2024
Extended-Release 7-Day Injectable Buprenorphine for Patients With Minimal to Mild Opioid Withdrawal
D’Onofrio G, Herring A, Perrone J, Hawk K, Samuels E, Cowan E, Anderson E, McCormack R, Huntley K, Owens P, Martel S, Schactman M, Lofwall M, Walsh S, Dziura J, Fiellin D. Extended-Release 7-Day Injectable Buprenorphine for Patients With Minimal to Mild Opioid Withdrawal. JAMA Network Open 2024, 7: e2420702. PMID: 38976265, PMCID: PMC11231806, DOI: 10.1001/jamanetworkopen.2024.20702.Peer-Reviewed Original ResearchConceptsClinical Opiate Withdrawal ScaleExtended-release buprenorphineOpioid use disorderPrecipitated withdrawalOpioid withdrawalOpioid use disorder treatmentCow scoreClinical Opiate Withdrawal Scale scoreAdverse eventsNonrandomized trialsSevere opioid use disorderDays of opioid useOpiate Withdrawal ScaleModerate to severe opioid use disorderFormulation of buprenorphineOpioid use disorder careWithdrawal ScaleUse disorderAssociated with medicationsNonprescribed opioidsPain scoresExtended-releaseInjection painOpioid useAdult patients
2023
Implementing Programs to Initiate Buprenorphine for Opioid Use Disorder Treatment in High-Need, Low-Resource Emergency Departments: A Nonrandomized Controlled Trial
McCormack R, Rotrosen J, Gauthier P, D'Onofrio G, Fiellin D, Marsch L, Novo P, Liu D, Edelman E, Farkas S, Matthews A, Mulatya C, Salazar D, Wolff J, Knight R, Goodman W, Williams J, Hawk K. Implementing Programs to Initiate Buprenorphine for Opioid Use Disorder Treatment in High-Need, Low-Resource Emergency Departments: A Nonrandomized Controlled Trial. Annals Of Emergency Medicine 2023, 82: 272-287. PMID: 37140493, PMCID: PMC10524047, DOI: 10.1016/j.annemergmed.2023.02.013.Peer-Reviewed Original ResearchConceptsBuprenorphine programImplementation facilitationEmergency departmentMedical recordsOpioid use disorder treatmentMain secondary outcomesMore treatment visitsPrimary implementation outcomeNonrandomized Controlled TrialPatient-level outcomesPatients' medical recordsUse disorder treatmentTreatment 30 daysBuprenorphine administrationOpioid useSecondary outcomesControlled TrialsTreatment visitsED settingUnique patientsClinicians' readinessEligibility criteriaClinical protocolsDisorder treatmentOverdose eventsImplementation 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
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
2019
Integrated 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 criteria
2018
Women and opioids: something different is happening here
Mazure CM, Fiellin DA. Women and opioids: something different is happening here. The Lancet 2018, 392: 9-11. PMID: 30047402, DOI: 10.1016/s0140-6736(18)31203-0.Peer-Reviewed Original Research
2016
Primary Care Physicians’ Willingness to Prescribe HIV Pre-exposure Prophylaxis for People who Inject Drugs
Edelman EJ, Moore BA, Calabrese SK, Berkenblit G, Cunningham C, Patel V, Phillips K, Tetrault JM, Shah M, Fiellin DA, Blackstock O. Primary Care Physicians’ Willingness to Prescribe HIV Pre-exposure Prophylaxis for People who Inject Drugs. AIDS And Behavior 2016, 21: 1025-1033. PMID: 27896552, PMCID: PMC5344709, DOI: 10.1007/s10461-016-1612-6.Peer-Reviewed Original ResearchConceptsPrimary care physiciansPre-exposure prophylaxisCare physiciansHIV pre-exposure prophylaxisHIV risk groupMore HIVClinic patientsRisk groupsGeneral internistsPWIDAcademic general internistsPractice characteristicsDisease preventionHIVPrEPProphylaxisPatientsPhysiciansCareDrugsOnline surveyInternistsHigher willingnessLower willingnessCentral roleA Cross-Sectional Online Survey of HIV Pre-Exposure Prophylaxis Adoption Among Primary Care Physicians
Blackstock OJ, Moore BA, Berkenblit GV, Calabrese SK, Cunningham CO, Fiellin DA, Patel VV, Phillips KA, Tetrault JM, Shah M, Edelman EJ. A Cross-Sectional Online Survey of HIV Pre-Exposure Prophylaxis Adoption Among Primary Care Physicians. Journal Of General Internal Medicine 2016, 32: 62-70. PMID: 27778215, PMCID: PMC5215171, DOI: 10.1007/s11606-016-3903-z.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnti-HIV AgentsCross-Sectional StudiesFemaleHealth Knowledge, Attitudes, PracticeHealth PersonnelHealth Risk BehaviorsHIV InfectionsHumansMaleMiddle AgedMultivariate AnalysisOdds RatioPractice Patterns, Physicians'Pre-Exposure ProphylaxisPrimary Health CareSurveys and QuestionnairesConceptsPrimary care physiciansHIV care experienceCare physiciansPrEP adoptionPrEP awarenessPractice characteristicsHIV pre-exposure prophylaxisCare experiencesAcademic primary care physiciansHIV-positive patientsPre-exposure prophylaxisHealth care providersResultsThe survey response rateSectional Online SurveyPCP adoptionHIV careKey ResultsThe survey response ratePercent of respondentsRisk compensationSurvey response ratePrEP knowledgePrEP useSelf-rated knowledgeMultivariable analysisClinical championsThe impact of prescribed opioids on CD4 cell count recovery among HIV‐infected patients newly initiating antiretroviral therapy
Edelman E, Gordon K, Tate J, Becker W, Bryant K, Crothers K, Gaither, Gibert C, Gordon A, Marshall B, Rodriguez‐Barradas M, Samet J, Skanderson M, Justice A, Fiellin D. The impact of prescribed opioids on CD4 cell count recovery among HIV‐infected patients newly initiating antiretroviral therapy. HIV Medicine 2016, 17: 728-739. PMID: 27186715, PMCID: PMC5053822, DOI: 10.1111/hiv.12377.Peer-Reviewed Original ResearchConceptsCD4 cell countBaseline CD4 cell countCell countPrescribed opioidsImmunosuppressive propertiesVeterans Aging Cohort Study (VACS) dataCD4 cell count recoveryAntiretroviral therapy responseCell count recoveryShort-term opioidsViral load suppressionCohort study dataOverall disease severityYear of initiationPrimary independent variableOpioid durationAntiretroviral therapyCount recoveryComorbid conditionsPharmacy dataOpioid propertiesTherapy responseOpioidsPatientsHIV
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 treatmentThe Impact of Recent Cocaine Use on Plasma Levels of Methadone and Buprenorphine in Patients with and Without HIV-infection
Tetrault JM, McCance-Katz EF, Moody DE, Fiellin DA, Lruie BS, DInh AT, Fiellin LE. The Impact of Recent Cocaine Use on Plasma Levels of Methadone and Buprenorphine in Patients with and Without HIV-infection. Journal Of Substance Use And Addiction Treatment 2014, 51: 70-74. PMID: 25480096, DOI: 10.1016/j.jsat.2014.10.010.Peer-Reviewed Original ResearchConceptsRecent cocaine useHIV infectionCocaine useNorbuprenorphine concentrationsHIV statusBuprenorphine concentrationsS-methadoneAntiretroviral medication useBuprenorphine plasma concentrationsUninfected subjectsMethadone concentrationsMedication usePlasma levelsPlasma concentrationsR-methadoneCocaine effectsClinical careMethadoneBuprenorphineHIVInfectionAbstinenceSubjectsCocaineStatus
2013
Racial/ethnic differences in report of drug testing practices at the workplace level in the U.S.
Becker WC, Meghani S, Tetrault JM, Fiellin DA. Racial/ethnic differences in report of drug testing practices at the workplace level in the U.S. American Journal On Addictions 2013, 23: 357-362. PMID: 24112118, DOI: 10.1111/j.1521-0391.2013.12109.x.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge FactorsBlack or African AmericanCross-Sectional StudiesData CollectionEducational StatusEmploymentFemaleHispanic or LatinoHumansIncomeMaleMiddle AgedMultivariate AnalysisOccupationsPrejudiceResidence CharacteristicsSelf ReportSex FactorsSubstance Abuse DetectionWhite PeopleWorkplaceYoung AdultConceptsDrug testingBlack raceStratified analysisWorkplace drug testingEthnic differencesSubstance abuse/dependenceImportant public health implicationsNon-urban residenceCross-sectional studyLogistic regression analysisAbuse/dependencePublic health implicationsDrug testing practicesSupport occupationsRace/ethnicityMale sexMultivariable analysisHispanic ethnicityDrug useYounger ageDrug testing policiesHealth implicationsFurther studiesHispanic respondentsRegression analysis
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 differencesCounselingPrevious Use of Alcohol, Cigarettes, and Marijuana and Subsequent Abuse of Prescription Opioids in Young Adults
Fiellin LE, Tetrault JM, Becker WC, Fiellin DA, Hoff RA. Previous Use of Alcohol, Cigarettes, and Marijuana and Subsequent Abuse of Prescription Opioids in Young Adults. Journal Of Adolescent Health 2012, 52: 158-163. PMID: 23332479, PMCID: PMC3552239, DOI: 10.1016/j.jadohealth.2012.06.010.Peer-Reviewed Original ResearchConceptsPrescription opioidsPrevious marijuana usePrevious substance usePrevious alcoholMarijuana useSubsequent abuseYoung womenSubstance useYoung adulthoodCommunity-dwelling individualsLogistic regression analysisCurrent abusePrevious alcohol useClinical dataOpioidsDrug useSubstance abuseAlcohol useCigarettesPrevention effortsPrevious useYoung adultsYoung individualsYoung menYear oldsCombining Rapid HIV Testing and a Brief Alcohol Intervention in Young Unhealthy Drinkers in the Emergency Department: A Pilot Study
Edelman EJ, Dinh A, Radulescu R, Lurie B, D'Onofrio G, Tetrault JM, Fiellin DA, Fiellin LE. Combining Rapid HIV Testing and a Brief Alcohol Intervention in Young Unhealthy Drinkers in the Emergency Department: A Pilot Study. The American Journal Of Drug And Alcohol Abuse 2012, 38: 539-543. PMID: 22794939, PMCID: PMC3522092, DOI: 10.3109/00952990.2012.701359.Peer-Reviewed Original ResearchConceptsSexual risk reduction counselingSexual risk behaviorsRisk reduction counselingRapid HIV testingEmergency departmentRisk behaviorsReduction counselingHIV testingAlcohol useUnhealthy drinkersAlcohol consumptionMean age 26 yearsAverage weekly drinksImportant preventive servicesAlcohol Use Disorders Identification Test (AUDIT) scoresUnknown HIV statusRapid HIV testsUnhealthy alcohol useAge 26 yearsBrief alcohol interventionHIV testHIV statusRegular doctorPreventive servicesRisk populationsScreening, Brief Intervention, and Referral to Treatment (SBIRT) for Alcohol and Other Drug Use among Adolescents: Evaluation of a Pediatric Residency Curriculum
Ryan SA, Martel S, Pantalon M, Martino S, Tetrault J, Thung SF, Bernstein SL, Auinger P, Green ML, Fiellin DA, O'Connor P, D'Onofrio G. Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Alcohol and Other Drug Use among Adolescents: Evaluation of a Pediatric Residency Curriculum. Substance Use & Addiction Journal 2012, 33: 251-260. PMID: 22738002, DOI: 10.1080/08897077.2011.640182.Peer-Reviewed Original ResearchConceptsBrief Negotiation InterviewBrief interventionPediatric residency programsDrug useKnowledge scorePost-training improvementPost-training knowledge scoresMain outcome measuresUrban teaching hospitalAdolescent medicine rotationPediatric residency curriculumMedicine/pediatric residentsResidency programsTraining satisfactionAdherence ScaleSBIRT curriculumTeaching hospitalOutcome measuresSignificant preTreatment curriculumClinical practiceClinical settingPediatric residentsResidents' knowledgeResidency curriculumPrevalence of Unhealthy Substance Use on Teaching and Hospitalist Medical Services: Implications for Education
Holt SR, Ramos J, Harma MA, Cabrera F, Louis‐Ashby C, Dinh A, Tetrault JM, Fiellin DA. Prevalence of Unhealthy Substance Use on Teaching and Hospitalist Medical Services: Implications for Education. American Journal On Addictions 2012, 21: 111-119. PMID: 22332853, DOI: 10.1111/j.1521-0391.2011.00207.x.Peer-Reviewed Original ResearchConceptsUnhealthy substance useAlcohol Use Disorders Identification Test-ConsumptionInternal medicine admissionsSubstance useHours of admissionTeaching serviceCommunity teaching hospitalCross-sectional studyDrug Abuse Screening TestMedical teaching serviceAbuse Screening TestMedicine admissionsChart reviewCurrent smokersMedical inpatientsPatient admissionsTeaching hospitalHospitalist serviceCase findingPatientsAdmissionDiagnostic InterviewScreening testMedical resident trainingT patients
2011
Hepatic Safety and Antiretroviral Effectiveness in HIV‐Infected Patients Receiving Naltrexone
Tetrault JM, Tate JP, McGinnis KA, Goulet JL, Sullivan LE, Bryant K, Justice AC, Fiellin DA, Team F. Hepatic Safety and Antiretroviral Effectiveness in HIV‐Infected Patients Receiving Naltrexone. Alcohol Clinical And Experimental Research 2011, 36: 318-324. PMID: 21797892, PMCID: PMC3221963, DOI: 10.1111/j.1530-0277.2011.01601.x.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAlanine TransaminaseAlcoholismAntiretroviral Therapy, Highly ActiveAspartate AminotransferasesCD4 Lymphocyte CountChemical and Drug Induced Liver InjuryCohort StudiesDatabases, FactualDrug InteractionsDrug-Related Side Effects and Adverse ReactionsFemaleHIV InfectionsHumansLiverLiver Function TestsMaleMiddle AgedNaltrexoneNarcotic AntagonistsOpioid-Related DisordersRNA, ViralVeteransConceptsNaltrexone prescriptionAlanine aminotransferaseOpioid dependenceVeterans Aging Cohort Study Virtual CohortAspartate aminotransferaseImpact of naltrexoneSignificant alanine aminotransferaseLiver enzyme elevationMean CD4 countHIV-infected individualsAST changesHepatic safetyHIV biomarkersOral naltrexoneCD4 countHIV RNAMedian durationEnzyme elevationMedian ageAST levelsNaltrexone useHepatic enzymesAntiretroviral effectivenessHIVPatientsNonmedical Use of Opioid Analgesics Obtained Directly From Physicians: Prevalence and Correlates
Becker WC, Tobin DG, Fiellin DA. Nonmedical Use of Opioid Analgesics Obtained Directly From Physicians: Prevalence and Correlates. JAMA Internal Medicine 2011, 171: 1034-1036. PMID: 21670373, DOI: 10.1001/archinternmed.2011.217.Peer-Reviewed Original Research