2022
Models for Implementing Emergency Department–Initiated Buprenorphine With Referral for Ongoing Medication Treatment at Emergency Department Discharge in Diverse Academic Centers
Whiteside LK, D'Onofrio G, Fiellin DA, Edelman EJ, Richardson L, O'Connor P, Rothman RE, Cowan E, Lyons MS, Fockele CE, Saheed M, Freiermuth C, Punches BE, Guo C, Martel S, Owens PH, Coupet E, Hawk KF. Models for Implementing Emergency Department–Initiated Buprenorphine With Referral for Ongoing Medication Treatment at Emergency Department Discharge in Diverse Academic Centers. Annals Of Emergency Medicine 2022, 80: 410-419. PMID: 35752520, PMCID: PMC9588652, DOI: 10.1016/j.annemergmed.2022.05.010.Peer-Reviewed Original ResearchMeSH KeywordsBuprenorphineEmergency Service, HospitalHumansNarcotic AntagonistsOpiate Substitution TreatmentOpioid-Related DisordersPatient DischargeReferral and ConsultationConceptsOpioid use disorderUse disordersEmergency Department-Initiated BuprenorphineEmergency department dischargeEmergency department patientsElectronic medical record integrationAcademic medical centerBuprenorphine programDepartment patientsTreatment initiationMedication treatmentEmergency physiciansMedical CenterAmerican CollegeClinical practiceImplementation facilitationQuality improvement processBuprenorphineCommon facilitatorsRecord integrationPatientsReferralED cultureEducational disseminationDisorders
2021
Consensus Recommendations on the Treatment of Opioid Use Disorder in the Emergency Department
Hawk K, Hoppe J, Ketcham E, LaPietra A, Moulin A, Nelson L, Schwarz E, Shahid S, Stader D, Wilson MP, D'Onofrio G. Consensus Recommendations on the Treatment of Opioid Use Disorder in the Emergency Department. Annals Of Emergency Medicine 2021, 78: 434-442. PMID: 34172303, DOI: 10.1016/j.annemergmed.2021.04.023.Peer-Reviewed Original ResearchMeSH KeywordsBuprenorphineConsensusEmergency Service, HospitalHumansNarcotic AntagonistsOpioid-Related DisordersReferral and ConsultationConceptsOpioid use disorderEmergency departmentUse disordersConsensus recommendationsEmergency physiciansUntreated opioid use disorderOpioid use disorder treatmentEmergency Physicians (ACEP) recommendationsInitiation of treatmentInitiation of buprenorphineUse disorder treatmentAppropriate patientsED referralsPhysician recommendationTreatment initiationOngoing treatmentAmerican CollegeClinical experienceTreatment linkageExpert consensusDisorder treatmentDrug usePatientsBuprenorphineClinical researchImplementation facilitation to introduce and support emergency department-initiated buprenorphine for opioid use disorder in high need, low resource settings: protocol for multi-site implementation-feasibility study
McCormack RP, Rotrosen J, Gauthier P, D’Onofrio G, Fiellin DA, Marsch LA, Novo P, Liu D, Edelman EJ, Farkas S, Matthews AG, Mulatya C, Salazar D, Wolff J, Knight R, Goodman W, Hawk K. Implementation facilitation to introduce and support emergency department-initiated buprenorphine for opioid use disorder in high need, low resource settings: protocol for multi-site implementation-feasibility study. Addiction Science & Clinical Practice 2021, 16: 16. PMID: 33750454, PMCID: PMC7941881, DOI: 10.1186/s13722-021-00224-y.Peer-Reviewed Original ResearchMeSH KeywordsBuprenorphineEmergency Service, HospitalFeasibility StudiesHumansOpioid-Related DisordersReferral and ConsultationConceptsEmergency departmentLow-resource settingsImplementation facilitationUse disordersEmergency department-initiated buprenorphineResource settingsImplementation-effectiveness studyTreatment of OUDOpioid use disorderNon-emergent conditionsSubstance use disordersImplementation feasibility studyOUD interventionsED settingMedical recordsBuprenorphineClinical protocolsHigh needReferral programDisorder screeningDiscussionThis studyImplementation studyAdministrative dataReferralTreatment
2020
Emergency department patients with untreated opioid use disorder: A comparison of those seeking versus not seeking referral to substance use treatment
Coupet E, D’Onofrio G, Chawarski M, Edelman E, O’Connor P, Owens P, Martel S, Fiellin DA, Cowan E, Richardson L, Huntley K, Whiteside LK, Lyons MS, Rothman RE, Pantalon M, Hawk K. Emergency department patients with untreated opioid use disorder: A comparison of those seeking versus not seeking referral to substance use treatment. Drug And Alcohol Dependence 2020, 219: 108428. PMID: 33307301, PMCID: PMC8110210, DOI: 10.1016/j.drugalcdep.2020.108428.Peer-Reviewed Original ResearchConceptsUntreated opioid use disorderOpioid use disorderEmergency department patientsDepartment patientsUse disordersTenth Revision diagnosis codesSevere opioid use disorderConclusions Most patientsInjection-related infectionsRevision diagnosis codesHealth insurance statusSubstance use treatmentCross-sectional analysisOpioid withdrawalClinical characteristicsED visitsMost patientsTreatment initiationUrine toxicologyClinical correlatesDiagnosis codesInsurance statusUnivariate analysisBackground LittleInternational ClassificationBarriers 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
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 daysInterventionScreening, treatment initiation, and referral for substance use disorders
Bernstein SL, D’Onofrio G. Screening, treatment initiation, and referral for substance use disorders. Addiction Science & Clinical Practice 2017, 12: 18. PMID: 28780906, PMCID: PMC5545867, DOI: 10.1186/s13722-017-0083-z.Peer-Reviewed Original ResearchConceptsUnhealthy alcohol useTreatment initiationSubstance useAlcohol useEfficacy of SBIRTSelf-reported abstinenceInitiation of buprenorphineOpioid-dependent individualsEmergency department settingClinical care settingsSubstance use disordersIndex visitAcute careOutpatient settingPrimary careMedication managementDepartment settingLeading causeAdult smokersPreventable deathsUnhealthy drinkersCare settingsNegative studiesMost trialsUse disordersEmergency 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
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 servicesSuccessful Tobacco Dependence Treatment in Low-Income Emergency Department Patients: A Randomized Trial
Bernstein SL, D’Onofrio G, Rosner J, O’Malley S, Makuch R, Busch S, Pantalon MV, Toll B. Successful Tobacco Dependence Treatment in Low-Income Emergency Department Patients: A Randomized Trial. Annals Of Emergency Medicine 2015, 66: 140-147. PMID: 25920384, PMCID: PMC4819432, DOI: 10.1016/j.annemergmed.2015.03.030.Peer-Reviewed Original ResearchMeSH KeywordsAdultEmergency Service, HospitalFemaleHumansMaleMotivational InterviewingPovertyReferral and ConsultationTobacco Use Cessation DevicesTobacco Use DisorderTreatment OutcomeConceptsEmergency department patientsDepartment patientsUS EDsTobacco abstinence ratesGroup of smokersTobacco dependence treatmentMultivariable logistic modelingState Smokers' QuitlineLow incomeED smokersFaxed referralsQuitline referralQuitline useSecondary endpointsEligible subjectsPrimary outcomeIntervention armMedicaid insuranceNicotine patchNicotine replacementAbstinence ratesBooster callsIntervention subjectsControl armControl subjects
2013
A Promising Approach For Emergency Departments To Care For Patients With Substance Use And Behavioral Disorders
Bernstein SL, D’Onofrio G. A Promising Approach For Emergency Departments To Care For Patients With Substance Use And Behavioral Disorders. Health Affairs 2013, 32: 2122-2128. PMID: 24301395, DOI: 10.1377/hlthaff.2013.0664.Peer-Reviewed Original ResearchMeSH KeywordsCounselingEmergency Service, HospitalHealth Care ReformHumansMental DisordersProfessional-Patient RelationsReferral and ConsultationSubstance-Related DisordersUnited StatesConceptsEmergency departmentPrimary care systemSubstance useBehavioral disordersCare systemAcuity of illnessUS emergency departmentsHigh patient volumeNation's primary care systemMillions of patientsHealth care systemED patientsBody of evidenceBrief interventionPatientsPatient volumeSBIRTMotivational interviewingHealth of millionsDisordersRisky behaviorsCounseling techniquesReflective listeningDepartmentAcuity
2012
Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Alcohol and Other Drug Use among Adolescents: Evaluation of a Pediatric Residency Curriculum
Ryan SA, Martel S, Pantalon M, Martino S, Tetrault J, Thung SF, Bernstein SL, Auinger P, Green ML, Fiellin DA, O'Connor P, D'Onofrio G. Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Alcohol and Other Drug Use among Adolescents: Evaluation of a Pediatric Residency Curriculum. Substance Abuse 2012, 33: 251-260. PMID: 22738002, DOI: 10.1080/08897077.2011.640182.Peer-Reviewed Original ResearchConceptsBrief Negotiation InterviewBrief interventionPediatric residency programsDrug useKnowledge scorePost-training improvementPost-training knowledge scoresMain outcome measuresUrban teaching hospitalAdolescent medicine rotationPediatric residency curriculumMedicine/pediatric residentsResidency programsTraining satisfactionAdherence ScaleSBIRT curriculumTeaching hospitalOutcome measuresSignificant preTreatment curriculumClinical practiceClinical settingPediatric residentsResidents' knowledgeResidency curriculumDeveloping and Implementing a Multispecialty Graduate Medical Education Curriculum on Screening, Brief Intervention, and Referral to Treatment (SBIRT)
Tetrault JM, Green ML, Martino S, Thung SF, Degutis LC, Ryan SA, Martel S, Pantalon MV, Bernstein SL, O'Connor P, Fiellin DA, D'Onofrio G. Developing and Implementing a Multispecialty Graduate Medical Education Curriculum on Screening, Brief Intervention, and Referral to Treatment (SBIRT). Substance Abuse 2012, 33: 168-181. PMID: 22489589, DOI: 10.1080/08897077.2011.640220.Peer-Reviewed Original ResearchConceptsBrief interventionInternal medicineEmergency medicineMean satisfaction scoreMultiple residency programsStandardized patient sessionSBIRT curriculumClinical practicePediatric programsSBIRTSatisfaction scoresClinical encountersPatient sessionsPediatric residentsProject facultyTraining Web siteStandardized patientsReferralGynecologyObstetricsNumber of residentsResidency programsSatisfaction surveyGraduate medical education curriculumFaculty supervision
2010
Integrating Project ASSERT: A Screening, Intervention, and Referral to Treatment Program for Unhealthy Alcohol and Drug Use Into an Urban Emergency Department
D’Onofrio G, Degutis LC. Integrating Project ASSERT: A Screening, Intervention, and Referral to Treatment Program for Unhealthy Alcohol and Drug Use Into an Urban Emergency Department. Academic Emergency Medicine 2010, 17: 903-911. PMID: 20670330, DOI: 10.1111/j.1553-2712.2010.00824.x.Peer-Reviewed Original ResearchConceptsSpecialized treatment facilitiesBrief Negotiation InterviewHealth promotion advocatesDrug useTreatment programUnhealthy alcoholED patientsEmergency departmentPercent of patientsAdult ED patientsAlcohol/drug useUrban emergency departmentLow-risk drinkingGeneral Health QuestionnaireAlcoholism guidelinesReferral completionUrban EDFacilitated referralDirect admissionHealth QuestionnaireUnhealthy drinkingAlcohol abusePatientsSeverity of useAlcohol consumption
2009
Alcohol, Tobacco, and Other Drugs: Future Directions for Screening and Intervention in the Emergency Department
Cunningham RM, Bernstein SL, Walton M, Broderick K, Vaca FE, Woolard R, Bernstein E, Blow F, D’Onofrio G. Alcohol, Tobacco, and Other Drugs: Future Directions for Screening and Intervention in the Emergency Department. Academic Emergency Medicine 2009, 16: 1078-1088. PMID: 20053226, DOI: 10.1111/j.1553-2712.2009.00552.x.Peer-Reviewed Original ResearchConceptsEmergency departmentBrief interventionED patientsSubstance useLarge public health impactEffectiveness of screeningMultiple risk behaviorsAvailable community servicesMental health treatmentPublic health impactOptimal delivery methodEffective brief interventionsPractical screening instrumentAcademic Emergency Medicine consensus conferenceMedical care systemCost-effectiveness researchED settingPatient subgroupsInterventional studyTreatment referralPreventive servicesEffectiveness trialReferral strategiesTobacco useInjury prevention
1998
Patients with Alcohol Problems in the Emergency Department, Part 2: Intervention and Referral
D'Onofrio G, Bernstein E, Bernstein J, Woolard R, Brewer P, Craig S, Zink B, Force F. Patients with Alcohol Problems in the Emergency Department, Part 2: Intervention and Referral. Academic Emergency Medicine 1998, 5: 1210-1217. PMID: 9864135, DOI: 10.1111/j.1553-2712.1998.tb02697.x.Peer-Reviewed Original ResearchMeSH KeywordsAlcoholismEmergency Service, HospitalHumansMass ScreeningReferral and ConsultationUnited States