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 treatment
2012
Counseling and Directly Observed Medication for Primary Care Buprenorphine Maintenance
Moore BA, Barry DT, Sullivan LE, O'Connor PG, Cutter CJ, Schottenfeld RS, Fiellin DA. Counseling and Directly Observed Medication for Primary Care Buprenorphine Maintenance. Journal Of Addiction Medicine 2012, 6: 205-211. PMID: 22614936, PMCID: PMC3419276, DOI: 10.1097/adm.0b013e3182596492.Peer-Reviewed Original ResearchConceptsCognitive behavioral therapyPhysician managementObserved medicationBaseline characteristicsCBT sessionsOpioid-negative urinesIndividual CBT sessionsBuprenorphine maintenanceOpioid useMedication adherencePatient satisfactionPrimary careImproved outcomesTreatment outcomesSession attendanceNegative urineTreatment groupsGreater abstinenceCounseling intensityDrug useTherapist availabilityMedicationsBuprenorphinePatientsIndependent effectsOpioid Detoxification and Naltrexone Induction Strategies: Recommendations for Clinical Practice
Sigmon SC, Bisaga A, Nunes EV, O'Connor PG, Kosten T, Woody G. Opioid Detoxification and Naltrexone Induction Strategies: Recommendations for Clinical Practice. The American Journal Of Drug And Alcohol Abuse 2012, 38: 187-199. PMID: 22404717, PMCID: PMC4331107, DOI: 10.3109/00952990.2011.653426.Peer-Reviewed Original ResearchConceptsΜ-opioid receptor antagonist naltrexoneSignificant public health problemDose of buprenorphinePublic health problemLevel of careOral naltrexoneOpioid detoxificationAntagonist naltrexoneOpioid dependencePatient selectionOpioid agonistsAgonist maintenanceAncillary medicationsFavorable outcomeHigh riskTarget doseClinical practiceHealth problemsNaltrexoneExpert cliniciansTreatmentDoseMore researchUseful alternativeBest approach
2008
Long‐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 dependence
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
1999
Measurement of compliance with naltrexone in the treatment of alcohol dependence: research and clinical implications.
Namkoong K, Farren CK, O'Connor PG, O'Malley SS. Measurement of compliance with naltrexone in the treatment of alcohol dependence: research and clinical implications. The Journal Of Clinical Psychiatry 1999, 60: 449-53. PMID: 10453799, DOI: 10.4088/jcp.v60n0706.Peer-Reviewed Original ResearchConceptsMedication Event Monitoring SystemMedication compliancePill countAlcohol dependenceOpen-label studyPill-taking behaviorSample of patientsEvent Monitoring SystemMeasurement of complianceEstimates of complianceCompliant groupPharmacotherapy researchTreatment outcomesClinical utilityCompliance rateNaltrexoneClinical implicationsOverall outcomeDrinking outcomesPatientsMEMS dataOutcomesCountTreatmentCompliance
1995
Primary care-based ambulatory opioid detoxification
O’Connor P, Waugh M, Carroll K, Rounsaville B, Diagkogiannis I, Schottenfeld R. Primary care-based ambulatory opioid detoxification. Journal Of General Internal Medicine 1995, 10: 255-260. PMID: 7616334, DOI: 10.1007/bf02599882.Peer-Reviewed Original ResearchConceptsInjection drug usersClonidine/naltrexoneOpioid detoxificationDrug treatmentProspective nonrandomized clinical trialMedical clinicsPrimary care medical clinicFirst heroin useOngoing drug treatmentNonrandomized clinical trialPrimary care providersWithdrawal symptom scoresSubstance abuse treatmentMuscle crampsSymptom scoresClinical trialsClonidineNurse practitionersCare providersDetoxified patientsHeroin useTreatment groupsNaltrexoneDrug usersMedical units