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 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 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
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
Emergency 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
Medical 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
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 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
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
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 ResearchMeSH KeywordsBuprenorphineCambodiaCost of IllnessDrug CostsGross Domestic ProductHealth Care CostsHeroin DependenceHumansLaosMalaysiaNaltrexoneNarcotic AntagonistsConceptsBuprenorphine 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
2006
A Trial of Integrated Buprenorphine/Naloxone and HIV Clinical Care
Sullivan LE, Barry D, Moore BA, Chawarski MC, Tetrault JM, Pantalon MV, O'Connor PG, Schottenfeld RS, Fiellin DA. A Trial of Integrated Buprenorphine/Naloxone and HIV Clinical Care. Clinical Infectious Diseases 2006, 43: s184-s190. PMID: 17109305, DOI: 10.1086/508182.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, SublingualAdultAntiretroviral Therapy, Highly ActiveBuprenorphineDose-Response Relationship, DrugDrug Administration ScheduleFemaleFollow-Up StudiesHIV InfectionsHumansMaleMiddle AgedNaloxoneNarcotic AntagonistsOpioid-Related DisordersPilot ProjectsProbabilityReference ValuesRisk FactorsTreatment OutcomeConceptsHIV clinical careHIV-1 RNA copies/mLBuprenorphine/naloxone treatmentRNA copies/mLCopies/mLOpioid dependenceClinical careOpioid useNaloxone treatmentPhysician managementTreatment retentionHIV type 1 RNA levelsHIV-1 RNA levelsDose of buprenorphinePartial opioid agonistRNA levelsCD4 lymphocyte countBuprenorphine/naloxoneOpioid-dependent patientsUrine toxicology testsWeeks of treatmentHuman immunodeficiency virusUrine test resultsBetter treatment retentionUntreated opioid dependenceCounseling plus Buprenorphine–Naloxone Maintenance Therapy for Opioid Dependence
Fiellin DA, Pantalon MV, Chawarski MC, Moore BA, Sullivan LE, O'Connor PG, Schottenfeld RS. Counseling plus Buprenorphine–Naloxone Maintenance Therapy for Opioid Dependence. New England Journal Of Medicine 2006, 355: 365-374. PMID: 16870915, DOI: 10.1056/nejmoa055255.Peer-Reviewed Original ResearchMeSH KeywordsAdultBuprenorphineCocaine-Related DisordersCombined Modality TherapyCounselingFemaleHumansMaleNaloxoneNarcotic AntagonistsOpioid-Related DisordersConceptsStandard medical managementBuprenorphine-naloxone treatmentIllicit opioid useMedical managementOpioid dependenceWeekly medicationOpioid useIllicit opioidsWeekly counselingPrimary careUrine specimensConsecutive weeksProportion of patientsImproved treatment outcomesMaintenance therapyPrimary outcomeClinical trialsMedication distributionSimilar efficacyTreatment outcomesMedicationsSelf-reported frequencyPatientsFrequency of attendanceMean percentageHeroin dependence and HIV infection in Malaysia
Chawarski MC, Mazlan M, Schottenfeld RS. Heroin dependence and HIV infection in Malaysia. Drug And Alcohol Dependence 2006, 82: s39-s42. PMID: 16769444, DOI: 10.1016/s0376-8716(06)80007-4.Peer-Reviewed Original ResearchMeSH KeywordsAdultBuprenorphineDemographyFemaleHeroin DependenceHIV InfectionsHumansMalaysiaMaleNaltrexoneNarcotic AntagonistsPrevalenceRisk-TakingConceptsInjection drug useCurrent injection drug useLifetime injection drug useHIV infectionNeedle sharingHepatitis CHeroin dependenceHigh prevalenceDrug useMajor risk factorChest X-rayHeroin-dependent individualsHIV risk behaviorsHeroin-dependent subjectsConsistent condom useAddiction Severity IndexDrug abuse treatmentRadiological evidenceHepatitis BMean ageRisk factorsClinical trialsMalay ethnicityBaseline assessmentHIV
2005
Buprenorphine tablet versus liquid: A clinical trial comparing plasma levels, efficacy, and symptoms
Chawarski MC, Moody DE, Pakes J, O'Connor PG, Schottenfeld RS. Buprenorphine tablet versus liquid: A clinical trial comparing plasma levels, efficacy, and symptoms. Journal Of Substance Use And Addiction Treatment 2005, 29: 307-312. PMID: 16311183, DOI: 10.1016/j.jsat.2005.08.011.Peer-Reviewed Original ResearchConceptsTrough concentrationsPlasma concentrationsOpiate-dependent volunteersIllicit opioid usePeak plasma concentrationBuprenorphine doseBuprenorphine tabletsOpioid useWithdrawal symptomsBuprenorphine levelsPlasma levelsTablet doseClinical trialsLarge intersubjectLiquid formulationStudy participantsIntrasubject variabilityPlasma samplesPeak concentrationTablet formulationLiquid dosesDays of maintenanceSymptomsDoseConcentration curveThe 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 programBuprenorphine