2023
Perspectives on and experiences of emergency department–initiated buprenorphine among clinical pharmacists: A multi-site qualitative study
Justen M, Edelman E, Chawarski M, Coupet E, Cowan E, Lyons M, Owens P, Martel S, Richardson L, Rothman R, Whiteside L, O'Connor P, Zahn E, D'Onofrio G, Fiellin D, Hawk K. Perspectives on and experiences of emergency department–initiated buprenorphine among clinical pharmacists: A multi-site qualitative study. Journal Of Substance Use And Addiction Treatment 2023, 155: 209058. PMID: 37149149, DOI: 10.1016/j.josat.2023.209058.Peer-Reviewed Original ResearchMeSH KeywordsBuprenorphineEmergency Service, HospitalHumansOpiate Substitution TreatmentOpioid-Related DisordersPharmacistsConceptsOpioid use disorderClinical pharmacistsED careEmergency department-initiated buprenorphineEffective OUD treatmentEffectiveness-implementation studyHealth Services frameworkFocus groups/interviewsMulti-site qualitative studyFuture implementation effortsOUD treatmentUrban EDGroups/interviewsEmergency departmentPromoting ActionUnique pharmacologyED staffBuprenorphinePharmacist participantsUse disordersED contextPharmacistsPractice changePharmacy resourcesSuccessful program implementationPerspectives of Clinicians and Staff at Community-Based Opioid Use Disorder Treatment Settings on Linkages With Emergency Department–Initiated Buprenorphine Programs
Sue K, Chawarski M, Curry L, McNeil R, Coupet E, Schwartz R, Wilder C, Tsui J, Hawk K, D’Onofrio G, O’Connor P, Fiellin D, Edelman E. Perspectives of Clinicians and Staff at Community-Based Opioid Use Disorder Treatment Settings on Linkages With Emergency Department–Initiated Buprenorphine Programs. JAMA Network Open 2023, 6: e2312718. PMID: 37163263, PMCID: PMC10173026, DOI: 10.1001/jamanetworkopen.2023.12718.Peer-Reviewed Original ResearchMeSH KeywordsBuprenorphineEmergency Service, HospitalFemaleHealth ServicesHumansMiddle AgedOpiate Substitution TreatmentOpioid-Related DisordersConceptsCommunity-based cliniciansOpioid use disorderEmergency departmentOUD treatmentMedication treatmentSubstance use disorders trainingUrban academic emergency departmentEffectiveness-implementation studyAcademic emergency departmentDisorder treatment settingsPerspectives of cliniciansCommunity-based treatmentCommunity-based treatment programsStaff perspectivesImplementation science frameworkBuprenorphine programTreatment cliniciansPeer navigatorsReferral sitesPromoting ActionMAIN OUTCOMEED staffBuprenorphineFocus groupsUse disordersImplementation 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
2020
Barriers and Facilitators to Clinician Readiness to Provide Emergency Department–Initiated Buprenorphine
Hawk KF, D’Onofrio G, Chawarski MC, O’Connor P, Cowan E, Lyons MS, Richardson L, Rothman RE, Whiteside LK, Owens PH, Martel SH, Coupet E, Pantalon M, Curry L, Fiellin DA, Edelman EJ. Barriers and Facilitators to Clinician Readiness to Provide Emergency Department–Initiated Buprenorphine. JAMA Network Open 2020, 3: e204561. PMID: 32391893, PMCID: PMC7215257, DOI: 10.1001/jamanetworkopen.2020.4561.Peer-Reviewed Original ResearchConceptsOpioid use disorderEmergency departmentAdvanced practice cliniciansED cliniciansClinicians' readinessOngoing treatmentTreatment of OUDEmergency Department-Initiated BuprenorphineUntreated opioid use disorderDrug Addiction Treatment ActDecrease opioid useVisual analog scaleHealth Services frameworkAcademic emergency departmentMixed-methods formative evaluationQuality of careSubset of participantsBuprenorphine initiationClinician typeOpioid useED patientsAnalog scaleOngoing careDepartmental protocolPractice clinicians
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
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 daysInterventionEmergency 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 useReferralPatients
2015
Evaluation of an implementation of methadone maintenance treatment in China
Marienfeld C, Liu P, Wang X, Schottenfeld R, Zhou W, Chawarski MC. Evaluation of an implementation of methadone maintenance treatment in China. Drug And Alcohol Dependence 2015, 157: 60-67. PMID: 26601934, PMCID: PMC4663107, DOI: 10.1016/j.drugalcdep.2015.10.001.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAnalgesics, OpioidChinaFemaleHumansMaleMethadoneMiddle AgedOpiate Substitution TreatmentOpioid-Related DisordersPatient ComplianceProgram EvaluationSex CharacteristicsYoung AdultConceptsInjection drug useMethadone maintenance treatmentMMT exposureDrug useMaintenance treatmentUrine testsPositive testOpiate positive urine testsDaily methadone dosesPositive urine testHigher adherence ratesOpioid use disorderNegative urine testsSelf-reported drug useElectronic medical recordsPriority improvement areasMonth drug useMethadone dosesMethadone dosingDose adjustmentAdherence ratesDaily dosesMedical recordsTreatment daysUse disordersBuprenorphine/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 useExpanding Substance Use Treatment Options for HIV Prevention With Buprenorphine–Naloxone
Metzger DS, Donnell D, Celentano DD, Jackson JB, Shao Y, Aramrattana A, Wei L, Fu L, Ma J, Lucas GM, Chawarski M, Ruan Y, Richardson P, Shin K, Chen RY, Sugarman J, Dye BJ, Rose SM, Beauchamp G, Burns DN. Expanding Substance Use Treatment Options for HIV Prevention With Buprenorphine–Naloxone. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2015, 68: 554-561. PMID: 25564105, PMCID: PMC4382671, DOI: 10.1097/qai.0000000000000510.Peer-Reviewed Original ResearchMeSH KeywordsAdultBuprenorphineChinaFemaleHIV InfectionsHumansIncidenceMaleNaloxoneOpiate Substitution TreatmentSubstance Abuse, IntravenousThailandTreatment OutcomeConceptsInjection-related risk behaviorsBUP/NXRisk behaviorsOpioid useNegative urinalysisTreatment strategiesInjection opioid useOpioid-dependent PWIDThrice-weekly dosingPrimary end pointBuprenorphine/naloxoneOpioid use disorderOpioid-dependent peopleEvidence-based treatmentsBehavioral drugBuprenorphine-naloxoneDose taperingOpioid injectionWeek 78HIV infectionActive treatmentHIV incidenceWeek 26Treatment optionsTreatment completionHepatitis C seroconversion in methadone maintenance treatment programs in Wuhan, China
Zhou W, Wang X, Zhou S, Xie N, Liu P, Luo L, Peng J, Liu M, Desrosiers A, Schottenfeld R, Chawarski MC. Hepatitis C seroconversion in methadone maintenance treatment programs in Wuhan, China. Addiction 2015, 110: 796-802. PMID: 25529103, PMCID: PMC4598328, DOI: 10.1111/add.12836.Peer-Reviewed Original ResearchConceptsMethadone maintenance treatmentInjection drug useHCV seroconversionPatients HCVSeroconversion ratesDrug useOpiate positive urine testsHepatitis C virus infectionRisk behaviorsMethadone maintenance treatment patientsMethadone maintenance treatment programHepatitis C seroconversionC virus infectionUrine toxicology resultsHepatitis C virusMaintenance treatment programPotential risk factorsOpiate-dependent individualsCross-sectional surveyHCV seroprevalenceMMT clinicsMaintenance treatmentTreatment patientsC virusUrine tests
2010
Behavioral drug and HIV risk reduction counseling (BDRC) in MMT programs in Wuhan, China: A pilot randomized clinical trial
Chawarski MC, Zhou W, Schottenfeld RS. Behavioral drug and HIV risk reduction counseling (BDRC) in MMT programs in Wuhan, China: A pilot randomized clinical trial. Drug And Alcohol Dependence 2010, 115: 237-239. PMID: 21159452, PMCID: PMC3076517, DOI: 10.1016/j.drugalcdep.2010.09.024.Peer-Reviewed Original ResearchConceptsHIV risk reduction counselingMethadone maintenance treatmentRisk reduction counselingIllicit opiate useHIV risk behaviorsBehavioral drugReduction counselingClinical trialsOpiate useMMT servicesRisk behaviorsPrimary outcome measurePilot clinical trialTime of enrollmentSignificant baseline differencesHeroin-dependent individualsNegative test resultsMMT clinicsDaily medicationMaintenance treatmentMMT programBaseline differencesOutcome measuresMMT groupTreatment retention