2023
Implementation Facilitation to Promote Emergency Department–Initiated Buprenorphine for Opioid Use Disorder
D’Onofrio G, Edelman E, Hawk K, Chawarski M, Pantalon M, Owens P, Martel S, Rothman R, Saheed M, Schwartz R, Cowan E, Richardson L, Salsitz E, Lyons M, Freiermuth C, Wilder C, Whiteside L, Tsui J, Klein J, Coupet E, O’Connor P, Matthews A, Murphy S, Huntley K, Fiellin D. Implementation Facilitation to Promote Emergency Department–Initiated Buprenorphine for Opioid Use Disorder. JAMA Network Open 2023, 6: e235439. PMID: 37017967, PMCID: PMC10077107, DOI: 10.1001/jamanetworkopen.2023.5439.Peer-Reviewed Original ResearchConceptsOpioid use disorderRate of patientsOUD treatmentImplementation facilitationED visitsObservational cohortED cliniciansX-waiverUse disordersEmergency Department-Initiated BuprenorphineUntreated opioid use disorderEvaluation periodHybrid type 3Provision of buprenorphineBaseline periodGrand roundsRates of EDPrimary outcomeWhite patientsAcademic EDBlack patientsED patientsEmergency departmentCommunity cliniciansMAIN OUTCOME
2022
The Impact of Access to Addiction Specialist on Attitudes, Beliefs and Hospital-Based Opioid Use Disorder Related Care: A Survey of Hospitalist Physicians
Calcaterra SL, Binswanger IA, Edelman EJ, McNair BK, Wakeman SE, O'Connor P. The Impact of Access to Addiction Specialist on Attitudes, Beliefs and Hospital-Based Opioid Use Disorder Related Care: A Survey of Hospitalist Physicians. Substance Abuse 2022, 43: 143-151. PMID: 32267807, PMCID: PMC7541600, DOI: 10.1080/08897077.2020.1748169.Peer-Reviewed Original ResearchConceptsOpioid use disorderAddiction specialistsLocal treatment resourcesLife-saving treatmentBuprenorphine initiationMultivariable analysisOUD careScreening practicesHospitalist physiciansUse disordersClinical practicePatientsRelated careTreatment resourcesHospitalistsHarm reductionCareTreatmentUnited StatesSpecialistsOnline surveyHospitalizationBuprenorphineComplicationsPrescribing
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 servicesOverdose Education and Naloxone Rescue Kits for Family Members of Individuals who Use Opioids: Characteristics, Motivations, and Naloxone Use
Bagley SM, Peterson J, Cheng DM, Jose C, Quinn E, O'Connor P, Walley AY. Overdose Education and Naloxone Rescue Kits for Family Members of Individuals who Use Opioids: Characteristics, Motivations, and Naloxone Use. Substance Abuse 2015, 36: 149-154. PMID: 25564892, PMCID: PMC4809347, DOI: 10.1080/08897077.2014.989352.Peer-Reviewed Original ResearchConceptsNaloxone rescue kitsOverdose educationRescue kitsOverdose rescueSupport groupsFamily membersOverdose prevention trainingCommunity support groupsFamilies of peopleOpioid usersOpioidsOverdose epidemicNaloxone useSelf-administered surveyKit useNaloxonePrevention trainingOverdoseMultisite studyFurther studies
2014
The impact of buprenorphine/naloxone treatment on HIV risk behaviors among HIV-infected, opioid-dependent patients
Edelman EJ, Chantarat T, Caffrey S, Chaudhry A, O’Connor P, Weiss L, Fiellin DA, Fiellin LE. The impact of buprenorphine/naloxone treatment on HIV risk behaviors among HIV-infected, opioid-dependent patients. Drug And Alcohol Dependence 2014, 139: 79-85. PMID: 24726429, PMCID: PMC4029496, DOI: 10.1016/j.drugalcdep.2014.03.006.Peer-Reviewed Original ResearchConceptsBuprenorphine/naloxone treatmentOpioid-dependent patientsHIV risk behaviorsBuprenorphine/naloxoneNon-condom useNaloxone treatmentRisk behaviorsTreatment initiationViral loadHIV-1 RNA viral loadCocaine/amphetaminesTime-updated variablesRNA viral loadMajor risk factorOpioid-dependent populationsCochran-Armitage trend testSexual risk behaviorsOlder patientsHIV infectionOpioid dependenceRisk factorsHeroin useHIVPatientsTargeted interventions
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
2011
The Impact of Cocaine Use on Outcomes in HIV-Infected Patients Receiving Buprenorphine/Naloxone
Sullivan LE, Botsko M, Cunningham CO, O'Connor PG, Hersh D, Mitty J, Lum PJ, Schottenfeld RS, Fiellin DA. The Impact of Cocaine Use on Outcomes in HIV-Infected Patients Receiving Buprenorphine/Naloxone. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2011, 56: s54-s61. PMID: 21317595, PMCID: PMC3065971, DOI: 10.1097/qai.0b013e3182097576.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnti-HIV AgentsBuprenorphineBuprenorphine, Naloxone Drug CombinationCocaine-Related DisordersFemaleHIV InfectionsHumansMaleMiddle AgedNaloxoneNarcotic AntagonistsNeedle SharingOpiate Substitution TreatmentOpioid-Related DisordersProspective StudiesRisk FactorsTreatment OutcomeUnsafe SexConceptsBuprenorphine/naloxoneTimes greater likelihoodBaseline cocaine useOpioid useCocaine useHIV RNAAntiretroviral adherenceTreatment outcomesBuprenorphine/naloxone treatmentGreater likelihoodRisk behaviorsConcurrent opioid useLog10 HIV RNAOpioid-dependent HIVSubsequent opioid useHIV treatment outcomesPercent of patientsIllicit opioid useHIV risk behaviorsSubsequent cocaine useCD4 lymphocytesNaloxone treatmentProspective studyPatientsNaloxoneHepatic Safety and Lack of Antiretroviral Interactions With Buprenorphine/Naloxone in HIV-Infected Opioid-Dependent Patients
Vergara-Rodriguez P, Tozzi MJ, Botsko M, Nandi V, Altice F, Egan JE, O'Connor PG, Sullivan LE, Fiellin DA. Hepatic Safety and Lack of Antiretroviral Interactions With Buprenorphine/Naloxone in HIV-Infected Opioid-Dependent Patients. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2011, 56: s62-s67. PMID: 21317596, DOI: 10.1097/qai.0b013e31820a820f.Peer-Reviewed Original ResearchConceptsBuprenorphine/naloxoneOpioid-dependent patientsMedian aspartate aminotransferasePharmacodynamic interactionsAspartate aminotransferaseBup/ALT valuesAlanine aminotransferaseBUP/NXOpioid-dependent HIVProspective cohort studyHepatic safetyHepatitis CCohort studyHepatic toxicityHIVPatientsAtazanavirNaloxonePrior reportsExposure measuresSignificant decreaseAminotransferaseSignificant changesTreatmentDrug 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
2009
The Association between Cocaine Use and Treatment Outcomes in Patients Receiving Office‐Based Buprenorphine/Naloxone for the Treatment of Opioid Dependence
Sullivan LE, Moore BA, O'Connor PG, Barry DT, Chawarski MC, Schottenfeld RS, Fiellin DA. The Association between Cocaine Use and Treatment Outcomes in Patients Receiving Office‐Based Buprenorphine/Naloxone for the Treatment of Opioid Dependence. American Journal On Addictions 2009, 19: 53-58. PMID: 20132122, PMCID: PMC3107713, DOI: 10.1111/j.1521-0391.2009.00003.x.Peer-Reviewed Original ResearchConceptsOpioid-negative urinesBuprenorphine/naloxoneUrine toxicology testsWeeks of treatmentWorse treatment outcomesTreatment outcomesCocaine useTreatment retentionMean weekBuprenorphine/naloxone maintenanceGreater percentageToxicology testsUrine toxicology resultsOpioid dependenceToxicology resultsPatientsTargeted interventionsWeeksNaloxoneOutcomesTreatmentBaselineUrineAssociationPercentage
2008
Long‐Term Treatment with Buprenorphine/Naloxone in Primary Care: Results at 2–5 Years
Fiellin DA, Moore BA, Sullivan LE, Becker WC, Pantalon MV, Chawarski MC, Barry DT, O'Connor PG, Schottenfeld RS. Long‐Term Treatment with Buprenorphine/Naloxone in Primary Care: Results at 2–5 Years. American Journal On Addictions 2008, 17: 116-120. PMID: 18393054, DOI: 10.1080/10550490701860971.Peer-Reviewed Original ResearchMeSH KeywordsAdultBuprenorphineCombined Modality TherapyCounselingCross-Sectional StudiesDose-Response Relationship, DrugDrug Administration ScheduleDrug Therapy, CombinationFemaleFollow-Up StudiesHeroin DependenceHumansLong-Term CareMaleMiddle AgedNaloxoneNarcotic AntagonistsOpioid-Related DisordersPatient DropoutsPrimary Health CareSubstance Abuse DetectionTreatment OutcomeConceptsOpioid-dependent patientsAdverse eventsSerum transaminasesBuprenorphine/naloxone treatmentSerious adverse eventsBuprenorphine/naloxoneLong-term outcomesOffice-based treatmentIllicit drug useOpioid useClinical stabilityNaloxone treatmentPrimary outcomePatient satisfactionPrimary careTerm treatmentDrug useUrine samplesPatientsTreatmentTransaminaseOutcomesYearsModerate levelsPercent
2007
Buprenorphine/naloxone treatment in primary care is associated with decreased human immunodeficiency virus risk behaviors
Sullivan LE, Moore BA, Chawarski MC, Pantalon MV, Barry D, O'Connor PG, Schottenfeld RS, Fiellin DA. Buprenorphine/naloxone treatment in primary care is associated with decreased human immunodeficiency virus risk behaviors. Journal Of Substance Use And Addiction Treatment 2007, 35: 87-92. PMID: 17933486, PMCID: PMC2587397, DOI: 10.1016/j.jsat.2007.08.004.Peer-Reviewed Original ResearchConceptsBuprenorphine/naloxone treatmentNaloxone treatmentHIV risk behaviorsHIV riskRisk behaviorsHuman immunodeficiency virus (HIV) risk behaviorsDrug-related HIV riskHuman immunodeficiency virus (HIV) riskSex-related HIV risk behaviorsBuprenorphine/naloxoneIntravenous drug useOpioid-dependent personsPrimary care clinicsInconsistent condom useBuprenorphine/Care clinicsMethadone treatmentPrimary careDrug useSteady partnerCondom useBaselineWeeksTreatmentPatientsPatient Satisfaction with Primary Care Office-Based Buprenorphine/Naloxone Treatment
Barry DT, Moore BA, Pantalon MV, Chawarski MC, Sullivan LE, O’Connor P, Schottenfeld RS, Fiellin DA. Patient Satisfaction with Primary Care Office-Based Buprenorphine/Naloxone Treatment. Journal Of General Internal Medicine 2007, 22: 242-245. PMID: 17356993, PMCID: PMC1824745, DOI: 10.1007/s11606-006-0050-y.Peer-Reviewed Original ResearchConceptsBuprenorphine/naloxonePatient satisfactionBuprenorphine/naloxone treatmentDrug treatment historyOpioid-dependent patientsPrimary care officesOpioid-dependent subjectsSubstance use statusOverall satisfaction scoreOffice visit frequencyNaloxone treatmentParticipantsOne hundredPrimary outcomeCare officesFemale genderTreatment historyPatientsNaloxoneSatisfaction scoresEthnicity/raceTreatment locationUse statusVisit frequencyMedicationsTreatment
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
1998
Rapid and Ultrarapid Opioid Detoxification Techniques
O'Connor PG, Kosten TR. Rapid and Ultrarapid Opioid Detoxification Techniques. JAMA 1998, 279: 229-234. PMID: 9438745, DOI: 10.1001/jama.279.3.229.Peer-Reviewed Original ResearchConceptsRapid opioid detoxificationControl groupInpatient studyAbstract-only publicationsSubstance withdrawal syndromeLong-term outcomesMethod of treatmentOpioid detoxificationPeer-reviewed journalsWithdrawal syndromeClinical outcomesOpioid dependenceTherapy allocationPharmacologic protocolAnesthesia protocolInclusion criteriaExclusion criteriaNumber of subjectsMEDLINE databaseSubstance abuseRandomized designSubstance dependenceBibliographies of papersMethodologic characteristicsSubject characteristics