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 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 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
2021
Behavioral counseling and abstinence‐contingent take‐home buprenorphine in general practitioners’ offices in Malaysia: a randomized, open‐label clinical trial
Schottenfeld RS, Chawarski M, Mazlan M. Behavioral counseling and abstinence‐contingent take‐home buprenorphine in general practitioners’ offices in Malaysia: a randomized, open‐label clinical trial. Addiction 2021, 116: 2135-2149. PMID: 33404150, DOI: 10.1111/add.15399.Peer-Reviewed Original ResearchConceptsOpioid-negative urine testsBuprenorphine-naloxone treatmentBehavioral counselingPhysician managementBehavioral interventionsUrine testsClinical trialsOpen-label clinical trialTake-home dosesOpioid-dependent patientsWeeks of treatmentOpioid use disorderPrimary care physiciansOpioid-dependent individualsHIV risk behaviorsGeneral practitioner's officeBuprenorphine-naloxoneOpioid usePrimary outcomeCare physiciansTreatment outcomesStudy interventionTreatment accessTreatment groupsUse disorders
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
Implementation facilitation to promote emergency department-initiated buprenorphine for opioid use disorder: protocol for a hybrid type III effectiveness-implementation study (Project ED HEALTH)
D’Onofrio G, Edelman EJ, Hawk KF, Pantalon MV, Chawarski MC, Owens PH, Martel SH, VanVeldhuisen P, Oden N, Murphy SM, Huntley K, O’Connor P, Fiellin DA. Implementation facilitation to promote emergency department-initiated buprenorphine for opioid use disorder: protocol for a hybrid type III effectiveness-implementation study (Project ED HEALTH). Implementation Science 2019, 14: 48. PMID: 31064390, PMCID: PMC6505286, DOI: 10.1186/s13012-019-0891-5.Peer-Reviewed Original ResearchConceptsOpioid use disorderEmergency departmentImplementation facilitationCost-effectiveness analysisUse disordersPatient engagementEmergency department-initiated buprenorphineEffectiveness-implementation studyEvaluation periodOpioid agonist treatmentSoft tissue infectionsInjection drug useGeneral medical conditionsHealth Services frameworkClinical Trials NetworkAcademic emergency departmentRate of provisionIF interventionOngoing medicationED visitsTissue infectionsED patientsFacilitated referralAgonist treatmentED providers
2018
Atomoxetine for amphetamine-type stimulant dependence during buprenorphine treatment: A randomized controlled trial
Schottenfeld RS, Chawarski MC, Sofuoglu M, Chooi WT, Zaharim NM, M Yasin MA, Ahmad I, Syed Jaapar SZ, Vicknasingam BK. Atomoxetine for amphetamine-type stimulant dependence during buprenorphine treatment: A randomized controlled trial. Drug And Alcohol Dependence 2018, 186: 130-137. PMID: 29573648, PMCID: PMC5911201, DOI: 10.1016/j.drugalcdep.2018.01.017.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic Uptake InhibitorsAdultAmphetamine-Related DisordersAtomoxetine HydrochlorideBehavior TherapyBuprenorphineBuprenorphine, Naloxone Drug CombinationDepressionDouble-Blind MethodHumansMaleMiddle AgedNarcotic AntagonistsOpioid-Related DisordersPilot ProjectsTreatment OutcomeYoung AdultConceptsATS use disorderPlacebo-treated participantsUse disordersAdverse eventsUrine testsPotential efficacyAmphetamine-type stimulant dependenceAmphetamine-type stimulant useSerious adverse eventsBuprenorphine/naloxoneBetween-group differencesATS dependenceClinical tolerabilityMedication discontinuationBuprenorphine treatmentPrimary outcomeOpioid dependenceClinical trialsITT sampleTreat sampleBehavioral counselingDepressive symptomsDays abstinentAtomoxetineStimulant dependence
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
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 servicesExpanding Substance Use Treatment Options for HIV Prevention With Buprenorphine–Naloxone
Metzger DS, Donnell D, Celentano DD, Jackson JB, Shao Y, Aramrattana A, Wei L, Fu L, Ma J, Lucas GM, Chawarski M, Ruan Y, Richardson P, Shin K, Chen RY, Sugarman J, Dye BJ, Rose SM, Beauchamp G, Burns DN. Expanding Substance Use Treatment Options for HIV Prevention With Buprenorphine–Naloxone. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2015, 68: 554-561. PMID: 25564105, PMCID: PMC4382671, DOI: 10.1097/qai.0000000000000510.Peer-Reviewed Original ResearchConceptsInjection-related risk behaviorsBUP/NXRisk behaviorsOpioid useNegative urinalysisTreatment strategiesInjection opioid useOpioid-dependent PWIDThrice-weekly dosingPrimary end pointBuprenorphine/naloxoneOpioid use disorderOpioid-dependent peopleEvidence-based treatmentsBehavioral drugBuprenorphine-naloxoneDose taperingOpioid injectionWeek 78HIV infectionActive treatmentHIV incidenceWeek 26Treatment optionsTreatment completion
2013
Randomized clinical trial of disulfiram for cocaine dependence or abuse during buprenorphine treatment
Schottenfeld RS, Chawarski MC, Cubells JF, George TP, Lappalainen J, Kosten TR. Randomized clinical trial of disulfiram for cocaine dependence or abuse during buprenorphine treatment. Drug And Alcohol Dependence 2013, 136: 36-42. PMID: 24462581, DOI: 10.1016/j.drugalcdep.2013.12.007.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAlcohol DeterrentsAlcoholismAllelesBuprenorphineCocaine-Related DisordersData Interpretation, StatisticalDisulfiramDNADouble-Blind MethodDrug Therapy, CombinationFemaleGenotypeHumansMaleMiddle AgedNarcotic AntagonistsOpioid-Related DisordersPharmacogeneticsPolymerase Chain ReactionSample SizeTreatment OutcomeYoung AdultConceptsUrine testsCocaine useMechanism of actionCocaine dependenceClinical trialsWeeks abstinencePlacebo-controlled clinical trialEfficacy of disulfiramPharmacogenetics of responseDouble-blind treatmentBuprenorphine maintenance treatmentRandomized clinical trialsOpioid-dependent participantsT allele carriersFrequent cocaine useDopamine β-hydroxylaseBuprenorphine treatmentPrimary outcomeTreat comparisonMaintenance treatmentPharmacogenetic interactionsTreatment responseTT genotypeCocaine abstinenceConsecutive weeks
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
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
Maintenance treatment with buprenorphine and naltrexone for heroin dependence in Malaysia: a randomised, double-blind, placebo-controlled trial
Schottenfeld RS, Chawarski MC, Mazlan M. Maintenance treatment with buprenorphine and naltrexone for heroin dependence in Malaysia: a randomised, double-blind, placebo-controlled trial. The Lancet 2008, 371: 2192-2200. PMID: 18586174, PMCID: PMC4041792, DOI: 10.1016/s0140-6736(08)60954-x.Peer-Reviewed Original ResearchConceptsFirst heroin useHIV risk behaviorsHeroin dependenceHeroin useHeroin relapseMaintenance treatmentHeroin abstinenceDrug counsellingComputer-generated randomisation sequenceRisk behaviorsEffective public health approachConsecutive daysInterim safety analysisOutpatient research clinicPlacebo-controlled trialEfficacy of naltrexoneHeroin-dependent patientsMonths of enrollmentPrevention of relapseWorldwide health priorityPublic health approachRandomisation sequencePrimary outcomeHIV transmissionHIV riskLong‐Term Treatment with Buprenorphine/Naloxone in Primary Care: Results at 2–5 Years
Fiellin DA, Moore BA, Sullivan LE, Becker WC, Pantalon MV, Chawarski MC, Barry DT, O'Connor PG, Schottenfeld RS. Long‐Term Treatment with Buprenorphine/Naloxone in Primary Care: Results at 2–5 Years. American Journal On Addictions 2008, 17: 116-120. PMID: 18393054, DOI: 10.1080/10550490701860971.Peer-Reviewed Original ResearchMeSH KeywordsAdultBuprenorphineCombined Modality TherapyCounselingCross-Sectional StudiesDose-Response Relationship, DrugDrug Administration ScheduleDrug Therapy, CombinationFemaleFollow-Up StudiesHeroin DependenceHumansLong-Term CareMaleMiddle AgedNaloxoneNarcotic AntagonistsOpioid-Related DisordersPatient DropoutsPrimary Health CareSubstance Abuse DetectionTreatment OutcomeConceptsOpioid-dependent patientsAdverse eventsSerum transaminasesBuprenorphine/naloxone treatmentSerious adverse eventsBuprenorphine/naloxoneLong-term outcomesOffice-based treatmentIllicit drug useOpioid useClinical stabilityNaloxone treatmentPrimary outcomePatient satisfactionPrimary careTerm treatmentDrug useUrine samplesPatientsTreatmentTransaminaseOutcomesYearsModerate levelsPercent
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 proportionBuprenorphine/naloxone treatment in primary care is associated with decreased human immunodeficiency virus risk behaviors
Sullivan LE, Moore BA, Chawarski MC, Pantalon MV, Barry D, O'Connor PG, Schottenfeld RS, Fiellin DA. Buprenorphine/naloxone treatment in primary care is associated with decreased human immunodeficiency virus risk behaviors. Journal Of Substance Use And Addiction Treatment 2007, 35: 87-92. PMID: 17933486, PMCID: PMC2587397, DOI: 10.1016/j.jsat.2007.08.004.Peer-Reviewed Original ResearchConceptsBuprenorphine/naloxone treatmentNaloxone treatmentHIV risk behaviorsHIV riskRisk behaviorsHuman immunodeficiency virus (HIV) risk behaviorsDrug-related HIV riskHuman immunodeficiency virus (HIV) riskSex-related HIV risk behaviorsBuprenorphine/naloxoneIntravenous drug useOpioid-dependent personsPrimary care clinicsInconsistent condom useBuprenorphine/Care clinicsMethadone treatmentPrimary careDrug useSteady partnerCondom useBaselineWeeksTreatmentPatients