2023
Perspectives of Clinicians and Staff at Community-Based Opioid Use Disorder Treatment Settings on Linkages With Emergency Department–Initiated Buprenorphine Programs
Sue K, Chawarski M, Curry L, McNeil R, Coupet E, Schwartz R, Wilder C, Tsui J, Hawk K, D’Onofrio G, O’Connor P, Fiellin D, Edelman E. Perspectives of Clinicians and Staff at Community-Based Opioid Use Disorder Treatment Settings on Linkages With Emergency Department–Initiated Buprenorphine Programs. JAMA Network Open 2023, 6: e2312718. PMID: 37163263, PMCID: PMC10173026, DOI: 10.1001/jamanetworkopen.2023.12718.Peer-Reviewed Original ResearchConceptsCommunity-based cliniciansOpioid use disorderEmergency departmentOUD treatmentMedication treatmentSubstance use disorders trainingUrban academic emergency departmentEffectiveness-implementation studyAcademic emergency departmentDisorder treatment settingsPerspectives of cliniciansCommunity-based treatmentCommunity-based treatment programsStaff perspectivesImplementation science frameworkBuprenorphine programTreatment cliniciansPeer navigatorsReferral sitesPromoting ActionMAIN OUTCOMEED staffBuprenorphineFocus groupsUse disordersImplementation 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
Characterizing the social support and functioning of a low-threshold medication for opioid use disorder treatment cohort at intake
Oles W, Alexander M, Kumar N, Howell B, O’Connor P, Madden LM, Barry DT. Characterizing the social support and functioning of a low-threshold medication for opioid use disorder treatment cohort at intake. BMC Psychiatry 2022, 22: 236. PMID: 35366844, PMCID: PMC8976510, DOI: 10.1186/s12888-022-03884-5.Peer-Reviewed Original ResearchConceptsLow-threshold clinicDemographic characteristicsOpioid use disorder treatmentMultivariate logistic regression modelBrief Pain InventoryPatient demographic characteristicsOpioid use disorderSocial supportSymptom Identification ScaleUse disorder treatmentNon-Hispanic whitesLogistic regression modelsOlder patientsPain InventoryTreatment cohortsSelf-reported social supportLife Events ChecklistMOUD treatmentBaseline disparitiesTreatment accessTreatment needsHigh riskUse disordersMortality rateDisorder treatmentPerspectives About Emergency Department Care Encounters Among Adults With Opioid Use Disorder
Hawk K, McCormack R, Edelman EJ, Coupet E, Toledo N, Gauthier P, Rotrosen J, Chawarski M, Martel S, Owens P, Pantalon MV, O’Connor P, Whiteside LK, Cowan E, Richardson LD, Lyons MS, Rothman R, Marsch L, Fiellin DA, D’Onofrio G. Perspectives About Emergency Department Care Encounters Among Adults With Opioid Use Disorder. JAMA Network Open 2022, 5: e2144955. PMID: 35076700, PMCID: PMC8790663, DOI: 10.1001/jamanetworkopen.2021.44955.Peer-Reviewed Original ResearchConceptsUntreated opioid use disorderOpioid use disorderEmergency departmentED visitsOUD treatmentUse disordersPublic safety-net hospitalRural critical access hospitalsEmergency department careSafety-net hospitalUrban academic centerLife-saving treatmentCritical access hospitalsImplementation science frameworkPatient factorsTreatment initiationED careUS patientsStaff trainingDemand treatmentPatient readinessNet hospitalPatient's perspectivePromoting ActionImproved care
2021
A qualitative study of emergency department patients who survived an opioid overdose: Perspectives on treatment and unmet needs
Hawk K, Grau LE, Fiellin DA, Chawarski M, O’Connor P, Cirillo N, Breen C, D’Onofrio G. A qualitative study of emergency department patients who survived an opioid overdose: Perspectives on treatment and unmet needs. Academic Emergency Medicine 2021, 28: 542-552. PMID: 33346926, PMCID: PMC8281441, DOI: 10.1111/acem.14197.Peer-Reviewed Original ResearchConceptsOpioid use disorderEmergency departmentSubstance use treatmentOpioid overdosePatient's perspectiveUnmet needUse treatmentAcute opioid overdoseAdult ED patientsEmergency department patientsPatient support servicesProvider communication skillsEmergency medicine cliniciansAcademic emergency departmentSocial ecologic modelEvidence-based treatmentsChoice of patientsBrief quantitative surveyPatient-oriented approachOpioid useDepartment patientsOUD treatmentUnmet basic needsED careED patients
2020
Emergency department patients with untreated opioid use disorder: A comparison of those seeking versus not seeking referral to substance use treatment
Coupet E, D’Onofrio G, Chawarski M, Edelman E, O’Connor P, Owens P, Martel S, Fiellin DA, Cowan E, Richardson L, Huntley K, Whiteside LK, Lyons MS, Rothman RE, Pantalon M, Hawk K. Emergency department patients with untreated opioid use disorder: A comparison of those seeking versus not seeking referral to substance use treatment. Drug And Alcohol Dependence 2020, 219: 108428. PMID: 33307301, PMCID: PMC8110210, DOI: 10.1016/j.drugalcdep.2020.108428.Peer-Reviewed Original ResearchConceptsUntreated opioid use disorderOpioid use disorderEmergency department patientsDepartment patientsUse disordersTenth Revision diagnosis codesSevere opioid use disorderConclusions Most patientsInjection-related infectionsRevision diagnosis codesHealth insurance statusSubstance use treatmentCross-sectional analysisOpioid withdrawalClinical characteristicsED visitsMost patientsTreatment initiationUrine toxicologyClinical correlatesDiagnosis codesInsurance statusUnivariate analysisBackground LittleInternational ClassificationValidating 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 regressionPatientsUse of Amphetamine-Type Stimulants Among Emergency Department Patients With Untreated Opioid Use Disorder
Chawarski MC, Hawk K, Edelman EJ, O'Connor P, Owens P, Martel S, Coupet E, Whiteside L, Tsui JI, Rothman R, Cowan E, Richardson L, Lyons MS, Fiellin DA, D'Onofrio G. Use of Amphetamine-Type Stimulants Among Emergency Department Patients With Untreated Opioid Use Disorder. Annals Of Emergency Medicine 2020, 76: 782-787. PMID: 32782084, PMCID: PMC8048036, DOI: 10.1016/j.annemergmed.2020.06.046.Peer-Reviewed Original ResearchConceptsUntreated opioid use disorderOpioid use disorderAmphetamine-type stimulant useUse disordersStimulant useAmphetamine-type stimulantsStudy admissionEmergency departmentEmergency department patientsImplementation science studyUrine test resultsFalse discovery rate correctionSubstance use problemsHepatitis CED visitsDepartment patientsReferral protocolsED patientsUrine testsDrug injectionOverdose riskPatientsHealth factorsUnstable housingConcurrent useIntegrated stepped alcohol treatment for patients with HIV and at-risk alcohol use: a randomized trial
Edelman EJ, Maisto SA, Hansen NB, Cutter CJ, Dziura J, Deng Y, Fiellin LE, O’Connor P, Bedimo R, Gibert CL, Marconi VC, Rimland D, Rodriguez-Barradas MC, Simberkoff MS, Tate JP, Justice AC, Bryant KJ, Fiellin DA. Integrated stepped alcohol treatment for patients with HIV and at-risk alcohol use: a randomized trial. Addiction Science & Clinical Practice 2020, 15: 28. PMID: 32727618, PMCID: PMC7388231, DOI: 10.1186/s13722-020-00200-y.Peer-Reviewed Original ResearchConceptsRisk alcohol useAlcohol useAlcohol treatmentHealth of patientsEvidence-based strategiesWeek 24HIV outcomesRoutine careTelephone boosterPhysician managementEnhancement therapyHIVPWHPatientsTrialsTarget populationTreatmentAlcohol-related researchMulti-pronged approachOutcomesParticipantsInsufficient numberTherapyPopulationMethodsInBarriers 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
2019
Integrated stepped alcohol treatment for patients with HIV and liver disease: A randomized trial
Edelman EJ, Maisto SA, Hansen NB, Cutter CJ, Dziura J, Deng Y, Fiellin LE, O'Connor PG, Bedimo R, Gibert CL, Marconi VC, Rimland D, Rodriguez-Barradas MC, Simberkoff MS, Tate JP, Justice AC, Bryant KJ, Fiellin DA. Integrated stepped alcohol treatment for patients with HIV and liver disease: A randomized trial. Journal Of Substance Use And Addiction Treatment 2019, 106: 97-106. PMID: 31540617, PMCID: PMC7244228, DOI: 10.1016/j.jsat.2019.08.007.Peer-Reviewed Original ResearchIntegrated stepped alcohol treatment for patients with HIV and alcohol use disorder: a randomised controlled trial
Edelman EJ, Maisto SA, Hansen NB, Cutter CJ, Dziura J, Deng Y, Fiellin LE, O'Connor PG, Bedimo R, Gibert CL, Marconi VC, Rimland D, Rodriguez-Barradas MC, Simberkoff MS, Tate JP, Justice AC, Bryant KJ, Fiellin DA. Integrated stepped alcohol treatment for patients with HIV and alcohol use disorder: a randomised controlled trial. The Lancet HIV 2019, 6: e509-e517. PMID: 31109915, PMCID: PMC7161741, DOI: 10.1016/s2352-3018(19)30076-1.Peer-Reviewed Original ResearchConceptsAlcohol use disorderWeek 24Use disordersAlcohol treatmentAdverse eventsNumber of drinksTreatment medicationsPhysician managementAlcohol abuseMental Disorders-IV criteriaAlcohol-related careFormal alcohol treatmentKey exclusion criteriaTimeline followback methodMotivational enhancement therapyTreat populationHIV clinicHIV outcomesPrimary outcomeSpecialty referralsMean ageUS National InstitutesWeek 4Medical conditionsExclusion criteriaImplementation facilitation to promote emergency department-initiated buprenorphine for opioid use disorder: protocol for a hybrid type III effectiveness-implementation study (Project ED HEALTH)
D’Onofrio G, Edelman EJ, Hawk KF, Pantalon MV, Chawarski MC, Owens PH, Martel SH, VanVeldhuisen P, Oden N, Murphy SM, Huntley K, O’Connor P, Fiellin DA. Implementation facilitation to promote emergency department-initiated buprenorphine for opioid use disorder: protocol for a hybrid type III effectiveness-implementation study (Project ED HEALTH). Implementation Science 2019, 14: 48. PMID: 31064390, PMCID: PMC6505286, DOI: 10.1186/s13012-019-0891-5.Peer-Reviewed Original ResearchConceptsOpioid use disorderEmergency departmentImplementation facilitationCost-effectiveness analysisUse disordersPatient engagementEmergency department-initiated buprenorphineEffectiveness-implementation studyEvaluation periodOpioid agonist treatmentSoft tissue infectionsInjection drug useGeneral medical conditionsHealth Services frameworkClinical Trials NetworkAcademic emergency departmentRate of provisionIF interventionOngoing medicationED visitsTissue infectionsED patientsFacilitated referralAgonist treatmentED providersA randomized trial of decision support for tobacco dependence treatment in an inpatient electronic medical record: clinical results
Bernstein SL, Weiss J, DeWitt M, Tetrault JM, Hsiao AL, Dziura J, Sussman S, Miller T, Carpenter K, O’Connor P, Toll B. A randomized trial of decision support for tobacco dependence treatment in an inpatient electronic medical record: clinical results. Implementation Science 2019, 14: 8. PMID: 30670043, PMCID: PMC6343239, DOI: 10.1186/s13012-019-0856-8.Peer-Reviewed Original ResearchConceptsPatient's primary care providerPrimary care providersTobacco treatment medicationsElectronic health recordsTobacco use disorderQuit ratesTreatment medicationsProblem listCare providersUse disordersOne-year quit ratesState tobacco quitlineTobacco quit ratesPrescription of medicationsTobacco dependence treatmentProcess of careSingle hospital systemElectronic medical recordsInpatient electronic medical recordPatient's problem listSustained quittingAdult patientsControl patientsCurrent smokingHospitalized smokers
2017
Past‐year Prescription Drug Monitoring Program Opioid Prescriptions and Self‐reported Opioid Use in an Emergency Department Population With Opioid Use Disorder
Hawk K, D'Onofrio G, Fiellin DA, Chawarski MC, O'Connor PG, Owens PH, Pantalon MV, Bernstein SL. Past‐year Prescription Drug Monitoring Program Opioid Prescriptions and Self‐reported Opioid Use in an Emergency Department Population With Opioid Use Disorder. Academic Emergency Medicine 2017, 25: 508-516. PMID: 29165853, PMCID: PMC5963969, DOI: 10.1111/acem.13352.Peer-Reviewed Original ResearchConceptsPrescription drug monitoring programsOpioid use disorderNonmedical prescription opioid usePrescription opioid useAberrant drug-related behaviorsOpioid useOpioid prescriptionsUse disordersED patientsDrug-related behaviorsPrescription recordsState prescription drug monitoring programStatistical Manual IV criteriaNonmedical opioid useRandomized clinical trialsEmergency department assessmentEmergency department populationDrug monitoring programsCharacteristics of participantsUrban EDOpioid dependencePrescription opioidsPDMP dataTreatment trialsClinical historyEmergency Department-Initiated Buprenorphine for Opioid Dependence with Continuation in Primary Care: Outcomes During and After Intervention
D’Onofrio G, Chawarski MC, O’Connor P, Pantalon MV, Busch SH, Owens PH, Hawk K, Bernstein SL, Fiellin DA. Emergency Department-Initiated Buprenorphine for Opioid Dependence with Continuation in Primary Care: Outcomes During and After Intervention. Journal Of General Internal Medicine 2017, 32: 660-666. PMID: 28194688, PMCID: PMC5442013, DOI: 10.1007/s11606-017-3993-2.Peer-Reviewed Original ResearchConceptsIllicit opioid useOpioid usePrimary careHIV riskBrief interventionAddiction treatmentBuprenorphine groupEmergency Department-Initiated BuprenorphineCohort of patientsLong-term followLong-term outcomesFormal addiction treatmentSignificant differencesMain MeasuresSelfStudy entryUrine toxicologyBuprenorphine/Opioid dependenceED interventionsUrine resultsBuprenorphineTreatment engagementDrug useReferralPatients
2016
Cognitive Behavioral Therapy Improves Treatment Outcomes for Prescription Opioid Users in Primary Care Buprenorphine Treatment
Moore BA, Fiellin DA, Cutter CJ, Buono FD, Barry DT, Fiellin LE, O'Connor PG, Schottenfeld RS. Cognitive Behavioral Therapy Improves Treatment Outcomes for Prescription Opioid Users in Primary Care Buprenorphine Treatment. Journal Of Substance Use And Addiction Treatment 2016, 71: 54-57. PMID: 27776678, PMCID: PMC5119533, DOI: 10.1016/j.jsat.2016.08.016.Peer-Reviewed Original ResearchConceptsOpioid-using patientsCognitive behavioral therapyUse patientsPhysician managementOpioid useTreatment outcomesBuprenorphine/naloxone treatmentHeroin use disorder patientsSelf-reported opioid useBehavioral therapyOpioid use groupPrevious drug treatmentUrine toxicology analysisEffects of CBTInjection drug useBaseline demographic differencesPrescription opioid usersBuprenorphine treatmentNaloxone treatmentOpioid abstinencePrescription opioidsOpioid usersOpioid categoryTreatment responseDrug treatmentImplementation of integrated stepped care for unhealthy alcohol use in HIV clinics
Edelman EJ, Hansen NB, Cutter CJ, Danton C, Fiellin LE, O’Connor P, Williams EC, Maisto SA, Bryant KJ, Fiellin DA. Implementation of integrated stepped care for unhealthy alcohol use in HIV clinics. Addiction Science & Clinical Practice 2016, 11: 1. PMID: 26763048, PMCID: PMC4711105, DOI: 10.1186/s13722-015-0048-z.Peer-Reviewed Original ResearchConceptsUnhealthy alcohol useHIV clinicAlcohol usePatient motivationIntervention characteristicsInner settingHIV treatment settingsImplementation Research domainsModel of careCharacteristics of individualsAddiction psychiatristsCare modelCFIR frameworkTreatment settingsCFIR domainsMultidisciplinary teamClinicConsolidated FrameworkImplementation themesPatientsProvider perspectivesCareEffective counselingSocial workersIntervention
2015
Opioid Dependence Treatment in the Emergency Department—Reply
Fiellin DA, O’Connor P, D’Onofrio G. Opioid Dependence Treatment in the Emergency Department—Reply. JAMA 2015, 314: 835-835. PMID: 26305657, DOI: 10.1001/jama.2015.8527.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