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 patientsAccessibility of Opioid Treatment Programs Based on Conventional vs Perceived Travel Time Measures
Kim J, Lee J, Thornhill T, Dennett J, Lu H, Howell B, Grau L, Fiellin D, Heimer R, Gonsalves G. Accessibility of Opioid Treatment Programs Based on Conventional vs Perceived Travel Time Measures. JAMA Network Open 2024, 7: e240209. PMID: 38376839, PMCID: PMC10879949, DOI: 10.1001/jamanetworkopen.2024.0209.Peer-Reviewed Original ResearchConceptsTransit travel timeAccessibility metricsTravel timeTravel componentsAccessibility scoresTransportation burdenTravel burdenOut-of-vehicleComponents of travelConventional accessibility measuresSpatial regression modelsTravel time measurementsPublic transitTransit schedulesAccessibility measuresDeparture timeTravel time analysisTrip durationTravelOperating hoursTime analysisCross-sectional studyOpioid use disorderPolicy recommendationsDecision-making
2023
Implementing Programs to Initiate Buprenorphine for Opioid Use Disorder Treatment in High-Need, Low-Resource Emergency Departments: A Nonrandomized Controlled Trial
McCormack R, Rotrosen J, Gauthier P, D'Onofrio G, Fiellin D, Marsch L, Novo P, Liu D, Edelman E, Farkas S, Matthews A, Mulatya C, Salazar D, Wolff J, Knight R, Goodman W, Williams J, Hawk K. Implementing Programs to Initiate Buprenorphine for Opioid Use Disorder Treatment in High-Need, Low-Resource Emergency Departments: A Nonrandomized Controlled Trial. Annals Of Emergency Medicine 2023, 82: 272-287. PMID: 37140493, PMCID: PMC10524047, DOI: 10.1016/j.annemergmed.2023.02.013.Peer-Reviewed Original ResearchConceptsBuprenorphine programImplementation facilitationEmergency departmentMedical recordsOpioid use disorder treatmentMain secondary outcomesMore treatment visitsPrimary implementation outcomeNonrandomized Controlled TrialPatient-level outcomesPatients' medical recordsUse disorder treatmentTreatment 30 daysBuprenorphine administrationOpioid useSecondary outcomesControlled TrialsTreatment visitsED settingUnique patientsClinicians' readinessEligibility criteriaClinical protocolsDisorder treatmentOverdose eventsPerspectives 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
2020
Barriers 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
2019
Integrated stepped alcohol treatment for patients with HIV and alcohol use disorder: a randomised controlled trial
Edelman EJ, Maisto SA, Hansen NB, Cutter CJ, Dziura J, Deng Y, Fiellin LE, O'Connor PG, Bedimo R, Gibert CL, Marconi VC, Rimland D, Rodriguez-Barradas MC, Simberkoff MS, Tate JP, Justice AC, Bryant KJ, Fiellin DA. Integrated stepped alcohol treatment for patients with HIV and alcohol use disorder: a randomised controlled trial. The Lancet HIV 2019, 6: e509-e517. PMID: 31109915, PMCID: PMC7161741, DOI: 10.1016/s2352-3018(19)30076-1.Peer-Reviewed Original ResearchConceptsAlcohol use disorderWeek 24Use disordersAlcohol treatmentAdverse eventsNumber of drinksTreatment medicationsPhysician managementAlcohol abuseMental Disorders-IV criteriaAlcohol-related careFormal alcohol treatmentKey exclusion criteriaTimeline followback methodMotivational enhancement therapyTreat populationHIV clinicHIV outcomesPrimary outcomeSpecialty referralsMean ageUS National InstitutesWeek 4Medical conditionsExclusion criteriaAssociation of Prescribed Opioids With Increased Risk of Community-Acquired Pneumonia Among Patients With and Without HIV
Edelman EJ, Gordon KS, Crothers K, Akgün K, Bryant KJ, Becker WC, Gaither JR, Gibert CL, Gordon AJ, Marshall BDL, Rodriguez-Barradas MC, Samet JH, Justice AC, Tate JP, Fiellin DA. Association of Prescribed Opioids With Increased Risk of Community-Acquired Pneumonia Among Patients With and Without HIV. JAMA Internal Medicine 2019, 179: 297-304. PMID: 30615036, PMCID: PMC6439696, DOI: 10.1001/jamainternmed.2018.6101.Peer-Reviewed Original ResearchConceptsVeterans Aging Cohort StudyCommunity-acquired pneumoniaImmunosuppressive propertiesPrescribed opioidsCaP riskHIV statusMedian morphine equivalent daily doseVeterans Health Administration medical centersMorphine equivalent daily doseEquivalent daily doseAging Cohort StudyCase-control studyImmune-related outcomesRace/ethnicityIndex dateOpioid exposureCohort studyDaily doseOpioid propertiesStratified analysisMedical CenterMAIN OUTCOMEOpioidsMedicaid dataHIV
2018
Women and opioids: something different is happening here
Mazure CM, Fiellin DA. Women and opioids: something different is happening here. The Lancet 2018, 392: 9-11. PMID: 30047402, DOI: 10.1016/s0140-6736(18)31203-0.Peer-Reviewed Original Research
2017
Video Game Intervention for Sexual Risk Reduction in Minority Adolescents: Randomized Controlled Trial
Fiellin LE, Hieftje KD, Pendergrass TM, Kyriakides TC, Duncan LR, Dziura JD, Sawyer BG, Mayes L, Crusto CA, Forsyth BW, Fiellin DA. Video Game Intervention for Sexual Risk Reduction in Minority Adolescents: Randomized Controlled Trial. Journal Of Medical Internet Research 2017, 19: e314. PMID: 28923788, PMCID: PMC5625130, DOI: 10.2196/jmir.8148.Peer-Reviewed Original ResearchConceptsSexual health attitudesHuman immunodeficiency virusIntervention groupHealth attitudesInitiation of intercourseVideo game interventionControl groupHIV sexual riskSexual health outcomesSexual risk reductionDelay of initiationDigital health interventionsSecondary outcomesControlled TrialsGame interventionPrimary outcomeImmunodeficiency virusMean ageAnal intercourseHealth outcomesHealth interventionsSexual riskMonthsMinority adolescentsIntervention
2016
Primary Care Physicians’ Willingness to Prescribe HIV Pre-exposure Prophylaxis for People who Inject Drugs
Edelman EJ, Moore BA, Calabrese SK, Berkenblit G, Cunningham C, Patel V, Phillips K, Tetrault JM, Shah M, Fiellin DA, Blackstock O. Primary Care Physicians’ Willingness to Prescribe HIV Pre-exposure Prophylaxis for People who Inject Drugs. AIDS And Behavior 2016, 21: 1025-1033. PMID: 27896552, PMCID: PMC5344709, DOI: 10.1007/s10461-016-1612-6.Peer-Reviewed Original ResearchConceptsPrimary care physiciansPre-exposure prophylaxisCare physiciansHIV pre-exposure prophylaxisHIV risk groupMore HIVClinic patientsRisk groupsGeneral internistsPWIDAcademic general internistsPractice characteristicsDisease preventionHIVPrEPProphylaxisPatientsPhysiciansCareDrugsOnline surveyInternistsHigher willingnessLower willingnessCentral roleA Cross-Sectional Online Survey of HIV Pre-Exposure Prophylaxis Adoption Among Primary Care Physicians
Blackstock OJ, Moore BA, Berkenblit GV, Calabrese SK, Cunningham CO, Fiellin DA, Patel VV, Phillips KA, Tetrault JM, Shah M, Edelman EJ. A Cross-Sectional Online Survey of HIV Pre-Exposure Prophylaxis Adoption Among Primary Care Physicians. Journal Of General Internal Medicine 2016, 32: 62-70. PMID: 27778215, PMCID: PMC5215171, DOI: 10.1007/s11606-016-3903-z.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnti-HIV AgentsCross-Sectional StudiesFemaleHealth Knowledge, Attitudes, PracticeHealth PersonnelHealth Risk BehaviorsHIV InfectionsHumansMaleMiddle AgedMultivariate AnalysisOdds RatioPractice Patterns, Physicians'Pre-Exposure ProphylaxisPrimary Health CareSurveys and QuestionnairesConceptsPrimary care physiciansHIV care experienceCare physiciansPrEP adoptionPrEP awarenessPractice characteristicsHIV pre-exposure prophylaxisCare experiencesAcademic primary care physiciansHIV-positive patientsPre-exposure prophylaxisHealth care providersResultsThe survey response rateSectional Online SurveyPCP adoptionHIV careKey ResultsThe survey response ratePercent of respondentsRisk compensationSurvey response ratePrEP knowledgePrEP useSelf-rated knowledgeMultivariable analysisClinical championsThe impact of prescribed opioids on CD4 cell count recovery among HIV‐infected patients newly initiating antiretroviral therapy
Edelman E, Gordon K, Tate J, Becker W, Bryant K, Crothers K, Gaither, Gibert C, Gordon A, Marshall B, Rodriguez‐Barradas M, Samet J, Skanderson M, Justice A, Fiellin D. The impact of prescribed opioids on CD4 cell count recovery among HIV‐infected patients newly initiating antiretroviral therapy. HIV Medicine 2016, 17: 728-739. PMID: 27186715, PMCID: PMC5053822, DOI: 10.1111/hiv.12377.Peer-Reviewed Original ResearchConceptsCD4 cell countBaseline CD4 cell countCell countPrescribed opioidsImmunosuppressive propertiesVeterans Aging Cohort Study (VACS) dataCD4 cell count recoveryAntiretroviral therapy responseCell count recoveryShort-term opioidsViral load suppressionCohort study dataOverall disease severityYear of initiationPrimary independent variableOpioid durationAntiretroviral therapyCount recoveryComorbid conditionsPharmacy dataOpioid propertiesTherapy responseOpioidsPatientsHIVHepatic 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
2015
Emergency 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 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
2013
Racial/ethnic differences in report of drug testing practices at the workplace level in the U.S.
Becker WC, Meghani S, Tetrault JM, Fiellin DA. Racial/ethnic differences in report of drug testing practices at the workplace level in the U.S. American Journal On Addictions 2013, 23: 357-362. PMID: 24112118, DOI: 10.1111/j.1521-0391.2013.12109.x.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge FactorsBlack or African AmericanCross-Sectional StudiesData CollectionEducational StatusEmploymentFemaleHispanic or LatinoHumansIncomeMaleMiddle AgedMultivariate AnalysisOccupationsPrejudiceResidence CharacteristicsSelf ReportSex FactorsSubstance Abuse DetectionWhite PeopleWorkplaceYoung AdultConceptsDrug testingBlack raceStratified analysisWorkplace drug testingEthnic differencesSubstance abuse/dependenceImportant public health implicationsNon-urban residenceCross-sectional studyLogistic regression analysisAbuse/dependencePublic health implicationsDrug testing practicesSupport occupationsRace/ethnicityMale sexMultivariable analysisHispanic ethnicityDrug useYounger ageDrug testing policiesHealth implicationsFurther studiesHispanic respondentsRegression analysisAssociation Between Risk Behaviors and Antiretroviral Resistance in HIV-Infected Patients Receiving Opioid Agonist Treatment
Tetrault JM, Kozal MJ, Chiarella J, Sullivan LE, Dinh AT, Fiellin DA. Association Between Risk Behaviors and Antiretroviral Resistance in HIV-Infected Patients Receiving Opioid Agonist Treatment. Journal Of Addiction Medicine 2013, 7: 102-107. PMID: 23388678, PMCID: PMC3618545, DOI: 10.1097/adm.0b013e31827f9bdf.Peer-Reviewed Original ResearchConceptsOpioid agonist treatmentTransmission risk behaviorsHIV transmission risk behaviorsInjection drug useAgonist treatmentARV resistanceRisk behaviorsDrug useAntiretroviral resistanceUrine toxicologyClass resistanceSelf-reported HIV risk behaviorsTriple-class resistanceOpioid treatment programsPositive urine toxicologyOpioid-dependent individualsPercent of subjectsHIV risk behaviorsCross-sectional studyResource limited settingsIllicit drug useHIV seroconversionRisky sexual behaviorHIV resistanceResistant viruses
2012
Physician Detection of Unhealthy Substance Use on Inpatient Teaching and Hospitalist Medical Services
Holt SR, Ramos J, Harma M, Cabrera F, Louis-Ashby C, Dinh A, Fiellin DA, Tetrault JM. Physician Detection of Unhealthy Substance Use on Inpatient Teaching and Hospitalist Medical Services. The American Journal Of Drug And Alcohol Abuse 2012, 39: 121-129. PMID: 22992028, DOI: 10.3109/00952990.2012.715703.Peer-Reviewed Original ResearchConceptsUnhealthy substance useAlcohol Use Disorders Identification Test-ConsumptionDrug Abuse Screening TestHospitalist serviceSubstance useScreening testSubstance Involvement Screening TestPhysicians' detection ratesUnhealthy drug useMedical record reviewTeaching serviceCommunity teaching hospitalMedical servicesCross-sectional studyICD-9 codingRate of detectionAbuse Screening TestEligible patientsMedicine admissionsCurrent smokersRecord reviewDetection ratePhysician detectionTeaching hospitalPhysician documentation