2017
Cost‐effectiveness of emergency department‐initiated treatment for opioid dependence
Busch SH, Fiellin DA, Chawarski MC, Owens PH, Pantalon MV, Hawk K, Bernstein SL, O'Connor PG, D'Onofrio G. Cost‐effectiveness of emergency department‐initiated treatment for opioid dependence. Addiction 2017, 112: 2002-2010. PMID: 28815789, PMCID: PMC5657503, DOI: 10.1111/add.13900.Peer-Reviewed Original ResearchConceptsCost-effectiveness acceptability curvesOpioid dependenceCommunity-based treatmentBrief interventionAcceptability curvesPast weekHealth care system costsHealth care system perspectiveAddiction treatmentOpioid-dependent patientsPatient time costsHealth care useFormal addiction treatmentBuprenorphine treatmentUrban EDEmergency departmentPrimary carePatient engagementTreatment engagementPatientsReferralSecondary analysisBuprenorphineNumber of daysIntervention
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 services
2014
The impact of buprenorphine/naloxone treatment on HIV risk behaviors among HIV-infected, opioid-dependent patients
Edelman EJ, Chantarat T, Caffrey S, Chaudhry A, O’Connor P, Weiss L, Fiellin DA, Fiellin LE. The impact of buprenorphine/naloxone treatment on HIV risk behaviors among HIV-infected, opioid-dependent patients. Drug And Alcohol Dependence 2014, 139: 79-85. PMID: 24726429, PMCID: PMC4029496, DOI: 10.1016/j.drugalcdep.2014.03.006.Peer-Reviewed Original ResearchConceptsBuprenorphine/naloxone treatmentOpioid-dependent patientsHIV risk behaviorsBuprenorphine/naloxoneNon-condom useNaloxone treatmentRisk behaviorsTreatment initiationViral loadHIV-1 RNA viral loadCocaine/amphetaminesTime-updated variablesRNA viral loadMajor risk factorOpioid-dependent populationsCochran-Armitage trend testSexual risk behaviorsOlder patientsHIV infectionOpioid dependenceRisk factorsHeroin useHIVPatientsTargeted interventions
2013
A Randomized Trial of Cognitive Behavioral Therapy in Primary Care-based Buprenorphine
Fiellin DA, Barry DT, Sullivan LE, Cutter CJ, Moore BA, O'Connor PG, Schottenfeld RS. A Randomized Trial of Cognitive Behavioral Therapy in Primary Care-based Buprenorphine. The American Journal Of Medicine 2013, 126: 74.e11-74.e17. PMID: 23260506, PMCID: PMC3621718, DOI: 10.1016/j.amjmed.2012.07.005.Peer-Reviewed Original ResearchConceptsCognitive behavioral therapyPhysician managementBehavioral therapyOpioid useOpioid dependencePrimary careSelf-reported frequencyBuprenorphine/naloxone treatmentConsecutive weeksOpioid-dependent patientsIllicit opioid usePrimary care clinicsPrimary outcome measureWeeks of treatmentNaloxone treatmentOpioid abstinenceBuprenorphine/Care clinicsIllicit opioidsRandomized trialsUrine toxicologyClinical trialsStudy completionOutcome measuresCocaine use
2012
Brief versus extended counseling along with buprenorphine/naloxone for HIV-infected opioid dependent patients
Tetrault JM, Moore BA, Barry DT, O'Connor PG, Schottenfeld R, Fiellin DA, Fiellin LE. Brief versus extended counseling along with buprenorphine/naloxone for HIV-infected opioid dependent patients. Journal Of Substance Use And Addiction Treatment 2012, 43: 433-439. PMID: 22938914, DOI: 10.1016/j.jsat.2012.07.011.Peer-Reviewed Original ResearchMeSH KeywordsAdultBuprenorphineBuprenorphine, Naloxone Drug CombinationCounselingDelivery of Health Care, IntegratedFeasibility StudiesFemaleFollow-Up StudiesHIV InfectionsHumansMaleMiddle AgedNaloxoneNarcotic AntagonistsOpioid-Related DisordersPsychotherapy, BriefSubstance Abuse DetectionTime FactorsTreatment OutcomeViral LoadConceptsEnhanced medical managementPhysician managementDetectable HIV viral loadHIV treatment settingsOpioid-negative urinesBuprenorphine/naloxoneHIV viral loadOpioid-dependent patientsPercentage of subjectsUntreated opioid dependenceExtended counselingHIV clinicHIV outcomesBuprenorphine/Medical managementOpioid dependenceViral loadDependent patientsExtensive counselingClinical trialsContinuous abstinenceNegative urineTreatment settingsGroup differencesCounseling
2011
Hepatic Safety and Lack of Antiretroviral Interactions With Buprenorphine/Naloxone in HIV-Infected Opioid-Dependent Patients
Vergara-Rodriguez P, Tozzi MJ, Botsko M, Nandi V, Altice F, Egan JE, O'Connor PG, Sullivan LE, Fiellin DA. Hepatic Safety and Lack of Antiretroviral Interactions With Buprenorphine/Naloxone in HIV-Infected Opioid-Dependent Patients. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2011, 56: s62-s67. PMID: 21317596, DOI: 10.1097/qai.0b013e31820a820f.Peer-Reviewed Original ResearchConceptsBuprenorphine/naloxoneOpioid-dependent patientsMedian aspartate aminotransferasePharmacodynamic interactionsAspartate aminotransferaseBup/ALT valuesAlanine aminotransferaseBUP/NXOpioid-dependent HIVProspective cohort studyHepatic safetyHepatitis CCohort studyHepatic toxicityHIVPatientsAtazanavirNaloxonePrior reportsExposure measuresSignificant decreaseAminotransferaseSignificant changesTreatmentDrug Treatment Outcomes Among HIV-Infected Opioid-Dependent Patients Receiving Buprenorphine/Naloxone
Fiellin DA, Weiss L, Botsko M, Egan JE, Altice FL, Bazerman LB, Chaudhry A, Cunningham CO, Gourevitch MN, Lum PJ, Sullivan LE, Schottenfeld RS, O'Connor PG. Drug Treatment Outcomes Among HIV-Infected Opioid-Dependent Patients Receiving Buprenorphine/Naloxone. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2011, 56: s33-s38. PMID: 21317592, PMCID: PMC3863630, DOI: 10.1097/qai.0b013e3182097537.Peer-Reviewed Original ResearchConceptsBuprenorphine/naloxoneBuprenorphine/naloxone treatmentOpioid-dependent patientsDrug useOpioid useNaloxone treatmentHIV treatment settingsIllicit opioid useOngoing drug useDrug treatment outcomesNaloxone dosesIllicit opioidsOpioid dependenceOffice visitsProspective studyHIV treatmentRetained patientsTreatment outcomesTreatment retentionPatientsTreatment settingsAddiction treatment processNaloxoneTreatment populationHIV
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
2007
Primary Care Office-based Buprenorphine Treatment: Comparison of Heroin and Prescription Opioid Dependent Patients
Moore BA, Fiellin DA, Barry DT, Sullivan LE, Chawarski MC, O’Connor P, Schottenfeld RS. Primary Care Office-based Buprenorphine Treatment: Comparison of Heroin and Prescription Opioid Dependent Patients. Journal Of General Internal Medicine 2007, 22: 527-530. PMID: 17372805, PMCID: PMC1829433, DOI: 10.1007/s11606-007-0129-0.Peer-Reviewed Original ResearchConceptsPrescription opioid useOpioid useOnly patientsPrescription opioidsTreatment outcomesBuprenorphine/naloxone maintenanceBuprenorphine/naloxone treatmentOpioid-negative urine samplesPrescription opioid-dependent patientsHepatitis C antibodyDrug treatment historyOpioid-dependent patientsPrimary care officesOffice-based settingClinical characteristicsBuprenorphine treatmentNaloxone treatmentBuprenorphine/Opioid dependenceCare officesDependent patientsTreatment responseC antibodyHeroin usePatientsPatient Satisfaction with Primary Care Office-Based Buprenorphine/Naloxone Treatment
Barry DT, Moore BA, Pantalon MV, Chawarski MC, Sullivan LE, O’Connor P, Schottenfeld RS, Fiellin DA. Patient Satisfaction with Primary Care Office-Based Buprenorphine/Naloxone Treatment. Journal Of General Internal Medicine 2007, 22: 242-245. PMID: 17356993, PMCID: PMC1824745, DOI: 10.1007/s11606-006-0050-y.Peer-Reviewed Original ResearchConceptsBuprenorphine/naloxonePatient satisfactionBuprenorphine/naloxone treatmentDrug treatment historyOpioid-dependent patientsPrimary care officesOpioid-dependent subjectsSubstance use statusOverall satisfaction scoreOffice visit frequencyNaloxone treatmentParticipantsOne hundredPrimary outcomeCare officesFemale genderTreatment historyPatientsNaloxoneSatisfaction scoresEthnicity/raceTreatment locationUse statusVisit frequencyMedicationsTreatment
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
2004
Counseling Requirements for Buprenorphine Maintenance in Primary Care
Pantalon M, Fiellin D, O’Connor P, Chawarski M, Pakes J, Schottenfeld R. Counseling Requirements for Buprenorphine Maintenance in Primary Care. Addictive Disorders & Their Treatment 2004, 3: 71-76. DOI: 10.1097/00132576-200406000-00003.Peer-Reviewed Original ResearchUrine toxicology testsMedical managementPrimary care settingBuprenorphine maintenanceCare settingsDrug counselingCounseling requirementsToxicology testsBuprenorphine-maintained patientsOpioid-dependent patientsMethadone maintenance programIndividual drug counselingBuprenorphine treatmentOpioid dependenceDependent patientsPrimary carePatientsConsecutive weeksDrug counselorsStatistical significanceWeeksPreliminary feasibilityPreliminary findingsEfficacyCounseling
2001
Methadone Maintenance in Primary Care: A Randomized Controlled Trial
Fiellin DA, O'Connor PG, Chawarski M, Pakes JP, Pantalon MV, Schottenfeld RS. Methadone Maintenance in Primary Care: A Randomized Controlled Trial. JAMA 2001, 286: 1724-1731. PMID: 11594897, DOI: 10.1001/jama.286.14.1724.Peer-Reviewed Original ResearchConceptsOpioid-dependent patientsNarcotic treatment programsOffice-based careStable opioid-dependent patientsIllicit drug usePrimary care physiciansMethadone maintenanceUse of healthDrug useNTP patientsCare physiciansClinical instabilityFunctional statusPrimary care physician's officeMethadone maintenance therapyPrimary care internistsMethadone maintenance patientsOpen clinical trialIllicit opiate useToxicology test resultsQuality of careMaintenance therapyUsual careControlled TrialsOpioid dependence
2000
Thrice-weekly versus daily buprenorphine maintenance
Schottenfeld R, Pakes J, O’Connor P, Chawarski M, Oliveto A, Kosten T. Thrice-weekly versus daily buprenorphine maintenance. Biological Psychiatry 2000, 47: 1072-1079. PMID: 10862807, DOI: 10.1016/s0006-3223(99)00270-x.Peer-Reviewed Original ResearchConceptsSublingual buprenorphineMaintenance treatmentSelf-reported illicit drug useDrug useOpioid agonist maintenance treatmentOpioid-positive urine testsAgonist maintenance treatmentDaily clinic attendanceDaily sublingual buprenorphineThrice-weekly dosingOpioid-dependent patientsUrine toxicology testsSignificant differencesIllicit drug useSelf-reported numberBuprenorphine maintenanceClinic attendanceWeekly doseIllicit opioidsMedication complianceThrice weeklyUrine testsOutcome measuresBuprenorphineCounseling attendance
1997
Three methods of opioid detoxification in a primary care setting. A randomized trial.
O'Connor PG, Carroll KM, Shi JM, Schottenfeld RS, Kosten TR, Rounsaville BJ. Three methods of opioid detoxification in a primary care setting. A randomized trial. Annals Of Internal Medicine 1997, 127: 526-30. PMID: 9313020, DOI: 10.7326/0003-4819-127-7-199710010-00004.Peer-Reviewed Original ResearchConceptsPrimary care settingOpioid detoxificationCare settingsBuprenorphine groupWithdrawal symptomsDouble-blind clinical trialOpioid-dependent patientsHeroin-dependent patientsPrimary care clinicsWithdrawal symptom scoresSevere withdrawal symptomsDrug treatment programsSubstance abuse treatmentNaltrexone groupCare clinicsSymptom scoresPharmacologic protocolClinical trialsTreatment protocolClonidineTreatment retentionBuprenorphineNaltrexoneTreatment programAbuse treatment