2021
The design and conduct of a randomized clinical trial comparing emergency department initiation of sublingual versus a 7-day extended-release injection formulation of buprenorphine for opioid use disorder: Project ED Innovation
D'Onofrio G, Hawk KF, Herring AA, Perrone J, Cowan E, McCormack RP, Dziura J, Taylor RA, Coupet E, Edelman EJ, Pantalon MV, Owens PH, Martel SH, O'Connor PG, Van Veldhuisen P, DeVogel N, Huntley K, Murphy SM, Lofwall MR, Walsh SL, Fiellin DA. The design and conduct of a randomized clinical trial comparing emergency department initiation of sublingual versus a 7-day extended-release injection formulation of buprenorphine for opioid use disorder: Project ED Innovation. Contemporary Clinical Trials 2021, 104: 106359. PMID: 33737199, PMCID: PMC9153252, DOI: 10.1016/j.cct.2021.106359.Peer-Reviewed Original ResearchConceptsOpioid use disorderRandomized clinical trialsPrimary outcomeFormal addiction treatmentOpioid withdrawalClinical trialsAncillary studiesUse disordersSelf-reported opioid useAddiction treatmentEmergency department initiationIncremental cost-effectiveness ratioReceipt of medicationEmergency department studyHealth service utilizationCost-effectiveness ratioOpioid useSecondary outcomesService utilizationTreatment accessEligibility criteriaImplementation facilitationBuprenorphineOverdose eventsDepartment study
2020
Validating Self‐Reported Unhealthy Alcohol Use With Phosphatidylethanol (PEth) Among Patients With HIV
Eyawo O, Deng Y, Dziura J, Justice AC, McGinnis K, Tate JP, Rodriguez‐Barradas M, Hansen NB, Maisto SA, Marconi VC, O’Connor P, Bryant K, Fiellin DA, Edelman EJ. Validating Self‐Reported Unhealthy Alcohol Use With Phosphatidylethanol (PEth) Among Patients With HIV. Alcohol Clinical And Experimental Research 2020, 44: 2053-2063. PMID: 33460225, PMCID: PMC8856627, DOI: 10.1111/acer.14435.Peer-Reviewed Original ResearchConceptsUnhealthy alcohol useSignificant alcohol useHeavy drinking daysAlcohol use disorderTimeline FollowbackAlcohol useSelf-reported alcohol useNumber of drinksClinical trialsRisk drinkingUse disordersDrinking daysBiomarker-based evidenceSample of PWHDrinks/dayMean numberSelf-reported alcohol consumptionMagnitude of associationBlood spot samplesLiver diseasePEth levelsTLFB interviewAlcohol consumptionLogistic regressionPatients
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
A Randomized Trial of Cognitive Behavioral Therapy in Primary Care-based Buprenorphine
Fiellin DA, Barry DT, Sullivan LE, Cutter CJ, Moore BA, O'Connor PG, Schottenfeld RS. A Randomized Trial of Cognitive Behavioral Therapy in Primary Care-based Buprenorphine. The American Journal Of Medicine 2013, 126: 74.e11-74.e17. PMID: 23260506, PMCID: PMC3621718, DOI: 10.1016/j.amjmed.2012.07.005.Peer-Reviewed Original ResearchConceptsCognitive behavioral therapyPhysician managementBehavioral therapyOpioid useOpioid dependencePrimary careSelf-reported frequencyBuprenorphine/naloxone treatmentConsecutive weeksOpioid-dependent patientsIllicit opioid usePrimary care clinicsPrimary outcome measureWeeks of treatmentNaloxone treatmentOpioid abstinenceBuprenorphine/Care clinicsIllicit opioidsRandomized trialsUrine toxicologyClinical trialsStudy completionOutcome measuresCocaine use
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 differencesCounseling
2008
Brief Intervention for Hazardous and Harmful Drinkers in the Emergency Department
D'Onofrio G, Pantalon MV, Degutis LC, Fiellin DA, Busch SH, Chawarski MC, Owens PH, O'Connor PG. Brief Intervention for Hazardous and Harmful Drinkers in the Emergency Department. Annals Of Emergency Medicine 2008, 51: 742-750.e2. PMID: 18436340, PMCID: PMC2819119, DOI: 10.1016/j.annemergmed.2007.11.028.Peer-Reviewed Original ResearchConceptsBrief Negotiation InterviewBinge-drinking episodesHarmful drinkersBrief interventionDischarge instructionsPatients 18 yearsRandomized clinical trialsEmergency department settingMean numberInterview groupAlcoholism guidelinesBaseline characteristicsUrban EDAlcohol ingestionED patientsEmergency departmentClinical trialsDepartment settingAlcohol abuseAlcohol consumptionEmergency practitionersTreatment servicesHarmful drinkingMonthsDrinkers
2007
Utility of sweat patch testing for drug use monitoring in outpatient treatment for opiate dependence
Chawarski MC, Fiellin DA, O'Connor PG, Bernard M, Schottenfeld RS. Utility of sweat patch testing for drug use monitoring in outpatient treatment for opiate dependence. Journal Of Substance Use And Addiction Treatment 2007, 33: 411-415. PMID: 17512157, PMCID: PMC3632440, DOI: 10.1016/j.jsat.2007.03.004.Peer-Reviewed Original ResearchConceptsOutpatient clinical settingPatch testingDrug useClinical settingSweat testingEfficacy of buprenorphinePrimary care settingRandomized clinical trialsSelf-reported drug usePositive urine resultsSweat test resultsDrug use monitoringUrine toxicologyOpioid dependenceOutpatient treatmentUrine testingClinical trialsCare settingsOpiate useOpiate dependenceUrine resultsStudy participantsLevel of agreementToxicology testsLow acceptabilitySystematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addiction.
Martell BA, O'Connor PG, Kerns RD, Becker WC, Morales KH, Kosten TR, Fiellin DA. Systematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addiction. Annals Of Internal Medicine 2007, 146: 116-27. PMID: 17227935, DOI: 10.7326/0003-4819-146-2-200701160-00006.Peer-Reviewed Original ResearchConceptsChronic back painSubstance use disordersEfficacy of opioidsBack painMedication-taking behaviorUse disordersOpioid treatmentOpioid medicationsStudy qualityShort-term pain reliefCurrent substance use disorderCochrane Central RegisterLifetime substance use disorderControlled Clinical TrialsLong-term efficacyPoor study qualityEnglish-language studiesTransdermal opioidsOpioid prescribingPain reliefCentral RegisterDifferent opioidsReduced painClinical trialsNonsignificant reduction
2006
Counseling 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
Buprenorphine tablet versus liquid: A clinical trial comparing plasma levels, efficacy, and symptoms
Chawarski MC, Moody DE, Pakes J, O'Connor PG, Schottenfeld RS. Buprenorphine tablet versus liquid: A clinical trial comparing plasma levels, efficacy, and symptoms. Journal Of Substance Use And Addiction Treatment 2005, 29: 307-312. PMID: 16311183, DOI: 10.1016/j.jsat.2005.08.011.Peer-Reviewed Original ResearchConceptsTrough concentrationsPlasma concentrationsOpiate-dependent volunteersIllicit opioid usePeak plasma concentrationBuprenorphine doseBuprenorphine tabletsOpioid useWithdrawal symptomsBuprenorphine levelsPlasma levelsTablet doseClinical trialsLarge intersubjectLiquid formulationStudy participantsIntrasubject variabilityPlasma samplesPeak concentrationTablet formulationLiquid dosesDays of maintenanceSymptomsDoseConcentration curveThe practice of office-based buprenorphine treatment of opioid dependence: is it associated with new patients entering into treatment?
Sullivan LE, Chawarski M, O’Connor P, Schottenfeld RS, Fiellin DA. The practice of office-based buprenorphine treatment of opioid dependence: is it associated with new patients entering into treatment? Drug And Alcohol Dependence 2005, 79: 113-116. PMID: 15943950, DOI: 10.1016/j.drugalcdep.2004.12.008.Peer-Reviewed Original ResearchConceptsPrimary care clinicsInjection drug useOpioid treatment programsMethadone treatmentOpioid dependenceClinical trialsTreatment outcomesHistory of IDUOffice-based buprenorphine treatmentOffice-based buprenorphineBuprenorphine/naloxoneOffice-based treatmentLower ratesHepatitis CClinical characteristicsBuprenorphine treatmentCare clinicsMethadone maintenancePCC patientsNew patientsTreatment retentionPatientsDrug useTreatment programBuprenorphine
2002
Treatment of heroin dependence with buprenorphine in primary care
Fiellin DA, Pantalon MV, Pakes JP, O'Connor PG, Chawarski M, Schottenfeld RS. Treatment of heroin dependence with buprenorphine in primary care. The American Journal Of Drug And Alcohol Abuse 2002, 28: 231-241. PMID: 12014814, DOI: 10.1081/ada-120002972.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, SublingualAdultAmbulatory CareBuprenorphineCombined Modality TherapyConnecticutCounselingDose-Response Relationship, DrugDrug Administration ScheduleFeasibility StudiesFemaleHeroin DependenceHumansMaleMiddle AgedPrimary Health CareSocial SupportTreatment OutcomeUrban PopulationConceptsUrine toxicologyHeroin dependencePrimary careBrief counselingUrine toxicology testsHeroin-dependent patientsPrimary care settingPrimary care centersUrban medical centerBuprenorphine maintenancePrimary outcomeDependent patientsCare centerClinical trialsCare settingsMedical CenterEffective treatmentTreatment retentionBuprenorphinePatientsPotential efficacyToxicology testsMaintenance phaseWeeksCare
2000
New therapies for alcohol problems: application to primary care
Fiellin D, Reid M, O’Connor P. New therapies for alcohol problems: application to primary care. The American Journal Of Medicine 2000, 108: 227-237. PMID: 10723977, DOI: 10.1016/s0002-9343(99)00448-9.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsAlcohol consumptionNew therapiesAlcohol dependenceAlcohol problemsPrimary care physiciansRecent clinical trialsNew treatment strategiesTwelve-step facilitationMotivational enhancement therapyPharmacologic therapyCare physiciansLongitudinal carePrimary careClinical trialsTreatment strategiesDrinking reductionsPatientsPsychosocial counselingBrief interventionHarmful drinkingTherapyPhysician effortEnhancement therapyCognitive behavioralCurrent review
1997
Three methods of opioid detoxification in a primary care setting. A randomized trial.
O'Connor PG, Carroll KM, Shi JM, Schottenfeld RS, Kosten TR, Rounsaville BJ. Three methods of opioid detoxification in a primary care setting. A randomized trial. Annals Of Internal Medicine 1997, 127: 526-30. PMID: 9313020, DOI: 10.7326/0003-4819-127-7-199710010-00004.Peer-Reviewed Original ResearchConceptsPrimary care settingOpioid detoxificationCare settingsBuprenorphine groupWithdrawal symptomsDouble-blind clinical trialOpioid-dependent patientsHeroin-dependent patientsPrimary care clinicsWithdrawal symptom scoresSevere withdrawal symptomsDrug treatment programsSubstance abuse treatmentNaltrexone groupCare clinicsSymptom scoresPharmacologic protocolClinical trialsTreatment protocolClonidineTreatment retentionBuprenorphineNaltrexoneTreatment programAbuse treatment
1995
Primary care-based ambulatory opioid detoxification
O’Connor P, Waugh M, Carroll K, Rounsaville B, Diagkogiannis I, Schottenfeld R. Primary care-based ambulatory opioid detoxification. Journal Of General Internal Medicine 1995, 10: 255-260. PMID: 7616334, DOI: 10.1007/bf02599882.Peer-Reviewed Original ResearchConceptsInjection drug usersClonidine/naltrexoneOpioid detoxificationDrug treatmentProspective nonrandomized clinical trialMedical clinicsPrimary care medical clinicFirst heroin useOngoing drug treatmentNonrandomized clinical trialPrimary care providersWithdrawal symptom scoresSubstance abuse treatmentMuscle crampsSymptom scoresClinical trialsClonidineNurse practitionersCare providersDetoxified patientsHeroin useTreatment groupsNaltrexoneDrug usersMedical units
1992
Peptide T Treatment of Cognitive Impairment in HIV‐Positive Intravenous Drug Users
Rosen M, Bridge T, O'Malley S, Pearsall H, Martini B, O'Connor P, Brett‐Smith H, Thomas H, Van Dyck C, Woods S, Kosten T. Peptide T Treatment of Cognitive Impairment in HIV‐Positive Intravenous Drug Users. American Journal On Addictions 1992, 1: 332-338. DOI: 10.1111/j.1521-0391.1992.tb00359.x.Peer-Reviewed Original ResearchHIV-positive intravenous drug usersDouble-blind crossover studyPeptide T treatmentHIV-positive patientsPeptide TOpen clinical trialIntravenous drug usersVasoactive intestinal peptideAIDS dementiaCrossover studyNeuropsychological improvementAZT treatmentIntestinal peptideClinical trialsDrug usersCognitive impairmentPatientsNeuropsychological functionCognitive functionT treatmentPlaceboThree timesWeeksPotential utilityTreatment
1991
Social and clinical features as predictors of outcome in outpatient alcohol withdrawal
O’Connor P, Gottlieb L, Kraus M, Segal S, Horwitz R. Social and clinical features as predictors of outcome in outpatient alcohol withdrawal. Journal Of General Internal Medicine 1991, 6: 312-316. PMID: 1890501, DOI: 10.1007/bf02597427.Peer-Reviewed Original ResearchConceptsWithdrawal symptom severityAlcohol withdrawal syndromeTreatment failureSymptom severityOutpatient managementAlcohol withdrawalClinical featuresWithdrawal syndromeOutpatient alcohol treatment programProspective observational cohort studyHigh-risk patientsObservational cohort studyTreatment failure rateMedical insurance statusPredictors of outcomeAlcohol treatment programsLow symptom groupCohort studyDrug therapyInsurance statusClinical trialsPatient featuresSociodemographic featuresPatientsTreatment program