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 effectivenessHealthBuprenorphine
2023
Perspectives 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 disorders
2017
Cost‐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
2012
Cost-Effectiveness of Buprenorphine and Naltrexone Treatments for Heroin Dependence in Malaysia
Ruger JP, Chawarski M, Mazlan M, Ng N, Schottenfeld R. Cost-Effectiveness of Buprenorphine and Naltrexone Treatments for Heroin Dependence in Malaysia. PLOS ONE 2012, 7: e50673. PMID: 23226534, PMCID: PMC3514172, DOI: 10.1371/journal.pone.0050673.Peer-Reviewed Original ResearchConceptsHeroin dependenceCost-effectiveness ratioSecondary outcomesOutcome measuresDrug usePlacebo-controlled clinical trialFirst heroin useIncremental cost-effectiveness ratioSocietal costsInjection drug useSecondary outcome measuresPrimary outcome measureIllicit opiate useIncremental treatment costNaltrexone treatmentPrimary outcomeMedication costsPlacebo interventionClinical trialsHeroin abstinenceOpiate useHeroin useBuprenorphineTreatment retentionNaltrexone
2011
Costs of Addressing Heroin Addiction in Malaysia and 32 Comparable Countries Worldwide
Ruger JP, Chawarski M, Mazlan M, Luekens C, Ng N, Schottenfeld R. Costs of Addressing Heroin Addiction in Malaysia and 32 Comparable Countries Worldwide. Health Services Research 2011, 47: 865-887. PMID: 22091732, PMCID: PMC3419893, DOI: 10.1111/j.1475-6773.2011.01335.x.Peer-Reviewed Original ResearchConceptsBuprenorphine treatmentOpioid dependence treatmentBlood testingDependence treatmentHeroin addictionHealth systemOpiate usersSimilar interventionsIncremental costLao People's Democratic RepublicPatientsHeroin problemTreatmentGreater percentagePeople's Democratic RepublicInterventionDemocratic RepublicMedicationsBuprenorphineNaltrexoneRCTs
2010
Injection of buprenorphine and buprenorphine/naloxone tablets in Malaysia
Vicknasingam B, Mazlan M, Schottenfeld RS, Chawarski MC. Injection of buprenorphine and buprenorphine/naloxone tablets in Malaysia. Drug And Alcohol Dependence 2010, 111: 44-49. PMID: 20478668, DOI: 10.1016/j.drugalcdep.2010.03.014.Peer-Reviewed Original ResearchConceptsBuprenorphine/naloxone tabletsInjection of buprenorphineInjection drug usersMisuse of buprenorphineFirst wave participantsBuprenorphine maintenanceOpioid dependenceBenzodiazepine abuseBuprenorphineDrug usersSecond-wave surveyIDUsFocus group participantsCombination tabletGroup participantsPreliminary dataSurvey participantsParticipantsFocus groupsWithdrawalAbuseDiversionSecond waveKuala Lumpur
2007
Behavioral drug and HIV risk reduction counseling (BDRC) with abstinence-contingent take-home buprenorphine: A pilot randomized clinical trial
Chawarski MC, Mazlan M, Schottenfeld RS. Behavioral drug and HIV risk reduction counseling (BDRC) with abstinence-contingent take-home buprenorphine: A pilot randomized clinical trial. Drug And Alcohol Dependence 2007, 94: 281-284. PMID: 18164145, DOI: 10.1016/j.drugalcdep.2007.11.008.Peer-Reviewed Original ResearchConceptsBuprenorphine maintenance treatmentOpioid-negative urine testsHIV risk reduction counselingRisk reduction counselingHIV risk behaviorsBehavioral drugReduction counselingUrine testsClinical trialsDrug counselingRisk behaviorsSelf-reported HIV risk behaviorsTake-home dosesUrine toxicology testsHeroin-dependent individualsIndividual drug counselingSelf-reported drug useMaintenance treatmentMedication adherenceLimited counselingBuprenorphineDrug useConsecutive abstinenceToxicology testsOverall proportion
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 programBuprenorphineMethadone Versus Buprenorphine With Contingency Management or Performance Feedback for Cocaine and Opioid Dependence
Schottenfeld RS, Chawarski MC, Pakes JR, Pantalon MV, Carroll KM, Kosten TR. Methadone Versus Buprenorphine With Contingency Management or Performance Feedback for Cocaine and Opioid Dependence. American Journal Of Psychiatry 2005, 162: 340-349. PMID: 15677600, DOI: 10.1176/appi.ajp.162.2.340.Peer-Reviewed Original ResearchConceptsCo-occurring cocaineDrug-free testOpioid dependenceMaintenance treatmentContingency managementOpioid agonist maintenance treatmentAgonist maintenance treatmentDaily sublingual buprenorphineEffects of buprenorphinePrimary outcome measureMixed-model repeated-measures analysisDouble-blind designUrine test resultsNarcotic treatment programsVoucher valueRepeated-measures analysisSublingual buprenorphineTreatment guidelinesIllicit opioidsUrine testsTreatment outcomesOutcome measuresSustained abstinenceWeek 13Buprenorphine
2004
Processes of Care During a Randomized Trial of Office‐based Treatment of Opioid Dependence in Primary Care
Fiellin DA, O'Connor PG, Chawarski M, Schottenfeld RS. Processes of Care During a Randomized Trial of Office‐based Treatment of Opioid Dependence in Primary Care. American Journal On Addictions 2004, 13: s67-s78. PMID: 15204676, DOI: 10.1080/10550490490440843.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultFemaleFocus GroupsHumansMaleMedical AuditMethadoneMiddle AgedMulticenter Studies as TopicNarcoticsOffice VisitsOpioid-Related DisordersOutcome and Process Assessment, Health CarePrimary Health CareProcess Assessment, Health CareQuality Assurance, Health CareRandomized Controlled Trials as TopicReferral and ConsultationSubstance Abuse DetectionTreatment RefusalUnited StatesConceptsUrine toxicology resultsProcess of careOpioid dependenceChart auditToxicology resultsOpioid treatment programsOffice-based careOffice-based treatmentDependent patientsMethadone maintenancePrimary carePsychiatric servicesFocus groupsQuality careTreatment programCareTreatmentTrialsAuditMedicationsBuprenorphinePatientsMethadoneGroupEvaluation of processes
2002
Treatment of heroin dependence with buprenorphine in primary care
Fiellin DA, Pantalon MV, Pakes JP, O'Connor PG, Chawarski M, Schottenfeld RS. Treatment of heroin dependence with buprenorphine in primary care. The American Journal Of Drug And Alcohol Abuse 2002, 28: 231-241. PMID: 12014814, DOI: 10.1081/ada-120002972.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, SublingualAdultAmbulatory CareBuprenorphineCombined Modality TherapyConnecticutCounselingDose-Response Relationship, DrugDrug Administration ScheduleFeasibility StudiesFemaleHeroin DependenceHumansMaleMiddle AgedPrimary Health CareSocial SupportTreatment OutcomeUrban PopulationConceptsUrine toxicologyHeroin dependencePrimary careBrief counselingUrine toxicology testsHeroin-dependent patientsPrimary care settingPrimary care centersUrban medical centerBuprenorphine maintenancePrimary outcomeDependent patientsCare centerClinical trialsCare settingsMedical CenterEffective treatmentTreatment retentionBuprenorphinePatientsPotential efficacyToxicology testsMaintenance phaseWeeksCare
2000
Thrice-weekly versus daily buprenorphine maintenance
Schottenfeld R, Pakes J, O’Connor P, Chawarski M, Oliveto A, Kosten T. Thrice-weekly versus daily buprenorphine maintenance. Biological Psychiatry 2000, 47: 1072-1079. PMID: 10862807, DOI: 10.1016/s0006-3223(99)00270-x.Peer-Reviewed Original ResearchConceptsSublingual buprenorphineMaintenance treatmentSelf-reported illicit drug useDrug useOpioid agonist maintenance treatmentOpioid-positive urine testsAgonist maintenance treatmentDaily clinic attendanceDaily sublingual buprenorphineThrice-weekly dosingOpioid-dependent patientsUrine toxicology testsSignificant differencesIllicit drug useSelf-reported numberBuprenorphine maintenanceClinic attendanceWeekly doseIllicit opioidsMedication complianceThrice weeklyUrine testsOutcome measuresBuprenorphineCounseling attendance