2020
Global opioid agonist treatment: a review of clinical practices by country
Jin H, Marshall B, Degenhardt L, Strang J, Hickman M, Fiellin D, Ali R, Bruneau J, Larney S. Global opioid agonist treatment: a review of clinical practices by country. Addiction 2020, 115: 2243-2254. PMID: 32289189, PMCID: PMC7554123, DOI: 10.1111/add.15087.Peer-Reviewed Original ResearchConceptsOpioid agonist treatmentOpioid use disorderUrine drug screeningRoutine clinical practiceClinical practiceUnsupervised dosingUse disordersObservational cohort studySignificant clinical benefitSearch of PubMedGrey literature databasesCohort studyMedian dosesOpioid dependenceAgonist treatmentClinical benefitPrescribing practicesEligible studiesOAT programsScreening practicesEligibility criteriaBuprenorphineMethadoneTreatment practicesLiterature databases
2015
A randomized clinical trial of emergency department initiated treatment for opioid dependence: Two and six month outcomes
D’Onofrio G, O’Connor P, Pantalon M, Chawarski M, Busch S, Owens P, Bernstein S, Fiellin D. A randomized clinical trial of emergency department initiated treatment for opioid dependence: Two and six month outcomes. Drug And Alcohol Dependence 2015, 156: e53. DOI: 10.1016/j.drugalcdep.2015.07.1062.Peer-Reviewed Original ResearchHealth service use in a randomized clinical trial comparing three methods of emergency department interventions for opioid dependence
Busch S, Hawk K, Fiellin D, O’Connor P, Chawarski M, Owens P, Pantalon M, Bernstein S, D’Onofrio G. Health service use in a randomized clinical trial comparing three methods of emergency department interventions for opioid dependence. Drug And Alcohol Dependence 2015, 156: e32. DOI: 10.1016/j.drugalcdep.2015.07.1005.Peer-Reviewed Original ResearchEmergency 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
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 differencesCounselingCurrent and Potential Pharmacological Treatment Options for Maintenance Therapy in Opioid-Dependent Individuals
Tetrault JM, Fiellin DA. Current and Potential Pharmacological Treatment Options for Maintenance Therapy in Opioid-Dependent Individuals. Drugs 2012, 72: 217-228. PMID: 22235870, PMCID: PMC3701303, DOI: 10.2165/11597520-000000000-00000.Commentaries, Editorials and LettersConceptsOpioid dependenceMaintenance treatmentDrug useHepatitis C virus transmissionOpioid agonist maintenanceOpioid agonist medicationsPotential pharmacological treatment optionsC virus transmissionPharmacological treatment optionsInjection drug useOpioid-dependent individualsDirect healthcare costsIllicit opioid usersHIV risk behaviorsGlobal economic burdenIllicit drug useTerms of HIVSustained-release formulationMaintenance therapyAgonist medicationsOpioid antagonistAgonist maintenanceTreatment optionsOpioid usersImproved outcomes
2011
Hepatic Safety and Antiretroviral Effectiveness in HIV‐Infected Patients Receiving Naltrexone
Tetrault JM, Tate JP, McGinnis KA, Goulet JL, Sullivan LE, Bryant K, Justice AC, Fiellin DA, Team F. Hepatic Safety and Antiretroviral Effectiveness in HIV‐Infected Patients Receiving Naltrexone. Alcohol Clinical And Experimental Research 2011, 36: 318-324. PMID: 21797892, PMCID: PMC3221963, DOI: 10.1111/j.1530-0277.2011.01601.x.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAlanine TransaminaseAlcoholismAntiretroviral Therapy, Highly ActiveAspartate AminotransferasesCD4 Lymphocyte CountChemical and Drug Induced Liver InjuryCohort StudiesDatabases, FactualDrug InteractionsDrug-Related Side Effects and Adverse ReactionsFemaleHIV InfectionsHumansLiverLiver Function TestsMaleMiddle AgedNaltrexoneNarcotic AntagonistsOpioid-Related DisordersRNA, ViralVeteransConceptsNaltrexone prescriptionAlanine aminotransferaseOpioid dependenceVeterans Aging Cohort Study Virtual CohortAspartate aminotransferaseImpact of naltrexoneSignificant alanine aminotransferaseLiver enzyme elevationMean CD4 countHIV-infected individualsAST changesHepatic safetyHIV biomarkersOral naltrexoneCD4 countHIV RNAMedian durationEnzyme elevationMedian ageAST levelsNaltrexone useHepatic enzymesAntiretroviral effectivenessHIVPatientsDrug 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
Integrating Buprenorphine Treatment into Office-based Practice: a Qualitative Study
Barry DT, Irwin KS, Jones ES, Becker WC, Tetrault JM, Sullivan LE, Hansen H, O’Connor P, Schottenfeld RS, Fiellin DA. Integrating Buprenorphine Treatment into Office-based Practice: a Qualitative Study. Journal Of General Internal Medicine 2008, 24: 218-225. PMID: 19089500, PMCID: PMC2628993, DOI: 10.1007/s11606-008-0881-9.Peer-Reviewed Original ResearchConceptsBuprenorphine maintenance treatmentOffice-based practicePhysicians' perceptionsPatient-related barriersOffice-based physiciansLack of remunerationBuprenorphine treatmentOpioid dependenceMaintenance treatmentPhysician barriersMethadone maintenancePrimary careResultsEighty percentLow prevalenceClinical practiceMedical providersMultidisciplinary teamPatient careInternal medicinePhysician facilitatorsInfectious diseasesAddiction medicinePhysiciansQualitative software programDesignQualitative studyNarrative review: buprenorphine for opioid-dependent patients in office practice.
Sullivan LE, Fiellin DA. Narrative review: buprenorphine for opioid-dependent patients in office practice. Annals Of Internal Medicine 2008, 148: 662-70. PMID: 18458279, PMCID: PMC3694223, DOI: 10.7326/0003-4819-148-9-200805060-00006.Peer-Reviewed Original ResearchConceptsOpioid dependencePrescription opioidsPartial opioid agonistOpioid-dependent patientsOpioid-dependent personsUse of buprenorphineOffice-based treatmentBuprenorphine-naloxone combinationClinical presentationIllicit opioidsOpioid agonistsPatient populationOpioidsBuprenorphineOffice practicePatientsTreatmentRecent dataPhysiciansAbuseAgonistsPrevalenceHeroin
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 dependenceTraining HIV Physicians to Prescribe Buprenorphine for Opioid Dependence
Sullivan LE, Tetrault J, Bangalore D, Fiellin DA. Training HIV Physicians to Prescribe Buprenorphine for Opioid Dependence. Substance Use & Addiction Journal 2006, 27: 13-18. PMID: 17135176, DOI: 10.1300/j465v27n03_03.Peer-Reviewed Original ResearchCounseling 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
2005
Faculty Development in Small-Group Teaching Skills Associated with a Training Course on Office-Based Treatment of Opioid Dependence
Wong JG, Holmboe ES, Becker W, Fiellin D, Jara G, Martin J. Faculty Development in Small-Group Teaching Skills Associated with a Training Course on Office-Based Treatment of Opioid Dependence. Substance Use & Addiction Journal 2005, 25: 35-40. PMID: 16172091, DOI: 10.1300/j465v25n04_05.Peer-Reviewed Original ResearchConceptsOpioid dependenceDrug Addiction Treatment ActOffice-Based TreatmentOpioid-dependent patientsOpioid treatment programsTreatment programQualified physiciansScore responsesSchedule IIITreatment ActDATADescriptive questionnairePhysiciansTraining sessionsTreatmentPatient case discussionsSignificant improvementFacilitatorsSessionsMedicationsBuprenorphinePatients
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
2002
New federal initiatives to enhance the medical treatment of opioid dependence.
Fiellin DA, O'Connor PG. New federal initiatives to enhance the medical treatment of opioid dependence. Annals Of Internal Medicine 2002, 137: 688-92. PMID: 12379070, DOI: 10.7326/0003-4819-137-8-200210150-00014.Peer-Reviewed Original ResearchConceptsOpioid dependenceMedical treatmentOpioid agonist medicationsRole of internistsAgonist medicationsPharmacologic treatmentMaintenance treatmentNew medicationsMedical conditionsOffice settingSubstantial healthMedicationsPatientsTreatmentInternistsRecent federal initiativesFederal initiativesNew federal initiativesComplicationsCare
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