David Fiellin, MD
Cards
Appointments
Titles
Vice Chief of Faculty Affairs, General Internal Medicine; Director, Program in Addiction Medicine
Contact Info
Appointments
Titles
Vice Chief of Faculty Affairs, General Internal Medicine; Director, Program in Addiction Medicine
Contact Info
Appointments
Titles
Vice Chief of Faculty Affairs, General Internal Medicine; Director, Program in Addiction Medicine
Contact Info
About
Titles
Professor of Medicine (General Medicine), of Emergency Medicine, and of Public Health
Vice Chief of Faculty Affairs, General Internal Medicine; Director, Program in Addiction MedicineBiography
Dr. Fiellin has focused his scholarly work on the interface between primary care, general healthcare settings and addiction. He is an Internal Medicine physician Board Certified in Addiction Medicine. He serves as the inaugural Director of the Yale Program in Addiction Medicine. He conducts research on the transfer of treatments for opioid use disorder and alcohol use disorder from specialized settings to office-based, primary care, Emergency Department and HIV specialty settings. He has served as Principal Investigator on multiple NIH-funded research clinical trials, observational studies and implementation science. He has received awards from the American Association for the Treatment of Opioid Dependence, the American Society of Addiction Medicine, AMERSA and the the Hazelden-Betty Ford Foundation. He is on the Editorial Boards of the Journal of Addiction Medicine, Journal of Substance Abuse Treatment, and Substance Abuse and is Co-Editor of Alcohol, Other Drugs & Health: Current Evidence and the Principles of Addiction Medicine, 4th, 5th and 6th Editions. He has served on the Board of Directors of the College on Problems of Drug Dependence and as Co-Chair of the Substance Abuse Task Force for the Society of General Internal Medicine.
Appointments
General Internal Medicine
ProfessorPrimaryHealth Policy & Management
ProfessorSecondary
Other Departments & Organizations
- Addiction Medicine Fellowship Program
- Center for Brain & Mind Health
- Center for Interdisciplinary Research on AIDS
- General Internal Medicine
- Health Policy & Management
- Internal Medicine
- Investigative Medicine Program
- Program in Addiction Medicine
- Psychotherapy Development Center
- SBIRT Training in Yale Residency Programs
- Substance Abuse Research
- Veterans Aging Cohort Study (VACS)
- Yale Center for Health & Learning Games
- Yale Center for Implementation Science (YCIS)
- Yale Medicine
- Yale School of Public Health
- Yale Ventures
- Yale-Drug use, Addiction, and HIV prevention Research Scholars (DAHRS)
- Yale-New Haven Hospital Primary Care Center
- Yale-UPR Integrated HIV Basic and Clinical Sciences Initiative
Education & Training
- Postdoctoral Fellow
- Yale School of Medicine (1997)
- Chief Resident
- Yale-New Haven Hospital and West Haven Veterans Affairs Medical Center (1995)
- Intern, Junior, and Senior Resident
- Yale-New Haven Hospital (1994)
- MD
- Emory University (1991)
- Student Intern
- Emory University School of Medicine (1989)
- BA
- Earlham College (1983)
Research
Overview
Medical Subject Headings (MeSH)
ORCID
0000-0002-4006-010X
Research at a Glance
Yale Co-Authors
Publications Timeline
Research Interests
Jeanette Tetrault, MD, FACP, FASAM
Patrick G. O'Connor, MD, MPH, MACP
E. Jennifer Edelman, MD, MHS, BS
Gail D'Onofrio, MD, MS
Amy Justice, MD, PhD
Marek Chawarski, PhD
Opioid-Related Disorders
Buprenorphine
Alcoholism
Drug Overdose
Substance Abuse Detection
Substance Withdrawal Syndrome
Publications
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 ResearchAltmetricMeSH Keywords and ConceptsConceptsClinical 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 patientsBuprenorphine-naloxone vs. extended-release naltrexone for opioid use disorder in individuals with and without criminal legal involvement: A secondary analysis of the X:BOT randomized controlled trial
Balter D, Puglisi L, Dziura J, Fiellin D, Howell B. Buprenorphine-naloxone vs. extended-release naltrexone for opioid use disorder in individuals with and without criminal legal involvement: A secondary analysis of the X:BOT randomized controlled trial. Journal Of Substance Use And Addiction Treatment 2024, 164: 209438. PMID: 38857827, DOI: 10.1016/j.josat.2024.209438.Peer-Reviewed Original ResearchConceptsXR-NTXBuprenorphine-naloxoneOpioid use disorderCriminal legal involvementUse disorderHazard of overdoseLifetime incarcerationLegal involvementOpioid use disorder treatment outcomesPer-protocol analysisExtended-release naltrexoneMOUD effectivenessTreatment outcomesEffects of medicationHazard of relapseSecondary analysisIntention-to-treat analysisIntention-to-treatRandomized controlled trialsEffects of MOUDRelapseControlled trialsDisordersOpioidPotential effect modifiersPrescription Opioid Dose Change Prior to Fatal Opioid-Detected Overdose.
Kazemitabar M, Howell B, Becker W, Lin H, Grau L, Heimer R, D'Onofrio G, Hawk K, Fiellin D, Black A. Prescription Opioid Dose Change Prior to Fatal Opioid-Detected Overdose. Journal Of Studies On Alcohol And Drugs 2024 PMID: 38775307, DOI: 10.15288/jsad.24-00026.Peer-Reviewed Original ResearchConceptsPrescribed opioidsOpioid dose changesRapid dose increaseNon-HispanicOverdose deathsToxicological resultsNon-prescription opioidsBlack non-HispanicMorphine equivalentsOpioid therapyWhite non-HispanicDose changesDaily doseMean ageDispensed opioidsPrescription opioidsPrescribing patternsOpioidDose increaseOpioid overdose crisisIncreasing dosesStudy investigated patternsEffect of timeEffects of ageSecondary analysisStepped 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, DOI: 10.1177/29767342241245095.Peer-Reviewed Original ResearchConceptsTreatment-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 responseAccessibility of Opioid Treatment Programs Based on Conventional vs Perceived Travel Time Measures
Kim J, Lee J, Thornhill T, Dennett J, Lu H, Howell B, Grau L, Fiellin D, Heimer R, Gonsalves G. Accessibility of Opioid Treatment Programs Based on Conventional vs Perceived Travel Time Measures. JAMA Network Open 2024, 7: e240209. PMID: 38376839, PMCID: PMC10879949, DOI: 10.1001/jamanetworkopen.2024.0209.Peer-Reviewed Original ResearchAltmetricMeSH Keywords and ConceptsConceptsTransit travel timeAccessibility metricsTravel timeTravel componentsAccessibility scoresTransportation burdenTravel burdenOut-of-vehicleComponents of travelConventional accessibility measuresSpatial regression modelsTravel time measurementsPublic transitTransit schedulesAccessibility measuresDeparture timeTravel time analysisTrip durationTravelOperating hoursTime analysisCross-sectional studyOpioid use disorderPolicy recommendationsDecision-makingThe MATE Act: Progress for substance use education, but is checking a box enough?
Morford K, Tetrault J, Fiellin D. The MATE Act: Progress for substance use education, but is checking a box enough? Journal Of General Internal Medicine 2024, 39: 1496-1498. PMID: 38308156, PMCID: PMC11169132, DOI: 10.1007/s11606-024-08652-7.Peer-Reviewed Original ResearchAltmetricImplementing a pharmacist-integrated collaborative model of medication treatment for opioid use disorder in primary care: study design and methodological considerations
McLeman B, Gauthier P, Lester L, Homsted F, Gardner V, Moore S, Joudrey P, Saldana L, Cochran G, Harris J, Hefner K, Chongsi E, Kramer K, Vena A, Ottesen R, Gallant T, Boggis J, Rao D, Page M, Cox N, Iandiorio M, Ambaah E, Ghitza U, Fiellin D, Marsch L. Implementing a pharmacist-integrated collaborative model of medication treatment for opioid use disorder in primary care: study design and methodological considerations. Addiction Science & Clinical Practice 2024, 19: 18. PMID: 38500166, PMCID: PMC10949656, DOI: 10.1186/s13722-024-00452-y.Peer-Reviewed Original ResearchCitationsAltmetricMeSH Keywords and ConceptsConceptsStages of Implementation CompletionPrimary care sitesOpioid use disorderCare sitesConsolidated Framework for Implementation ResearchPatient electronic health record dataCollaborative model of careTreatment of opioid use disorderElectronic health record dataPrimary care teamsCollaborative care modelModels of careHealth record dataOpioid use disorder careUse disorderImplementation facilitatorsCare modelCare teamPrimary careImplementation researchDiscussionThis studyDispensed medicationsPharmacy techniciansInterpretation of findingsImplementation Completion
2023
Receipt of opioid use disorder treatments prior to fatal overdoses and comparison to no treatment in Connecticut, 2016–17
Heimer R, Black A, Lin H, Grau L, Fiellin D, Howell B, Hawk K, D'Onofrio G, Becker W. Receipt of opioid use disorder treatments prior to fatal overdoses and comparison to no treatment in Connecticut, 2016–17. Drug And Alcohol Dependence 2023, 254: 111040. PMID: 38043226, PMCID: PMC10872282, DOI: 10.1016/j.drugalcdep.2023.111040.Peer-Reviewed Original ResearchCitationsAltmetricMeSH Keywords and ConceptsConceptsNon-medication treatmentsRelative riskOpioid overdose deathsIncidence rateMOUD treatmentOverdose deathsOpioid use disorder treatmentResults Incidence ratesRetrospective cohort studyDifferent treatment modalitiesPopulation-level effortsUse disorder treatmentFatal opioid poisoningsCohort studyOpioid poisoningTreatment modalitiesConclusion ExposurePoisoning deathsFatal overdosesTreatment exposureDisorder treatmentDeathTreatmentMethadoneRiskComputational 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. Computational phenotypes for patients with opioid-related disorders presenting to the emergency department. PLOS ONE 2023, 18: e0291572. PMID: 37713393, PMCID: PMC10503758, DOI: 10.1371/journal.pone.0291572.Peer-Reviewed Original ResearchCitationsAltmetricMeSH Keywords and ConceptsConceptsSubstance use disordersUse disordersED visitsPatient presentationCarlson comorbidity indexOpioid-related diagnosesOpioid-related disordersOne-year survivalRate of medicationOpioid use disorderElectronic health record dataPatient-oriented outcomesYears of ageHealth record dataChronic substance use disordersED returnComorbidity indexAcute overdoseMedical managementClinical entityRetrospective studyEmergency departmentChronic conditionsInclusion criteriaUnique cohortAlcohol Use and Sustained Virologic Response to Hepatitis C Virus Direct-Acting Antiviral Therapy
Cartwright E, Pierret C, Minassian C, Esserman D, Tate J, Goetz M, Bhattacharya D, Fiellin D, Justice A, Re V, Rentsch C. Alcohol Use and Sustained Virologic Response to Hepatitis C Virus Direct-Acting Antiviral Therapy. JAMA Network Open 2023, 6: e2335715. PMID: 37751206, PMCID: PMC10523171, DOI: 10.1001/jamanetworkopen.2023.35715.Peer-Reviewed Original ResearchCitationsAltmetricMeSH Keywords and ConceptsConceptsSustained virologic responseAlcohol use disorderHigh-risk consumptionHistory of AUDLow-risk consumptionDAA therapyAlcohol use categoriesAlcohol useVirologic responseCohort studyAntiviral therapyOdds ratioChronic hepatitis C virus (HCV) infectionAlcohol Use Disorders Identification Test-Consumption (AUDIT-C) questionnaireHepatitis C virus infectionVeterans AffairsActing antiviral (DAA) therapyDAA treatment initiationHCV elimination goalsUndetectable HCV RNAC virus infectionFibrosis-4 scoreRetrospective cohort studyMultivariable logistic regressionTenth Revision diagnosis
Clinical Trials
Current Trials
Prazosin for Alcohol Use Disorder
HIC ID2000029805RoleSub InvestigatorPrimary Completion Date01/15/2026Recruiting ParticipantsGenderBothAge18 years - 70 yearsSupport Models for Addiction Related Treatment (SMART) Trial of Opioid Use Disorder in Pregnant Women
HIC ID2000027031RoleSub InvestigatorPrimary Completion Date04/28/2023Recruiting ParticipantsGenderFemaleAge18+ years
Academic Achievements and Community Involvement
honor Elected Member
National AwardAssociation of American PhysiciansDetails04/06/2024United Stateshonor James H. Tharp Award
National AwardAmerican Society of Addiction MedicineDetails10/06/2022United Stateshonor Dan Anderson Research Award
National AwardHazelden-Betty Ford FoundationDetails05/06/2016United Stateshonor W. Anderson Spickard Jr. Excellence in Mentorship Award
National AwardAssociation for Medical Education and Research in Substance Abuse (AMERSA)Details11/07/2014United Stateshonor Elected Member, Board of Directors
National AwardCollege on Problems of Drug Dependence (CPDD)Details01/01/2011, 01/01/2010, 01/01/2009, 01/01/2008United States
Clinical Care
Overview
David Fiellin, MD, is a primary care physician specializing in addiction medicine at Yale Medicine. He received his medical education at Emory University before arriving at Yale.
Dr. Fiellin believes strongly in providing nonjudgmental and empathetic support for his patients. This is particularly important for Dr. Fiellin’s patients with substance use disorders because he wants them to know that he doesn’t define them by their diagnosis.
One of the most rewarding aspects of treating patients with addictive disorders is seeing how quickly they improve in a short amount of time, says Dr. Fiellin. “There are few things we do in primary care where we see such a rapid evolution and such positive results,” he says.
After conditions improve, Dr. Fiellin maintains relationships with his patients for years. “I have seen them often for five or ten years and we get to the point where their addictive disorder is no longer an issue and spend most of our time addressing other medical conditions or simply making sure they are up to date on their health maintenance,” he says.
In addition to treating patients with and without addiction, Dr. Fiellin conducts research on treatment of addiction in general medical settings. He is also a professor of medicine (general medicine, emergency medicine, and public health) at the Yale School of Medicine.
Clinical Specialties
Board Certifications
Addiction Medicine
- Certification Organization
- AB of Preventive Medicine
- Original Certification Date
- 2019
Yale Medicine News
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News
- July 08, 2024Source: Yale News
Seven-day Buprenorphine Is Safe for Those With Minimal Opioid Withdrawal
- May 23, 2024
Sandy Alfano, Expert in Pharmacy and Ethics of Human Subjects Research, Retires
- April 30, 2024
Amid Opioid Overdose Crisis, Yale Program in Addiction Medicine Advises State on Drug Company Settlement Spending
- March 19, 2024Source: Yale Medicine
Why Is Fentanyl Driving Overdose Deaths?
Get In Touch
Contacts
Locations
E.S. Harkness Memorial Hall, Building A
Academic Office
367 Cedar Street, Ste Suite 406A
New Haven, CT 06510
Patient Care Locations
Are You a Patient? View this doctor's clinical profile on the Yale Medicine website for information about the services we offer and making an appointment.
Events
Everyone Kelly Dunn, PhD, MBAThis session will be held virtually via Zoom. A registration link is forthcoming.
Everyone Jacob Tebes, PhD, BSThis session will be held virtually via Zoom. A registration link is forthcoming.
Everyone Chyrell Bellamy, MSW, PhDThis session will be held virtually via Zoom. A registration link is forthcoming.
Everyone Kaveh Khoshnood, PhD, MPH - Jenna Butner, MD, MPH, FASAM, AAHIVSThis session will be held virtually via Zoom. A registration link is forthcoming.