2024
Using qualitative system dynamics modeling to understand overdose bystander behavior in the context of Connecticut’s Good Samaritan Laws and identify effective policy options
Thompson R, Sabounchi N, Ali S, Heimer R, D’Onofrio G, Heckmann R. Using qualitative system dynamics modeling to understand overdose bystander behavior in the context of Connecticut’s Good Samaritan Laws and identify effective policy options. Harm Reduction Journal 2024, 21: 124. PMID: 38937759, PMCID: PMC11210010, DOI: 10.1186/s12954-024-00990-3.Peer-Reviewed Original ResearchMeSH KeywordsConnecticutDrug OverdoseHarm ReductionHealth PolicyHumansLaw EnforcementNaloxoneNarcotic AntagonistsOpiate OverdoseConceptsSamaritan lawsGood Samaritan lawsBystander behaviorGroup model buildingFear of legal consequencesKnowledge of protectionResponses to opioid overdosesCriminal liabilityDrug arrestsLegal consequencesLaw enforcementNaloxone useLawStakeholder-engaged processOpioid overdoseHealth care providersFatal opioid overdoseSustainable system changeOpioid-related outcomesBystander experiencesSamaritanCare providersHarm reductionPotential bystandersPolicy determination
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 ResearchConceptsNon-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 treatmentDeathTreatmentMethadoneRiskFentanyl-Associated Overdose Deaths Outside the Hospital
Jeffery M, Stevens M, D'Onofrio G, Melnick E. Fentanyl-Associated Overdose Deaths Outside the Hospital. New England Journal Of Medicine 2023, 389: 87-88. PMID: 37342960, PMCID: PMC10388669, DOI: 10.1056/nejmc2304991.Peer-Reviewed Original ResearchConcordance between controlled substance receipt and post-mortem toxicology in opioid-detected overdose deaths: A statewide analysis
Howell B, Black A, Grau L, Lin H, Greene C, Lee H, Heimer R, Hawk K, D'Onofrio G, Fiellin D, Becker W. Concordance between controlled substance receipt and post-mortem toxicology in opioid-detected overdose deaths: A statewide analysis. Drug And Alcohol Dependence 2023, 244: 109788. PMID: 36738634, PMCID: PMC9975083, DOI: 10.1016/j.drugalcdep.2023.109788.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidBenzodiazepinesControlled SubstancesDrug OverdoseHumansOpiate OverdoseUnited StatesConceptsPost-mortem toxicologyOverdose deathsChief Medical ExaminerBenzodiazepine prescribingBenzodiazepine prescriptionsPrimary outcomePreventable deathsOpioid overdosesOpioidsAddiction servicesBenzodiazepinesMental healthStudy periodDeathMedical examinersConcordanceStatewide analysisSubstantial numberReceiptDaysDepartmentMedicationsToxicologyFentanylPrescribing
2022
Assessing the impact of the Good Samaritan Law in the state of Connecticut: a system dynamics approach
Sabounchi NS, Heckmann R, D’Onofrio G, Walker J, Heimer R. Assessing the impact of the Good Samaritan Law in the state of Connecticut: a system dynamics approach. Health Research Policy And Systems 2022, 20: 5. PMID: 34991591, PMCID: PMC8734429, DOI: 10.1186/s12961-021-00807-w.Peer-Reviewed Original ResearchConceptsOpioid use disorderOverdose deathsGood Samaritan lawsEmergency department visitsOpioid-related deathsPublic health interventionsBehavioral changesPublic health officialsED visitsDepartment visitsOpioid usersUse disordersHealth outcomesOpioid crisisHealth interventionsHealth officialsDeathOverdoseVisitsInterventionOutcomesState of ConnecticutMultiple strategies
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 patientsMerging statewide data in a public/university collaboration to address opioid use disorder and overdose
Becker WC, Heimer R, Dormitzer CM, Doernberg M, D’Onofrio G, Grau LE, Hawk K, Lin HJ, Secora AM, Fiellin DA. Merging statewide data in a public/university collaboration to address opioid use disorder and overdose. Addiction Science & Clinical Practice 2021, 16: 1. PMID: 33397480, PMCID: PMC7780404, DOI: 10.1186/s13722-020-00211-9.Peer-Reviewed Original Research
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 ClassificationNaloxone Use by Emergency Medical Services During the COVID-19 Pandemic: A National Survey
Cone DC, Bogucki S, Burns K, D’Onofrio G, Hawk K, Joseph D, Fiellin DA. Naloxone Use by Emergency Medical Services During the COVID-19 Pandemic: A National Survey. Journal Of Addiction Medicine 2020, 14: e369-e371. PMID: 33031212, PMCID: PMC7647432, DOI: 10.1097/adm.0000000000000746.Peer-Reviewed Original ResearchConceptsIntranasal naloxoneOverdose eventsEmergency medical services (EMS) cliniciansNovel coronavirus infectionOpioid overdose mortalityEmergency medical servicesOpioid overdose crisisAdministration practicesPercent of respondentsEMS cliniciansEMS fellowship programsIntramuscular naloxoneOpioid overdosesService cliniciansNaloxone useOverdose mortalityNaloxoneFuture disaster planningCoronavirus infectionOverdose crisisCOVID-19 epidemicMedical servicesCOVID-19 pandemicNational surveyClinicians
2018
A Quality Framework for Emergency Department Treatment of Opioid Use Disorder
Samuels EA, D'Onofrio G, Huntley K, Levin S, Schuur JD, Bart G, Hawk K, Tai B, Campbell CI, Venkatesh AK. A Quality Framework for Emergency Department Treatment of Opioid Use Disorder. Annals Of Emergency Medicine 2018, 73: 237-247. PMID: 30318376, PMCID: PMC6817947, DOI: 10.1016/j.annemergmed.2018.08.439.Peer-Reviewed Original ResearchConceptsOpioid use disorder treatmentEmergency department treatmentOpioid-associated morbidityOpioid use disorderClinical Trials NetworkNational InstituteUse disorder treatmentClinical quality improvementOpioid overdose deathsImplementation science researchersQuality improvement effortsQuality measure developmentEmergency cliniciansSafe prescribingOutpatient treatmentDrug Abuse CenterOpioid epidemicQuality improvement frameworkAmerican CollegeData registryOverdose deathsUse disordersDisorder treatmentTrials NetworkAddiction medicineDiscerning suicide in drug intoxication deaths: Paucity and primacy of suicide notes and psychiatric history
Rockett IRH, Caine ED, Connery HS, D’Onofrio G, Gunnell DJ, Miller TR, Nolte KB, Kaplan MS, Kapusta ND, Lilly CL, Nelson LS, Putnam SL, Stack S, Värnik P, Webster LR, Jia H. Discerning suicide in drug intoxication deaths: Paucity and primacy of suicide notes and psychiatric history. PLOS ONE 2018, 13: e0190200. PMID: 29320540, PMCID: PMC5761891, DOI: 10.1371/journal.pone.0190200.Peer-Reviewed Original ResearchConceptsPrior suicide attemptsSuicide attemptsIntoxication casesDrug intoxicationPsychiatric historyDrug intoxication deathsUndetermined intent deathsDrug intoxication casesMechanisms/causesPrevention of suicideIntoxication deathsNational Violent Death Reporting SystemViolent Death Reporting SystemDrug deathsSuicide classificationOutcome measuresDeath Reporting SystemRelative oddsPrevalence gapAffective disordersBipolar disorderEtiologic understandingSuicide notesUndetermined deathsClassification of suicide
2017
Multiple Fentanyl Overdoses — New Haven, Connecticut, June 23, 2016
Tomassoni AJ, Hawk KF, Jubanyik K, Nogee DP, Durant T, Lynch KL, Patel R, Dinh D, Ulrich A, D’Onofrio G. Multiple Fentanyl Overdoses — New Haven, Connecticut, June 23, 2016. MMWR Morbidity And Mortality Weekly Report 2017, 66: 107-111. PMID: 28151928, PMCID: PMC5657834, DOI: 10.15585/mm6604a4.Peer-Reviewed Case Reports and Technical NotesMeSH KeywordsAdultAgedConnecticutDrug OverdoseEmergency Service, HospitalFatal OutcomeFemaleFentanylHumansMaleMiddle AgedNaloxoneConceptsIntensive care unitEmergency departmentYale-New Haven HospitalEmergency medical services (EMS) crewsInterviews of patientsContinuous naloxone infusionNew Haven HospitalPublic health alertsRespiratory failureCare unitNaloxone infusionEndotracheal intubationOpioid overdoseNaloxone distributionPatientsRoute of intoxicationSubsequent episodesHealth alertsOpioid antidoteFentanylHospitalPublic healthFamily membersCocaineRapid notification