2023
Implementation 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
2022
Missed Opportunities for HIV and Hepatitis C Screening Among Emergency Department Patients With Untreated Opioid Use Disorder
Lyons MS, Chawarski MC, Rothman R, Whiteside L, Cowan E, Richardson LD, Hawk K, Tsui JI, Schwartz RP, O’Connor P, D’Onofrio G, Fiellin DA, Edelman EJ. Missed Opportunities for HIV and Hepatitis C Screening Among Emergency Department Patients With Untreated Opioid Use Disorder. Journal Of Addiction Medicine 2022, 17: 210-214. PMID: 36170184, PMCID: PMC10023471, DOI: 10.1097/adm.0000000000001074.Peer-Reviewed Original ResearchConceptsUntreated opioid use disorderOpioid use disorderRecent injection drug useEmergency department HIVInjection drug useHCV screeningED patientsUse disordersEnrollment periodDrug useHepatitis C screeningStructured screening programmeUnknown HCV statusUnknown HIV statusHigh-risk cohortMedical care providersHCV statusC screeningHepatitis CED visitsAcademic EDHIV statusEmergency departmentCohort 2Cohort 1Perspectives About Emergency Department Care Encounters Among Adults With Opioid Use Disorder
Hawk K, McCormack R, Edelman EJ, Coupet E, Toledo N, Gauthier P, Rotrosen J, Chawarski M, Martel S, Owens P, Pantalon MV, O’Connor P, Whiteside LK, Cowan E, Richardson LD, Lyons MS, Rothman R, Marsch L, Fiellin DA, D’Onofrio G. Perspectives About Emergency Department Care Encounters Among Adults With Opioid Use Disorder. JAMA Network Open 2022, 5: e2144955. PMID: 35076700, PMCID: PMC8790663, DOI: 10.1001/jamanetworkopen.2021.44955.Peer-Reviewed Original ResearchConceptsUntreated opioid use disorderOpioid use disorderEmergency departmentED visitsOUD treatmentUse disordersPublic safety-net hospitalRural critical access hospitalsEmergency department careSafety-net hospitalUrban academic centerLife-saving treatmentCritical access hospitalsImplementation science frameworkPatient factorsTreatment initiationED careUS patientsStaff trainingDemand treatmentPatient readinessNet hospitalPatient's perspectivePromoting ActionImproved care
2021
A qualitative study of emergency department patients who survived an opioid overdose: Perspectives on treatment and unmet needs
Hawk K, Grau LE, Fiellin DA, Chawarski M, O’Connor P, Cirillo N, Breen C, D’Onofrio G. A qualitative study of emergency department patients who survived an opioid overdose: Perspectives on treatment and unmet needs. Academic Emergency Medicine 2021, 28: 542-552. PMID: 33346926, PMCID: PMC8281441, DOI: 10.1111/acem.14197.Peer-Reviewed Original ResearchConceptsOpioid use disorderEmergency departmentSubstance use treatmentOpioid overdosePatient's perspectiveUnmet needUse treatmentAcute opioid overdoseAdult ED patientsEmergency department patientsPatient support servicesProvider communication skillsEmergency medicine cliniciansAcademic emergency departmentSocial ecologic modelEvidence-based treatmentsChoice of patientsBrief quantitative surveyPatient-oriented approachOpioid useDepartment patientsOUD treatmentUnmet basic needsED careED patients
2020
Emergency department patients with untreated opioid use disorder: A comparison of those seeking versus not seeking referral to substance use treatment
Coupet E, D’Onofrio G, Chawarski M, Edelman E, O’Connor P, Owens P, Martel S, Fiellin DA, Cowan E, Richardson L, Huntley K, Whiteside LK, Lyons MS, Rothman RE, Pantalon M, Hawk K. Emergency department patients with untreated opioid use disorder: A comparison of those seeking versus not seeking referral to substance use treatment. Drug And Alcohol Dependence 2020, 219: 108428. PMID: 33307301, PMCID: PMC8110210, DOI: 10.1016/j.drugalcdep.2020.108428.Peer-Reviewed Original ResearchConceptsUntreated opioid use disorderOpioid use disorderEmergency department patientsDepartment patientsUse disordersTenth Revision diagnosis codesSevere opioid use disorderConclusions Most patientsInjection-related infectionsRevision diagnosis codesHealth insurance statusSubstance use treatmentCross-sectional analysisOpioid withdrawalClinical characteristicsED visitsMost patientsTreatment initiationUrine toxicologyClinical correlatesDiagnosis codesInsurance statusUnivariate analysisBackground LittleInternational ClassificationUse of Amphetamine-Type Stimulants Among Emergency Department Patients With Untreated Opioid Use Disorder
Chawarski MC, Hawk K, Edelman EJ, O'Connor P, Owens P, Martel S, Coupet E, Whiteside L, Tsui JI, Rothman R, Cowan E, Richardson L, Lyons MS, Fiellin DA, D'Onofrio G. Use of Amphetamine-Type Stimulants Among Emergency Department Patients With Untreated Opioid Use Disorder. Annals Of Emergency Medicine 2020, 76: 782-787. PMID: 32782084, PMCID: PMC8048036, DOI: 10.1016/j.annemergmed.2020.06.046.Peer-Reviewed Original ResearchConceptsUntreated opioid use disorderOpioid use disorderAmphetamine-type stimulant useUse disordersStimulant useAmphetamine-type stimulantsStudy admissionEmergency departmentEmergency department patientsImplementation science studyUrine test resultsFalse discovery rate correctionSubstance use problemsHepatitis CED visitsDepartment patientsReferral protocolsED patientsUrine testsDrug injectionOverdose riskPatientsHealth factorsUnstable housingConcurrent useKratom and Pain Tolerance: A Randomized, Placebo-Controlled, Double-Blind Study.
Vicknasingam B, Chooi WT, Rahim AA, Ramachandram D, Singh D, Ramanathan S, Yusof NSM, Zainal H, Murugaiyah V, Gueorguieva R, Mansor SM, Chawarski MC. Kratom and Pain Tolerance: A Randomized, Placebo-Controlled, Double-Blind Study. The Yale Journal Of Biology And Medicine 2020, 93: 229-238. PMID: 32607084, PMCID: PMC7309661.Peer-Reviewed Original ResearchConceptsDouble-blind studyPain toleranceCold pressor taskConsumption of placeboSigns of withdrawalKratom consumptionTraditional medicine useKratom ingestionPain reliefPain onsetInpatient staySafety profileMedicine useWithdrawal symptomsPlacebo drinkHand withdrawalHealth statusVital signsKratom productsSelf-reported dataRandomized sequencePlaceboKratomSignificant increaseDecoctionBarriers 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
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 historyEarly Initiation of Amphetamine-Type Stimulants (ATS) Use Associated with Lowered Cognitive Performance among Individuals with Co-Occurring Opioid and ATS Use Disorders in Malaysia
Chooi WT, Zaharim N, Desrosiers A, Ahmad I, Yasin MAM, Jaapar S, Schottenfeld RS, Vicknasingam BK, Chawarski MC. Early Initiation of Amphetamine-Type Stimulants (ATS) Use Associated with Lowered Cognitive Performance among Individuals with Co-Occurring Opioid and ATS Use Disorders in Malaysia. Journal Of Psychoactive Drugs 2017, 49: 326-332. PMID: 28661714, PMCID: PMC6218246, DOI: 10.1080/02791072.2017.1342152.Peer-Reviewed Original ResearchConceptsCognitive performanceStandard Progressive MatricesRey-Osterrieth Complex Figure TestSymbol digit substitution taskCognitive performance groupsComplex Figure TestRaven's Standard Progressive MatricesATS use disorderATS useDigit spanTrail MakingCognitive functioningFigures TestAmphetamine-type stimulant useSubstitution taskProgressive MatricesFunctioning profilesDrug useCo-occurring opioidGroup differencesCurrent study findingsStimulant useClusters of individualsATS dependenceUse disordersEmergency 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 useReferralPatientsPsychiatric symptoms, quality of life, and HIV status among people using opioids in Saint Petersburg, Russia
Desrosiers A, Blokhina E, Krupitsky E, Zvartau E, Schottenfeld R, Chawarski M. Psychiatric symptoms, quality of life, and HIV status among people using opioids in Saint Petersburg, Russia. Drug And Alcohol Dependence 2017, 172: 60-65. PMID: 28130990, PMCID: PMC5408353, DOI: 10.1016/j.drugalcdep.2016.12.007.Peer-Reviewed Original ResearchConceptsQuality of lifeOpioid use disorderPsychiatric symptomsUse disordersCo-occurring opioid use disordersBaseline psychiatric symptomsPsychiatric symptom presentationsWorld Health Organization QualityPsychiatric symptom profilesRandomized clinical trialsHealth Organization QualityPsychiatric symptom levelsLife indicatorsHIV individualsHIV infectionNaltrexone treatmentHIV statusBrief Symptom InventoryOutpatient treatmentClinical trialsDrug treatmentLife-BREFBSI anxietyOrganization QualitySymptom profiles
2016
Emerging Drug Use Trends in Kelantan, Malaysia
Desrosiers A, Chooi WT, Zaharim NM, Ahmad I, Yasin M, Jaapar S, Schottenfeld RS, Vicknasingam B, Chawarski MC. Emerging Drug Use Trends in Kelantan, Malaysia. Journal Of Psychoactive Drugs 2016, 48: 218-226. PMID: 27224011, DOI: 10.1080/02791072.2016.1185553.Peer-Reviewed Original ResearchConceptsDrug useAmphetamine-type stimulant useDrug use initiationTreatment optionsHigh prevalenceTreatment needsDrug use trendsTreatment servicesYounger ageStimulant useUse initiationPrevention effortsUnique sociocultural factorsTreatment seekingFGD participantsRural areasHigh rateEarly agePrevalencePWUDDrugsAgeSociocultural factorsParticipantsMajor contributorMedical treatments for opioid use disorder in Iran: a randomized, double‐blind placebo‐controlled comparison of buprenorphine/naloxone and naltrexone maintenance treatment
Mokri A, Chawarski MC, Taherinakhost H, Schottenfeld RS. Medical treatments for opioid use disorder in Iran: a randomized, double‐blind placebo‐controlled comparison of buprenorphine/naloxone and naltrexone maintenance treatment. Addiction 2016, 111: 874-882. PMID: 26639678, DOI: 10.1111/add.13259.Peer-Reviewed Original ResearchConceptsOpioid-negative urine testsBuprenorphine/naloxoneOpioid use disorderSublingual buprenorphine/naloxoneUrine testsUse disordersOral naltrexoneOpioid abstinenceClinical trialsTreatment retentionDouble-blind placebo-controlled comparisonMean numberDouble-blind clinical trialOpioid use disorder treatmentNaltrexone maintenance treatmentTwo-group parallelEffective opioid use disorder treatmentPlacebo-controlled comparisonUrine toxicology testsPilot clinical trialGroup drug counselingUse disorder treatmentClinical research programBNx groupNTX group
2015
Aripiprazole and Risperidone for Treatment of Methamphetamine-Associated Psychosis in Chinese Patients
Wang G, Zhang Y, Zhang S, Chen H, Xu Z, Schottenfeld RS, Hao W, Chawarski MC. Aripiprazole and Risperidone for Treatment of Methamphetamine-Associated Psychosis in Chinese Patients. Journal Of Substance Use And Addiction Treatment 2015, 62: 84-88. PMID: 26733277, PMCID: PMC4724444, DOI: 10.1016/j.jsat.2015.11.009.Peer-Reviewed Original ResearchConceptsRisperidone-treated patientsSimpson-Angus ScaleVisual analog scalePsychotic symptomsRisperidone groupSelf-reported adverse effectsClinical Global Impressions-SeverityKaplan-Meier survival analysisAdverse effectsAripiprazole-treated patientsEfficacy of aripiprazoleMethamphetamine-Associated PsychosisExtra-pyramidal symptomsInpatient hospital stayTreatment of methamphetamineNegative Syndrome ScaleGreater methamphetamineHospital stayAripiprazole groupEntire studyAngus ScaleAnalog scaleAcute methamphetamineChinese patientsIllness ScaleEvaluation of an implementation of methadone maintenance treatment in China
Marienfeld C, Liu P, Wang X, Schottenfeld R, Zhou W, Chawarski MC. Evaluation of an implementation of methadone maintenance treatment in China. Drug And Alcohol Dependence 2015, 157: 60-67. PMID: 26601934, PMCID: PMC4663107, DOI: 10.1016/j.drugalcdep.2015.10.001.Peer-Reviewed Original ResearchConceptsInjection drug useMethadone maintenance treatmentMMT exposureDrug useMaintenance treatmentUrine testsPositive testOpiate positive urine testsDaily methadone dosesPositive urine testHigher adherence ratesOpioid use disorderNegative urine testsSelf-reported drug useElectronic medical recordsPriority improvement areasMonth drug useMethadone dosesMethadone dosingDose adjustmentAdherence ratesDaily dosesMedical recordsTreatment daysUse disordersEmergency 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 servicesBuprenorphine/naloxone treatment practices in Malaysia: Results of national surveys of physicians and patients
Vicknasingam B, Dazali MN, Singh D, Schottenfeld RS, Chawarski MC. Buprenorphine/naloxone treatment practices in Malaysia: Results of national surveys of physicians and patients. Drug And Alcohol Dependence 2015, 152: 164-169. PMID: 25935736, DOI: 10.1016/j.drugalcdep.2015.04.007.Peer-Reviewed Original ResearchConceptsBUP/NXNX treatmentGeneral practitionersPast monthOpiate positive urine testsOptimal treatment effectivenessRoutine toxicology testingToxicology testingBuprenorphine/naloxonePositive urine testUrine toxicology testingIllicit opiate useInjection of heroinInjection of drugsCross-sectional surveyMaintenance treatmentPatient surveyUrine testingUrine testsTreatment responseOpiate usePatient experiencePatientsDispensing practicesDrug use