPrescription opioidsTreatment outcomesBuprenorphine/naloxone maintenanceBuprenorphine/naloxone treatmentOpioid-negative urine samplesPrescription opioid-dependent patientsHepatitis C antibodyDrug treatment historyOpioid-dependent patientsPrimary care officesOffice-based settingClinical characteristicsBuprenorphine treatmentNaloxone treatmentBuprenorphine/Opioid dependenceCare officesDependent patientsTreatment responseC antibodyHeroin usePatients
2006
A Trial of Integrated Buprenorphine/Naloxone and HIV Clinical Care
Sullivan LE, Barry D, Moore BA, Chawarski MC, Tetrault JM, Pantalon MV, O'Connor PG, Schottenfeld RS, Fiellin DA. A Trial of Integrated Buprenorphine/Naloxone and HIV Clinical Care. Clinical Infectious Diseases 2006, 43: s184-s190. PMID: 17109305, DOI: 10.1086/508182.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, SublingualAdultAntiretroviral Therapy, Highly ActiveBuprenorphineDose-Response Relationship, DrugDrug Administration ScheduleFemaleFollow-Up StudiesHIV InfectionsHumansMaleMiddle AgedNaloxoneNarcotic AntagonistsOpioid-Related DisordersPilot ProjectsProbabilityReference ValuesRisk FactorsTreatment OutcomeConceptsHIV clinical careHIV-1 RNA copies/mLBuprenorphine/naloxone treatmentRNA copies/mLCopies/mLOpioid dependenceClinical careOpioid useNaloxone treatmentPhysician managementTreatment retentionHIV type 1 RNA levelsHIV-1 RNA levelsDose of buprenorphinePartial opioid agonistRNA levelsCD4 lymphocyte countBuprenorphine/naloxoneOpioid-dependent patientsUrine toxicology testsWeeks of treatmentHuman immunodeficiency virusUrine test resultsBetter treatment retentionUntreated opioid dependenceCounseling plus Buprenorphine–Naloxone Maintenance Therapy for Opioid Dependence
Fiellin DA, Pantalon MV, Chawarski MC, Moore BA, Sullivan LE, O'Connor PG, Schottenfeld RS. Counseling plus Buprenorphine–Naloxone Maintenance Therapy for Opioid Dependence. New England Journal Of Medicine 2006, 355: 365-374. PMID: 16870915, DOI: 10.1056/nejmoa055255.Peer-Reviewed Original ResearchConceptsStandard medical managementBuprenorphine-naloxone treatmentIllicit opioid useMedical managementOpioid dependenceWeekly medicationOpioid useIllicit opioidsWeekly counselingPrimary careUrine specimensConsecutive weeksProportion of patientsImproved treatment outcomesMaintenance therapyPrimary outcomeClinical trialsMedication distributionSimilar efficacyTreatment outcomesMedicationsSelf-reported frequencyPatientsFrequency of attendanceMean percentage
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