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 studyA 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
Barriers 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
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 treatment
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 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
Counseling and Directly Observed Medication for Primary Care Buprenorphine Maintenance
Moore BA, Barry DT, Sullivan LE, O'Connor PG, Cutter CJ, Schottenfeld RS, Fiellin DA. Counseling and Directly Observed Medication for Primary Care Buprenorphine Maintenance. Journal Of Addiction Medicine 2012, 6: 205-211. PMID: 22614936, PMCID: PMC3419276, DOI: 10.1097/adm.0b013e3182596492.Peer-Reviewed Original ResearchConceptsCognitive behavioral therapyPhysician managementObserved medicationBaseline characteristicsCBT sessionsOpioid-negative urinesIndividual CBT sessionsBuprenorphine maintenanceOpioid useMedication adherencePatient satisfactionPrimary careImproved outcomesTreatment outcomesSession attendanceNegative urineTreatment groupsGreater abstinenceCounseling intensityDrug useTherapist availabilityMedicationsBuprenorphinePatientsIndependent effects
2011
Drug 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 populationHIVThe 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 studyPatientsNaloxone
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
Primary Care Office-based Buprenorphine Treatment: Comparison of Heroin and Prescription Opioid Dependent Patients
Moore BA, Fiellin DA, Barry DT, Sullivan LE, Chawarski MC, O’Connor P, Schottenfeld RS. Primary Care Office-based Buprenorphine Treatment: Comparison of Heroin and Prescription Opioid Dependent Patients. Journal Of General Internal Medicine 2007, 22: 527-530. PMID: 17372805, PMCID: PMC1829433, DOI: 10.1007/s11606-007-0129-0.Peer-Reviewed Original ResearchConceptsPrescription opioid useOpioid useOnly patientsPrescription opioidsTreatment outcomesBuprenorphine/naloxone maintenanceBuprenorphine/naloxone treatmentOpioid-negative urine samplesPrescription opioid-dependent patientsHepatitis C antibodyDrug treatment historyOpioid-dependent patientsPrimary care officesOffice-based settingClinical characteristicsBuprenorphine treatmentNaloxone treatmentBuprenorphine/Opioid dependenceCare officesDependent patientsTreatment responseC antibodyHeroin usePatients
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
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 curve
2001
Targeting Behavioral Therapies to Enhance Naltrexone Treatment of Opioid Dependence: Efficacy of Contingency Management and Significant Other Involvement
Carroll KM, Ball SA, Nich C, O'Connor PG, Eagan DA, Frankforter TL, Triffleman EG, Shi J, Rounsaville BJ. Targeting Behavioral Therapies to Enhance Naltrexone Treatment of Opioid Dependence: Efficacy of Contingency Management and Significant Other Involvement. JAMA Psychiatry 2001, 58: 755-761. PMID: 11483141, PMCID: PMC3651594, DOI: 10.1001/archpsyc.58.8.755.Peer-Reviewed Original ResearchConceptsDrug-free urine specimensNaltrexone treatmentFamily counseling sessionsContingency managementOpioid dependenceTreatment retentionUrine specimensBehavioral therapyOpioid-dependent individualsCounseling sessionsDrug use outcomesSubstance abuse outcomesNaltrexone complianceNaltrexone therapyOpioid useAvailable pharmacotherapiesMedication complianceSpecific pharmacotherapySignificant improvementTherapyUse outcomesAbuse outcomesPrincipal outcomePharmacotherapyTreatment