2024
Extended-Release 7-Day Injectable Buprenorphine for Patients With Minimal to Mild Opioid Withdrawal
D’Onofrio G, Herring A, Perrone J, Hawk K, Samuels E, Cowan E, Anderson E, McCormack R, Huntley K, Owens P, Martel S, Schactman M, Lofwall M, Walsh S, Dziura J, Fiellin D. Extended-Release 7-Day Injectable Buprenorphine for Patients With Minimal to Mild Opioid Withdrawal. JAMA Network Open 2024, 7: e2420702. PMID: 38976265, PMCID: PMC11231806, DOI: 10.1001/jamanetworkopen.2024.20702.Peer-Reviewed Original ResearchConceptsClinical Opiate Withdrawal ScaleExtended-release buprenorphineOpioid use disorderPrecipitated withdrawalOpioid withdrawalOpioid use disorder treatmentCow scoreClinical Opiate Withdrawal Scale scoreAdverse eventsNonrandomized trialsSevere opioid use disorderDays of opioid useOpiate Withdrawal ScaleModerate to severe opioid use disorderFormulation of buprenorphineOpioid use disorder careWithdrawal ScaleUse disorderAssociated with medicationsNonprescribed opioidsPain scoresExtended-releaseInjection painOpioid useAdult patientsAccessibility of Opioid Treatment Programs Based on Conventional vs Perceived Travel Time Measures
Kim J, Lee J, Thornhill T, Dennett J, Lu H, Howell B, Grau L, Fiellin D, Heimer R, Gonsalves G. Accessibility of Opioid Treatment Programs Based on Conventional vs Perceived Travel Time Measures. JAMA Network Open 2024, 7: e240209. PMID: 38376839, PMCID: PMC10879949, DOI: 10.1001/jamanetworkopen.2024.0209.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidCross-Sectional StudiesFemaleHumansMaleOpioid-Related DisordersTransportationTravelConceptsTransit travel timeAccessibility metricsTravel timeTravel componentsAccessibility scoresTransportation burdenTravel burdenOut-of-vehicleComponents of travelConventional accessibility measuresSpatial regression modelsTravel time measurementsPublic transitTransit schedulesAccessibility measuresDeparture timeTravel time analysisTrip durationTravelOperating hoursTime analysisCross-sectional studyOpioid use disorderPolicy recommendationsDecision-making
2023
Receipt of opioid use disorder treatments prior to fatal overdoses and comparison to no treatment in Connecticut, 2016–17
Heimer R, Black A, Lin H, Grau L, Fiellin D, Howell B, Hawk K, D'Onofrio G, Becker W. Receipt of opioid use disorder treatments prior to fatal overdoses and comparison to no treatment in Connecticut, 2016–17. Drug And Alcohol Dependence 2023, 254: 111040. PMID: 38043226, PMCID: PMC10872282, DOI: 10.1016/j.drugalcdep.2023.111040.Peer-Reviewed Original ResearchConceptsNon-medication treatmentsRelative riskOpioid overdose deathsIncidence rateMOUD treatmentOverdose deathsOpioid use disorder treatmentResults Incidence ratesRetrospective cohort studyDifferent treatment modalitiesPopulation-level effortsUse disorder treatmentFatal opioid poisoningsCohort studyOpioid poisoningTreatment modalitiesConclusion ExposurePoisoning deathsFatal overdosesTreatment exposureDisorder treatmentDeathTreatmentMethadoneRiskComputational phenotypes for patients with opioid-related disorders presenting to the emergency department
Taylor R, Gilson A, Schulz W, Lopez K, Young P, Pandya S, Coppi A, Chartash D, Fiellin D, D’Onofrio G. Computational phenotypes for patients with opioid-related disorders presenting to the emergency department. PLOS ONE 2023, 18: e0291572. PMID: 37713393, PMCID: PMC10503758, DOI: 10.1371/journal.pone.0291572.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidEmergency Service, HospitalHumansOpioid-Related DisordersPhenotypeRetrospective StudiesConceptsSubstance use disordersUse disordersED visitsPatient presentationCarlson comorbidity indexOpioid-related diagnosesOpioid-related disordersOne-year survivalRate of medicationOpioid use disorderElectronic health record dataPatient-oriented outcomesYears of ageHealth record dataChronic substance use disordersED returnComorbidity indexAcute overdoseMedical managementClinical entityRetrospective studyEmergency departmentChronic conditionsInclusion criteriaUnique cohortAvailability of Specific Programs and Medications for Addiction Treatment to Vulnerable Populations: Results from the Addiction Treatment Locator, Assessment, and Standards (ATLAS) Survey
Oldfield B, Chen K, Joudrey P, Biegacki E, Fiellin D. Availability of Specific Programs and Medications for Addiction Treatment to Vulnerable Populations: Results from the Addiction Treatment Locator, Assessment, and Standards (ATLAS) Survey. Journal Of Addiction Medicine 2023, 17: 477-480. PMID: 37579115, DOI: 10.1097/adm.0000000000001158.Peer-Reviewed Original ResearchConcordance between controlled substance receipt and post-mortem toxicology in opioid-detected overdose deaths: A statewide analysis
Howell B, Black A, Grau L, Lin H, Greene C, Lee H, Heimer R, Hawk K, D'Onofrio G, Fiellin D, Becker W. Concordance between controlled substance receipt and post-mortem toxicology in opioid-detected overdose deaths: A statewide analysis. Drug And Alcohol Dependence 2023, 244: 109788. PMID: 36738634, PMCID: PMC9975083, DOI: 10.1016/j.drugalcdep.2023.109788.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidBenzodiazepinesControlled SubstancesDrug OverdoseHumansOpiate OverdoseUnited StatesConceptsPost-mortem toxicologyOverdose deathsChief Medical ExaminerBenzodiazepine prescribingBenzodiazepine prescriptionsPrimary outcomePreventable deathsOpioid overdosesOpioidsAddiction servicesBenzodiazepinesMental healthStudy periodDeathMedical examinersConcordanceStatewide analysisSubstantial numberReceiptDaysDepartmentMedicationsToxicologyFentanylPrescribing
2022
Outcomes of Patients with Opioid-Related Diagnoses in Acute Coronary Syndrome: a National Inpatient Sample-Based Analysis
Kim Y, Pacor J, Do A, Brennan J, Fiellin D, Edelman E. Outcomes of Patients with Opioid-Related Diagnoses in Acute Coronary Syndrome: a National Inpatient Sample-Based Analysis. Journal Of General Internal Medicine 2022, 38: 563-570. PMID: 36376632, PMCID: PMC9971420, DOI: 10.1007/s11606-022-07399-3.Peer-Reviewed Original ResearchMeSH KeywordsAcute Coronary SyndromeAnalgesics, OpioidHeart ArrestHospital MortalityHumansInpatientsPercutaneous Coronary InterventionTreatment OutcomeConceptsOpioid-related diagnosesPercutaneous coronary interventionCardiac arrestHospital mortalityCoronary syndromeNational Inpatient Sample databaseManagement of ACSRisk of ACSCardiovascular risk factorsOutcomes of patientsAcute coronary syndromeProportion of patientsMultivariable logistic regressionNational Inpatient SampleHospital cardiac arrestRisk of mortalityBackgroundAcute coronary syndromeOutcomes of interestT-testStudent's t-testPrimary independent variableHospital outcomesACS managementCoronary interventionOpioid use
2020
Global opioid agonist treatment: a review of clinical practices by country
Jin H, Marshall B, Degenhardt L, Strang J, Hickman M, Fiellin D, Ali R, Bruneau J, Larney S. Global opioid agonist treatment: a review of clinical practices by country. Addiction 2020, 115: 2243-2254. PMID: 32289189, PMCID: PMC7554123, DOI: 10.1111/add.15087.Peer-Reviewed Original ResearchConceptsOpioid agonist treatmentOpioid use disorderUrine drug screeningRoutine clinical practiceClinical practiceUnsupervised dosingUse disordersObservational cohort studySignificant clinical benefitSearch of PubMedGrey literature databasesCohort studyMedian dosesOpioid dependenceAgonist treatmentClinical benefitPrescribing practicesEligible studiesOAT programsScreening practicesEligibility criteriaBuprenorphineMethadoneTreatment practicesLiterature databases
2019
Patients With Opioid Use Disorder Deserve Trained Providers.
Weimer MB, Tetrault JM, Fiellin DA. Patients With Opioid Use Disorder Deserve Trained Providers. Annals Of Internal Medicine 2019, 171: 931-932. PMID: 31766053, DOI: 10.7326/m19-2303.Commentaries, Editorials and LettersAssociation of Prescribed Opioids With Increased Risk of Community-Acquired Pneumonia Among Patients With and Without HIV
Edelman EJ, Gordon KS, Crothers K, Akgün K, Bryant KJ, Becker WC, Gaither JR, Gibert CL, Gordon AJ, Marshall BDL, Rodriguez-Barradas MC, Samet JH, Justice AC, Tate JP, Fiellin DA. Association of Prescribed Opioids With Increased Risk of Community-Acquired Pneumonia Among Patients With and Without HIV. JAMA Internal Medicine 2019, 179: 297-304. PMID: 30615036, PMCID: PMC6439696, DOI: 10.1001/jamainternmed.2018.6101.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidCase-Control StudiesCommunity-Acquired InfectionsFemaleHIV InfectionsHumansMaleMiddle AgedPneumoniaUnited StatesVeteransConceptsVeterans Aging Cohort StudyCommunity-acquired pneumoniaImmunosuppressive propertiesPrescribed opioidsCaP riskHIV statusMedian morphine equivalent daily doseVeterans Health Administration medical centersMorphine equivalent daily doseEquivalent daily doseAging Cohort StudyCase-control studyImmune-related outcomesRace/ethnicityIndex dateOpioid exposureCohort studyDaily doseOpioid propertiesStratified analysisMedical CenterMAIN OUTCOMEOpioidsMedicaid dataHIV
2018
Toward Better Stewardship: Gaining Control Over Controlled Substances.
Fiellin LE, Fiellin DA. Toward Better Stewardship: Gaining Control Over Controlled Substances. Annals Of Internal Medicine 2018, 168: 883-884. PMID: 29799985, DOI: 10.7326/m18-1146.Peer-Reviewed Educational Materials
2017
Limited evidence, faulty reasoning, and potential for a global opioid crisis
Becker WC, Fiellin DA. Limited evidence, faulty reasoning, and potential for a global opioid crisis. The BMJ 2017, 358: j3115. PMID: 28679499, DOI: 10.1136/bmj.j3115.Peer-Reviewed Original ResearchAbuse-Deterrent Opioid Formulations — Putting the Potential Benefits into Perspective
Becker WC, Fiellin DA. Abuse-Deterrent Opioid Formulations — Putting the Potential Benefits into Perspective. New England Journal Of Medicine 2017, 376: 2103-2105. PMID: 28564568, DOI: 10.1056/nejmp1701553.Peer-Reviewed Educational Materials
2016
Can Primary Care Practices Help Address the Health Crisis Fueled by Prescription Opioids?
Edelman EJ, Fiellin DA. Can Primary Care Practices Help Address the Health Crisis Fueled by Prescription Opioids? Annals Of Internal Medicine 2016, 166: 307-308. PMID: 27919106, DOI: 10.7326/m16-2666.Commentaries, Editorials and LettersThe impact of prescribed opioids on CD4 cell count recovery among HIV‐infected patients newly initiating antiretroviral therapy
Edelman E, Gordon K, Tate J, Becker W, Bryant K, Crothers K, Gaither, Gibert C, Gordon A, Marshall B, Rodriguez‐Barradas M, Samet J, Skanderson M, Justice A, Fiellin D. The impact of prescribed opioids on CD4 cell count recovery among HIV‐infected patients newly initiating antiretroviral therapy. HIV Medicine 2016, 17: 728-739. PMID: 27186715, PMCID: PMC5053822, DOI: 10.1111/hiv.12377.Peer-Reviewed Original ResearchConceptsCD4 cell countBaseline CD4 cell countCell countPrescribed opioidsImmunosuppressive propertiesVeterans Aging Cohort Study (VACS) dataCD4 cell count recoveryAntiretroviral therapy responseCell count recoveryShort-term opioidsViral load suppressionCohort study dataOverall disease severityYear of initiationPrimary independent variableOpioid durationAntiretroviral therapyCount recoveryComorbid conditionsPharmacy dataOpioid propertiesTherapy responseOpioidsPatientsHIV
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
2013
Association Between Risk Behaviors and Antiretroviral Resistance in HIV-Infected Patients Receiving Opioid Agonist Treatment
Tetrault JM, Kozal MJ, Chiarella J, Sullivan LE, Dinh AT, Fiellin DA. Association Between Risk Behaviors and Antiretroviral Resistance in HIV-Infected Patients Receiving Opioid Agonist Treatment. Journal Of Addiction Medicine 2013, 7: 102-107. PMID: 23388678, PMCID: PMC3618545, DOI: 10.1097/adm.0b013e31827f9bdf.Peer-Reviewed Original ResearchConceptsOpioid agonist treatmentTransmission risk behaviorsHIV transmission risk behaviorsInjection drug useAgonist treatmentARV resistanceRisk behaviorsDrug useAntiretroviral resistanceUrine toxicologyClass resistanceSelf-reported HIV risk behaviorsTriple-class resistanceOpioid treatment programsPositive urine toxicologyOpioid-dependent individualsPercent of subjectsHIV risk behaviorsCross-sectional studyResource limited settingsIllicit drug useHIV seroconversionRisky sexual behaviorHIV resistanceResistant viruses
2012
Federal plan for prescriber education on opioids misses opportunities.
Becker WC, Fiellin DA. Federal plan for prescriber education on opioids misses opportunities. Annals Of Internal Medicine 2012, 157: 205-6. PMID: 22868838, DOI: 10.7326/0003-4819-157-3-201208070-00448.Peer-Reviewed Educational MaterialsCurrent and Potential Pharmacological Treatment Options for Maintenance Therapy in Opioid-Dependent Individuals
Tetrault JM, Fiellin DA. Current and Potential Pharmacological Treatment Options for Maintenance Therapy in Opioid-Dependent Individuals. Drugs 2012, 72: 217-228. PMID: 22235870, PMCID: PMC3701303, DOI: 10.2165/11597520-000000000-00000.Commentaries, Editorials and LettersMeSH KeywordsAnalgesics, OpioidHumansNarcotic AntagonistsOpiate Substitution TreatmentOpioid-Related DisordersConceptsOpioid dependenceMaintenance treatmentDrug useHepatitis C virus transmissionOpioid agonist maintenanceOpioid agonist medicationsPotential pharmacological treatment optionsC virus transmissionPharmacological treatment optionsInjection drug useOpioid-dependent individualsDirect healthcare costsIllicit opioid usersHIV risk behaviorsGlobal economic burdenIllicit drug useTerms of HIVSustained-release formulationMaintenance therapyAgonist medicationsOpioid antagonistAgonist maintenanceTreatment optionsOpioid usersImproved outcomes
2011
Nonmedical Use of Opioid Analgesics Obtained Directly From Physicians: Prevalence and Correlates
Becker WC, Tobin DG, Fiellin DA. Nonmedical Use of Opioid Analgesics Obtained Directly From Physicians: Prevalence and Correlates. JAMA Internal Medicine 2011, 171: 1034-1036. PMID: 21670373, DOI: 10.1001/archinternmed.2011.217.Peer-Reviewed Original Research