2024
Extended-Release 7-Day Injectable Buprenorphine for Patients With Minimal to Mild Opioid Withdrawal
D’Onofrio G, Herring A, Perrone J, Hawk K, Samuels E, Cowan E, Anderson E, McCormack R, Huntley K, Owens P, Martel S, Schactman M, Lofwall M, Walsh S, Dziura J, Fiellin D. Extended-Release 7-Day Injectable Buprenorphine for Patients With Minimal to Mild Opioid Withdrawal. JAMA Network Open 2024, 7: e2420702. PMID: 38976265, PMCID: PMC11231806, DOI: 10.1001/jamanetworkopen.2024.20702.Peer-Reviewed Original ResearchConceptsClinical Opiate Withdrawal ScaleExtended-release buprenorphineOpioid use disorderPrecipitated withdrawalOpioid withdrawalOpioid use disorder treatmentCow scoreClinical Opiate Withdrawal Scale scoreAdverse eventsNonrandomized trialsSevere opioid use disorderDays of opioid useOpiate Withdrawal ScaleModerate to severe opioid use disorderFormulation of buprenorphineOpioid use disorder careWithdrawal ScaleUse disorderAssociated with medicationsNonprescribed opioidsPain scoresExtended-releaseInjection painOpioid useAdult patients
2023
Receipt of opioid use disorder treatments prior to fatal overdoses and comparison to no treatment in Connecticut, 2016–17
Heimer R, Black A, Lin H, Grau L, Fiellin D, Howell B, Hawk K, D'Onofrio G, Becker W. Receipt of opioid use disorder treatments prior to fatal overdoses and comparison to no treatment in Connecticut, 2016–17. Drug And Alcohol Dependence 2023, 254: 111040. PMID: 38043226, PMCID: PMC10872282, DOI: 10.1016/j.drugalcdep.2023.111040.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidBuprenorphineConnecticutDrug OverdoseHumansMethadoneOpiate OverdoseOpiate Substitution TreatmentOpioid-Related DisordersRetrospective StudiesConceptsNon-medication treatmentsRelative riskOpioid overdose deathsIncidence rateMOUD treatmentOverdose deathsOpioid use disorder treatmentResults Incidence ratesRetrospective cohort studyDifferent treatment modalitiesPopulation-level effortsUse disorder treatmentFatal opioid poisoningsCohort studyOpioid poisoningTreatment modalitiesConclusion ExposurePoisoning deathsFatal overdosesTreatment exposureDisorder treatmentDeathTreatmentMethadoneRiskPerspectives 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 ResearchMeSH KeywordsBuprenorphineEmergency Service, HospitalHumansOpiate Substitution TreatmentOpioid-Related DisordersPharmacistsConceptsOpioid 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 ResearchMeSH KeywordsBuprenorphineEmergency Service, HospitalFemaleHealth ServicesHumansMiddle AgedOpiate Substitution TreatmentOpioid-Related DisordersConceptsCommunity-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 ResearchMeSH KeywordsAdultBuprenorphineEmergency Service, HospitalFemaleHumansMaleNaloxoneNarcotic AntagonistsOpiate Substitution TreatmentOpioid-Related DisordersConceptsOpioid 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 OUTCOMEAvailability of Specific Programs and Medications for Addiction Treatment to Vulnerable Populations: Results from the Addiction Treatment Locator, Assessment, and Standards (ATLAS) Survey
Oldfield B, Chen K, Joudrey P, Biegacki E, Fiellin D. Availability of Specific Programs and Medications for Addiction Treatment to Vulnerable Populations: Results from the Addiction Treatment Locator, Assessment, and Standards (ATLAS) Survey. Journal Of Addiction Medicine 2023, 17: 477-480. PMID: 37579115, DOI: 10.1097/adm.0000000000001158.Peer-Reviewed Original Research
2020
Global opioid agonist treatment: a review of clinical practices by country
Jin H, Marshall B, Degenhardt L, Strang J, Hickman M, Fiellin D, Ali R, Bruneau J, Larney S. Global opioid agonist treatment: a review of clinical practices by country. Addiction 2020, 115: 2243-2254. PMID: 32289189, PMCID: PMC7554123, DOI: 10.1111/add.15087.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidBuprenorphineBuprenorphine, Naloxone Drug CombinationHumansMethadoneNarcotic AntagonistsOpiate Substitution TreatmentOpioid-Related DisordersConceptsOpioid agonist treatmentOpioid use disorderUrine drug screeningRoutine clinical practiceClinical practiceUnsupervised dosingUse disordersObservational cohort studySignificant clinical benefitSearch of PubMedGrey literature databasesCohort studyMedian dosesOpioid dependenceAgonist treatmentClinical benefitPrescribing practicesEligible studiesOAT programsScreening practicesEligibility criteriaBuprenorphineMethadoneTreatment practicesLiterature databasesBarriers 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 clinicians
2016
Hepatic 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
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 Recent Cocaine Use on Plasma Levels of Methadone and Buprenorphine in Patients with and Without HIV-infection
Tetrault JM, McCance-Katz EF, Moody DE, Fiellin DA, Lruie BS, DInh AT, Fiellin LE. The Impact of Recent Cocaine Use on Plasma Levels of Methadone and Buprenorphine in Patients with and Without HIV-infection. Journal Of Substance Use And Addiction Treatment 2014, 51: 70-74. PMID: 25480096, DOI: 10.1016/j.jsat.2014.10.010.Peer-Reviewed Original ResearchConceptsRecent cocaine useHIV infectionCocaine useNorbuprenorphine concentrationsHIV statusBuprenorphine concentrationsS-methadoneAntiretroviral medication useBuprenorphine plasma concentrationsUninfected subjectsMethadone concentrationsMedication usePlasma levelsPlasma concentrationsR-methadoneCocaine effectsClinical careMethadoneBuprenorphineHIVInfectionAbstinenceSubjectsCocaineStatus
2012
Current and Potential Pharmacological Treatment Options for Maintenance Therapy in Opioid-Dependent Individuals
Tetrault JM, Fiellin DA. Current and Potential Pharmacological Treatment Options for Maintenance Therapy in Opioid-Dependent Individuals. Drugs 2012, 72: 217-228. PMID: 22235870, PMCID: PMC3701303, DOI: 10.2165/11597520-000000000-00000.Commentaries, Editorials and LettersMeSH KeywordsAnalgesics, OpioidHumansNarcotic AntagonistsOpiate Substitution TreatmentOpioid-Related DisordersConceptsOpioid dependenceMaintenance treatmentDrug useHepatitis C virus transmissionOpioid agonist maintenanceOpioid agonist medicationsPotential pharmacological treatment optionsC virus transmissionPharmacological treatment optionsInjection drug useOpioid-dependent individualsDirect healthcare costsIllicit opioid usersHIV risk behaviorsGlobal economic burdenIllicit drug useTerms of HIVSustained-release formulationMaintenance therapyAgonist medicationsOpioid antagonistAgonist maintenanceTreatment optionsOpioid usersImproved outcomes
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