2025
Health Services Usage in Patients Receiving Buprenorphine for Opioid Use Disorder or Long-Term Opioid Therapy for Chronic Pain: Retrospective Cohort Study
Savitz S, Stevens M, Nath B, D'Onofrio G, Melnick E, Jeffery M. Health Services Usage in Patients Receiving Buprenorphine for Opioid Use Disorder or Long-Term Opioid Therapy for Chronic Pain: Retrospective Cohort Study. JMIR Formative Research 2025, 9: e66596. PMID: 40537088, DOI: 10.2196/66596.Peer-Reviewed Original ResearchConceptsIncidence rate ratiosLong-term opioid therapyIn-person careMental illness cohortOpioid use disorderIn-personTelemedicine visitsChronic painPain medicineOpioid therapyEmergency medicineMental healthFamily practiceHealth service usageChronic opioidsPercentage of visitsIn-person visitsIn-person treatmentPoor outcomeAdministrative claims dataUse disorderMedicare Advantage patientsOptumLabs Data WarehouseVulnerable patient populationCare deliveryCorrection: Computational 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. Correction: Computational phenotypes for patients with opioid-related disorders presenting to the emergency department. PLOS ONE 2025, 20: e0324877. PMID: 40378111, PMCID: PMC12083821, DOI: 10.1371/journal.pone.0324877.Peer-Reviewed Original ResearchReceipt of addiction treatment after nonfatal opioid overdose and risk of subsequent overdose: A retrospective cohort study
Howell B, Black A, Lin H, Liberatore M, Greene C, D'Onofrio G, Heimer R, Grau L, Hawk K, Fiellin D, Becker W. Receipt of addiction treatment after nonfatal opioid overdose and risk of subsequent overdose: A retrospective cohort study. Drug And Alcohol Dependence 2025, 273: 112679. PMID: 40413965, PMCID: PMC12178112, DOI: 10.1016/j.drugalcdep.2025.112679.Peer-Reviewed Original ResearchConceptsAddiction treatment modalitiesAddiction treatmentInpatient addiction treatmentOpioid overdose survivorsOverdose survivorsOpioid agonist treatmentOpioid overdoseReceipt of methadoneOpioid withdrawalInpatient treatmentBenzodiazepine exposureNon-medicalAddictionAssociated with reduced riskNonfatal opioid overdoseAgonist treatmentNon-fatal opioid overdoseTreatment modalitiesAssociated with increased riskBenzodiazepinesIndividual level dataMethadoneRetrospective cohort studyOpioidBuprenorphineRacial, ethnic, and sex disparities in buprenorphine treatment from emergency departments by discharge diagnosis
Chhabra N, Smith D, Parde N, Hsing‐Smith N, Bianco J, Taylor R, D'Onofrio G, Karnik N. Racial, ethnic, and sex disparities in buprenorphine treatment from emergency departments by discharge diagnosis. Academic Emergency Medicine 2025 PMID: 40277252, DOI: 10.1111/acem.70035.Peer-Reviewed Original ResearchOpioid withdrawalPrescribing of buprenorphineEmergency departmentSex disparitiesBlack patientsDischarge diagnosisEffects of opioidsOpioid overdoseED-initiated buprenorphineOpioid-related ED encountersMultivariate logistic regressionReceipt of buprenorphineFemale patientsOpioid complicationsBuprenorphine treatmentWhite patientsCross-sectional analysisOpioid-related encountersOpioidAmerican patientsAdjusted oddsDecreased oddsBuprenorphinePatientsSubtype analysisDisentangling informing participants from obtaining their consent
O'Rourke P, Ali J, Carrithers J, Magnus D, Wilfond B, Bull S, Dember L, D'Onofrio G, Goldman J, Ho P, Melnick E, Staman K, Tulsky J, Vazquez M, Volandes A, Wendler D. Disentangling informing participants from obtaining their consent. Learning Health Systems 2025 DOI: 10.1002/lrh2.70014.Peer-Reviewed Original ResearchResearch consentParticipants' understandingContext of routine careStudy team membersPragmatic clinical trialsContext of trialsRoutine careConsentWaiverParticipant consentParticipant engagementResearch participantsEthical analysisTeam membersSignificant riskInstitutional review boardParticipantsParticipants' abilityReview boardCommunicating informationTrialsRegulatory criteriaRiskState Investment in Emergency Department Buprenorphine Pays Off
D’Onofrio G, Cole J, Perrone J. State Investment in Emergency Department Buprenorphine Pays Off. JAMA 2025, 333: 1209-1211. PMID: 39969859, DOI: 10.1001/jama.2025.0609.Peer-Reviewed Original ResearchPredicting White Matter Hyperintensity: Leveraging Portable Magnetic Resonance Imaging for Accessible Brain Health Screening.
Johnson I, Brigger H, Smith J, Peasley E, Champagne A, Littig L, Lalwani D, Sze G, Payabvash S, Safdar B, D'Onofrio G, Wira C, Iglesias J, Rosen M, Sorby-Adams A, Kimberly W, Sheth K, de Havenon A. Predicting White Matter Hyperintensity: Leveraging Portable Magnetic Resonance Imaging for Accessible Brain Health Screening. American Journal Of Neuroradiology 2025, ajnr.a8734. PMID: 40081846, DOI: 10.3174/ajnr.a8734.Peer-Reviewed Original ResearchWhite matter hyperintensitiesWMH measuresMagnetic resonance imagingConventional MRIScreening pilot programRisk factorsValidation cohortHigh-risk individualsAcute neurologic pathologyVascular risk factorsTertiary care hospitalSystolic blood pressure >Resonance imagingDevelopment cohortWhite matter hyperintensities burdensHealth screeningTobacco useBlood pressure >Emergency departmentCare hospitalPortable MRIRisk scoreScreening toolPilot programPrimary outcomeAdaptive decision support for addiction treatment to implement initiation of buprenorphine for opioid use disorder in the emergency department: protocol for the ADAPT Multiphase Optimization Strategy trial
Iscoe M, Hooper C, Levy D, Buchanan L, Dziura J, Meeker D, Taylor R, D’Onofrio G, Oladele C, Sarpong D, Paek H, Wilson F, Heagerty P, Delgado M, Hoppe J, Melnick E. Adaptive decision support for addiction treatment to implement initiation of buprenorphine for opioid use disorder in the emergency department: protocol for the ADAPT Multiphase Optimization Strategy trial. BMJ Open 2025, 15: e098072. PMID: 39979056, PMCID: PMC11842997, DOI: 10.1136/bmjopen-2024-098072.Peer-Reviewed Original ResearchConceptsClinical decision supportMultiphase optimization strategyOpioid use disorderEmergency departmentInitiation of buprenorphineClinical decision support usePlan-Do-Study-Act cyclesLearning health system approachPlan-Do-Study-ActClinical decision support toolHealth system approachAdaptive decision supportUse disorderDecision supportAddiction treatmentPeer-reviewed journalsBuprenorphine initiationOpioid use disorder treatment initiationOpioid-related mortalityIntervention componentsED settingClinician feedbackInstitute Institutional Review BoardTreatment of opioid use disorderParticipating sitesDepression and Low Social Support Mediate the Association of Marital Stress and 12-Month Cardiac-Specific Quality of Life in Young Adults With Acute Myocardial Infarction
Zhu C, Dreyer R, Li F, Spatz E, Caraballo C, Mahajan S, Raparelli V, Leifheit E, Lu Y, Krumholz H, Spertus J, D’Onofrio G, Pilote L, Lichtman J. Depression and Low Social Support Mediate the Association of Marital Stress and 12-Month Cardiac-Specific Quality of Life in Young Adults With Acute Myocardial Infarction. Biopsychosocial Science And Medicine 2025, 87: 129-137. PMID: 39909011, DOI: 10.1097/psy.0000000000001363.Peer-Reviewed Original ResearchConceptsLow social supportCardiac-specific quality of lifeNatural direct effectSocial supportMonths post-AMIQuality of lifeAcute myocardial infarctionMarital stressComprehensive secondary preventive strategySignificant depressive symptomsPost-AMISecondary prevention strategiesYoung adultsMyocardial infarctionSociodemographic factorsDepressive symptomsAMI survivorsCovariate adjustmentPrevention strategiesSelf-reportContinuous scoresQoLBaseline QoLCategorical depressionDepression
2024
A Prehospital Quality Improvement Framework to Reduce Mortality and Other Harms Associated with Opioid Use Disorder
Glenn M, Crowe R, Dorsett M, Taigman M, Herring A, Mercer M, Joiner A, Venkatesh A, Davis C, Hawk K, Hern H, Carroll G, Cabañas J, D’Onofrio G, Samuels E. A Prehospital Quality Improvement Framework to Reduce Mortality and Other Harms Associated with Opioid Use Disorder. Prehospital Emergency Care 2024, 29: 510-518. PMID: 39671519, DOI: 10.1080/10903127.2024.2428671.Peer-Reviewed Original ResearchEmergency medical servicesOpioid use disorderQI frameworkQuality improvementHarm reductionQuality improvement frameworkHarms associated with opioid useEvidence-based practiceReduce mortalityReduce overdose deathsEscalating overdose crisisImproved frameworkMedical servicesMultidisciplinary teamOverdose crisisAddiction medicinePublic healthOverdose deathsSubject matter expertsPrehospitalOpioid useQuality measuresAdverse outcomesUse disorderHarmCost-Effectiveness of Implementation Facilitation to Promote Emergency Department-Initiated Buprenorphine for Opioid Use Disorder
Lu T, Ryan D, Cadet T, Chawarski M, Coupet E, Edelman E, Hawk K, Huntley K, Jalali A, O'Connor P, Owens P, Martel S, Fiellin D, D'Onofrio G, Murphy S. Cost-Effectiveness of Implementation Facilitation to Promote Emergency Department-Initiated Buprenorphine for Opioid Use Disorder. Annals Of Emergency Medicine 2024, 85: 205-213. PMID: 39570250, PMCID: PMC11845297, DOI: 10.1016/j.annemergmed.2024.10.001.Peer-Reviewed Original ResearchHealth care sector perspectiveImplementation facilitatorsOpioid use disorder careIncremental cost-effectiveness ratioCost-effectiveness ratioHealth care sector costsEducational strategiesImplementation facilitation strategyCost-effectiveness acceptability curvesLikelihood of cost-effectivenessCost-effectiveOpioid use disorderQuality-adjusted life yearsUse disorderPatient engagementAcademic EDED visitsAcceptability curvesStandard educationEmergency departmentLife yearsFacilitation strategiesMeasures of effectivenessHealthBuprenorphine403EMF Barriers and Facilitators to Addiction Treatment Access From the Emergency Department Among Black Individuals With Opioid Use Disorder
Coupet E, Chawarski M, Hercules K, Williams J, Murphy A, Owens P, D'Onofrio G. 403EMF Barriers and Facilitators to Addiction Treatment Access From the Emergency Department Among Black Individuals With Opioid Use Disorder. Annals Of Emergency Medicine 2024, 84: s182-s183. DOI: 10.1016/j.annemergmed.2024.08.403.Peer-Reviewed Original Research488 Impact of Housing Status and Treatment Engagement for Emergency Department Patients With Substance Use Disorders
Ryus C, Hawk K, Canty T, Maffei J, Martel S, Heckmann R, Sabounchi N, Pantalon M, D'Onofrio G. 488 Impact of Housing Status and Treatment Engagement for Emergency Department Patients With Substance Use Disorders. Annals Of Emergency Medicine 2024, 84: s216-s217. DOI: 10.1016/j.annemergmed.2024.08.478.Peer-Reviewed Original Research428 Self-Reported Readiness to Change Alcohol Use in Emergency Department Patients With Alcohol Use Disorder Predicts Successful Linkage to Treatment
Hawk K, Ryus C, Martel S, Heckmann R, Sabounchi N, Canty T, Pantalone M, D'Onofrio G. 428 Self-Reported Readiness to Change Alcohol Use in Emergency Department Patients With Alcohol Use Disorder Predicts Successful Linkage to Treatment. Annals Of Emergency Medicine 2024, 84: s191-s192. DOI: 10.1016/j.annemergmed.2024.08.426.Peer-Reviewed Original ResearchTrends and Disparities in Initiation of Buprenorphine in US Emergency Departments, 2013-2022
Chhabra N, Smith D, Dickinson G, Caglianone L, Taylor R, D’Onofrio G, Karnik N. Trends and Disparities in Initiation of Buprenorphine in US Emergency Departments, 2013-2022. JAMA Network Open 2024, 7: e2435603. PMID: 39325455, PMCID: PMC11428009, DOI: 10.1001/jamanetworkopen.2024.35603.Peer-Reviewed Original Research“SafetyNet”: Evaluation of a Recovery Coach and Paramedic Intervention Following Naloxone Resuscitation From an Opioid Overdose
Joseph D, Brokowski C, D’Onofrio G, Bogucki S, McGovern J, Allen R, Dziura J, Cone D, Pantalon M. “SafetyNet”: Evaluation of a Recovery Coach and Paramedic Intervention Following Naloxone Resuscitation From an Opioid Overdose. Substance Abuse 2024, 46: 302-312. PMID: 39171791, DOI: 10.1177/29767342241266412.Peer-Reviewed Original ResearchOverdose eventsRecovery coachesOpioid overdoseFollow-up encountersReducing illicit drug useFifty-five participantsIllicit drug useParamedic interventionsTrained paramedicsPeer recoveryFollow-upHealth educationOpioid use disorderSample size estimationParamedicsOpioid-positive urine testsPositive urine toxicology screenMOUD engagementMedical concernsMOUDUrine toxicology screenDrug useParticipantsPositive urine testInterventionExtended-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 patientsW81 Implementation Facilitation Improves Clinician Readiness to Provide Emergency Department-Initiated Buprenorphine in Four Urban Academic Centers
Hawk K, D'Onofrio G, Chawarski M, Coupet E, Cowan E, Curry L, Freiermurth C, Lyons M, Murphy A, O'Connor P, Richardson L, Rothman R, Whiteside L, Williams J, Fiellin D, Edelman E. W81 Implementation Facilitation Improves Clinician Readiness to Provide Emergency Department-Initiated Buprenorphine in Four Urban Academic Centers. Drug And Alcohol Dependence 2024, 260: 110699. DOI: 10.1016/j.drugalcdep.2023.110699.Peer-Reviewed Original ResearchT50 Receipt of Prescribed Opioids and Benzodiazepines After Non-Fatal Overdose and Risk of Subsequent Overdose
Howell B, Black A, Lin H, Lauretta G, Heimer R, Hawk K, D'Onofrio G, Fiellin D, Becker W. T50 Receipt of Prescribed Opioids and Benzodiazepines After Non-Fatal Overdose and Risk of Subsequent Overdose. Drug And Alcohol Dependence 2024, 260: 110499. DOI: 10.1016/j.drugalcdep.2023.110499.Peer-Reviewed Original ResearchUsing qualitative system dynamics modeling to understand overdose bystander behavior in the context of Connecticut’s Good Samaritan Laws and identify effective policy options
Thompson R, Sabounchi N, Ali S, Heimer R, D’Onofrio G, Heckmann R. Using qualitative system dynamics modeling to understand overdose bystander behavior in the context of Connecticut’s Good Samaritan Laws and identify effective policy options. Harm Reduction Journal 2024, 21: 124. PMID: 38937759, PMCID: PMC11210010, DOI: 10.1186/s12954-024-00990-3.Peer-Reviewed Original ResearchConceptsSamaritan lawsGood Samaritan lawsBystander behaviorGroup model buildingFear of legal consequencesKnowledge of protectionResponses to opioid overdosesCriminal liabilityDrug arrestsLegal consequencesLaw enforcementNaloxone useLawStakeholder-engaged processOpioid overdoseHealth care providersFatal opioid overdoseSustainable system changeOpioid-related outcomesBystander experiencesSamaritanCare providersHarm reductionPotential bystandersPolicy determination
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