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 patientsStepped Care for Patients to Optimize Whole Recovery (SC-POWR): An Effectiveness Trial Evaluating a Stepped Care Model for Individuals With Opioid Use Disorder and Chronic Pain.
Rossi R, Cutter C, Beitel M, Covelli M, Fiellin D, Kerns R, Vassilieva S, Olabisi D, Barry D. Stepped Care for Patients to Optimize Whole Recovery (SC-POWR): An Effectiveness Trial Evaluating a Stepped Care Model for Individuals With Opioid Use Disorder and Chronic Pain. Substance Use & Addiction Journal 2024, 29767342241245095. PMID: 38606900, PMCID: PMC11470109, DOI: 10.1177/29767342241245095.Peer-Reviewed Original ResearchTreatment-as-usualOpioid use disorderChronic painCognitive behavioral therapyStepped careNonmedical opioid useEffectiveness trialOpioid useAlcohol useSession of exerciseStepped care modelWeekly group sessionsPain-related outcomesStress reductionDecreased pain intensityUse disorderNational Institutes of HealthOpioid use disorder treatmentCare modelInstitutes of HealthAssociated with higher levelsPain intensityPilot study of patientsPain improvementDurability of treatment response
2023
Implementing Programs to Initiate Buprenorphine for Opioid Use Disorder Treatment in High-Need, Low-Resource Emergency Departments: A Nonrandomized Controlled Trial
McCormack R, Rotrosen J, Gauthier P, D'Onofrio G, Fiellin D, Marsch L, Novo P, Liu D, Edelman E, Farkas S, Matthews A, Mulatya C, Salazar D, Wolff J, Knight R, Goodman W, Williams J, Hawk K. Implementing Programs to Initiate Buprenorphine for Opioid Use Disorder Treatment in High-Need, Low-Resource Emergency Departments: A Nonrandomized Controlled Trial. Annals Of Emergency Medicine 2023, 82: 272-287. PMID: 37140493, PMCID: PMC10524047, DOI: 10.1016/j.annemergmed.2023.02.013.Peer-Reviewed Original ResearchConceptsBuprenorphine programImplementation facilitationEmergency departmentMedical recordsOpioid use disorder treatmentMain secondary outcomesMore treatment visitsPrimary implementation outcomeNonrandomized Controlled TrialPatient-level outcomesPatients' medical recordsUse disorder treatmentTreatment 30 daysBuprenorphine administrationOpioid useSecondary outcomesControlled TrialsTreatment visitsED settingUnique patientsClinicians' readinessEligibility criteriaClinical protocolsDisorder treatmentOverdose events
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 ResearchConceptsOpioid-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
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
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
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
Treating Pain in Patients Receiving Methadone Maintenance for Opioid Dependence
Alford D, Barry D, Fiellin D. Treating Pain in Patients Receiving Methadone Maintenance for Opioid Dependence. 2013, 31-37. DOI: 10.1007/978-1-4614-6974-2_3.ChaptersPain complaintsOpioid dependenceMethadone maintenanceChronic painOpioid-dependent patientsIllicit opioid useTreatment of painOpioid usePrescription opioidsMaintenance treatmentPain perceptionClinical challengePainPsychiatric disordersPatientsMethadonePhysiologic toleranceEffective coping skillsComplaintsOpioidsMedicationsTreatmentCoping skillsLoss of controlAddiction
2011
Drug 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 populationHIVAdding buprenorphine implants to counselling reduces opioid use over 6 months in opioid-dependent adults
Tetrault JM, Fiellin DA. Adding buprenorphine implants to counselling reduces opioid use over 6 months in opioid-dependent adults. BMJ Mental Health 2011, 14: 30. PMID: 21266627, DOI: 10.1136/ebmh.14.1.30.Commentaries, Editorials and Letters
2007
Non-medical use, abuse and dependence on prescription opioids among U.S. adults: Psychiatric, medical and substance use correlates
Becker WC, Sullivan LE, Tetrault JM, Desai RA, Fiellin DA. Non-medical use, abuse and dependence on prescription opioids among U.S. adults: Psychiatric, medical and substance use correlates. Drug And Alcohol Dependence 2007, 94: 38-47. PMID: 18063321, DOI: 10.1016/j.drugalcdep.2007.09.018.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgoraphobiaAlcohol DrinkingChildChronic DiseaseCross-Sectional StudiesDiagnostic and Statistical Manual of Mental DisordersDrug PrescriptionsFactor Analysis, StatisticalFemaleHealth StatusHumansMaleOpioid-Related DisordersPainPanic DisorderPhobic DisordersPrevalenceSurveys and QuestionnairesUnited StatesConceptsAbuse/dependenceNon-medical usePast-year non-medical usePrescription opioidsLower self-rated health statusNon-medical prescription opioid useAgoraphobic symptomsSelf-rated health statusPrescription opioid useSubstance use correlatesCross-sectional surveyRespondents 18 yearsOpioid useMultivariable analysisPrescription medicationsMultivariable associationsOpioidsHealth statusSubstance misuseDrug useMeet criteriaU.S. adultsPoor healthSubstance useUse correlates
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 dependenceCounseling plus Buprenorphine–Naloxone Maintenance Therapy for Opioid Dependence
Fiellin DA, Pantalon MV, Chawarski MC, Moore BA, Sullivan LE, O'Connor PG, Schottenfeld RS. Counseling plus Buprenorphine–Naloxone Maintenance Therapy for Opioid Dependence. New England Journal Of Medicine 2006, 355: 365-374. PMID: 16870915, DOI: 10.1056/nejmoa055255.Peer-Reviewed Original ResearchConceptsStandard medical managementBuprenorphine-naloxone treatmentIllicit opioid useMedical managementOpioid dependenceWeekly medicationOpioid useIllicit opioidsWeekly counselingPrimary careUrine specimensConsecutive weeksProportion of patientsImproved treatment outcomesMaintenance therapyPrimary outcomeClinical trialsMedication distributionSimilar efficacyTreatment outcomesMedicationsSelf-reported frequencyPatientsFrequency of attendanceMean percentage