2023
Early emergency department experience with 7‐day extended‐release injectable buprenorphine for opioid use disorder
D'Onofrio G, Perrone J, Hawk K, Cowan E, McCormack R, Coupet E, Owens P, Martel S, Huntley K, Walsh S, Lofwall M, Herring A, Investigators T. Early emergency department experience with 7‐day extended‐release injectable buprenorphine for opioid use disorder. Academic Emergency Medicine 2023, 30: 1264-1271. PMID: 37501652, PMCID: PMC10822018, DOI: 10.1111/acem.14782.Peer-Reviewed Original ResearchConceptsOpioid use disorderEmergency departmentUse disordersSevere opioid use disorderOngoing clinical trialsEuropean Medicines AgencyEmergency department experienceInjectable buprenorphineClinician barriersED patientsED settingEmergency cliniciansInsurance statusClinical trialsReferral sitesDrug AdministrationMedicines AgencyBuprenorphine preparationsMedicationsU.S. FoodTreatment innovationsBuprenorphineDepartment's experienceEarly experienceDisordersURINE TOXICOLOGY PROFILES OF EMERGENCY DEPARTMENT PATIENTS WITH UNTREATED OPIOID USE DISORDER: A MULTI-SITE VIEW
Cowan E, Perrone J, Dziura J, Edelman E, Hawk K, Herring A, McCormack R, Murphy A, Phadke M, Fiellin D, D'Onofrio G. URINE TOXICOLOGY PROFILES OF EMERGENCY DEPARTMENT PATIENTS WITH UNTREATED OPIOID USE DISORDER: A MULTI-SITE VIEW. Journal Of Emergency Medicine 2023, 65: e357-e365. PMID: 37716904, PMCID: PMC10591927, DOI: 10.1016/j.jemermed.2023.06.007.Peer-Reviewed Original ResearchUrine drug screensOpioid use disorderEmergency departmentUntreated opioid use disorderAdult ED patientsOpioid overdose deathsED patientsOnly opioidCommon opioidsOverdose deathsUse disordersCommon drugsOpioidsPolysubstance useDrug useDrug screensAmphetamine-type stimulantsFentanylPatientsAddiction treatmentStimulantsParticipantsBuprenorphineMethadoneBenzodiazepinesUse of an Automated Bilingual Digital Health Tool to Reduce Unhealthy Alcohol Use Among Latino Emergency Department Patients
Vaca F, Dziura J, Abujarad F, Pantalon M, Hsiao A, Reynolds J, Maciejewski K, Field C, D’Onofrio G. Use of an Automated Bilingual Digital Health Tool to Reduce Unhealthy Alcohol Use Among Latino Emergency Department Patients. JAMA Network Open 2023, 6: e2314848. PMID: 37219901, PMCID: PMC10208138, DOI: 10.1001/jamanetworkopen.2023.14848.Peer-Reviewed Original ResearchConceptsStandard care groupNumber of bingesEmergency department patientsStandard careED patientsCare groupBrief interventionDepartment patientsAlcohol screeningDisease burdenUnhealthy drinkingDigital health toolsLevel II trauma centerHealth toolsParticipants 25 yearsAlcohol-related health disparitiesTertiary care centerAdverse health behaviorsUnhealthy alcohol useHigh disease burdenAlcohol use disorderTimeline followback methodEmergency medical careSelf-reported numberHigh-risk drinkingImplementation 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
Missed Opportunities for HIV and Hepatitis C Screening Among Emergency Department Patients With Untreated Opioid Use Disorder
Lyons MS, Chawarski MC, Rothman R, Whiteside L, Cowan E, Richardson LD, Hawk K, Tsui JI, Schwartz RP, O’Connor P, D’Onofrio G, Fiellin DA, Edelman EJ. Missed Opportunities for HIV and Hepatitis C Screening Among Emergency Department Patients With Untreated Opioid Use Disorder. Journal Of Addiction Medicine 2022, 17: 210-214. PMID: 36170184, PMCID: PMC10023471, DOI: 10.1097/adm.0000000000001074.Peer-Reviewed Original ResearchConceptsUntreated opioid use disorderOpioid use disorderRecent injection drug useEmergency department HIVInjection drug useHCV screeningED patientsUse disordersEnrollment periodDrug useHepatitis C screeningStructured screening programmeUnknown HCV statusUnknown HIV statusHigh-risk cohortMedical care providersHCV statusC screeningHepatitis CED visitsAcademic EDHIV statusEmergency departmentCohort 2Cohort 1Use of a Brief Negotiation Interview in the emergency department to reduce high‐risk alcohol use among older adults: A randomized trial
Shenvi CL, Wang Y, Revankar R, Phillips J, Bush M, Biese KJ, Aylward A, D'Onofrio G, Platts‐Mills T. Use of a Brief Negotiation Interview in the emergency department to reduce high‐risk alcohol use among older adults: A randomized trial. Journal Of The American College Of Emergency Physicians Open 2022, 3: e12651. PMID: 35156089, PMCID: PMC8828696, DOI: 10.1002/emp2.12651.Peer-Reviewed Original ResearchHigh-risk alcohol useBrief Negotiation InterviewEmergency departmentHigh-risk drinkersAlcohol usePrimary outcomeOlder adultsSingle academic emergency departmentAcademic emergency departmentNon-Hispanic whitesUsual careED visitsED patientsEligible individualsAlcohol abuseAlcohol consumptionFull criteriaAlcoholism definitionMonthsNational InstituteAdultsSignificant differencesPatientsSignificant reductionOutcomes
2021
Feasibility and acceptability of electronic administration of patient reported outcomes using mHealth platform in emergency department patients with non-medical opioid use
Hawk K, Malicki C, Kinsman J, D’Onofrio G, Taylor A, Venkatesh A. Feasibility and acceptability of electronic administration of patient reported outcomes using mHealth platform in emergency department patients with non-medical opioid use. Addiction Science & Clinical Practice 2021, 16: 66. PMID: 34758881, PMCID: PMC8579535, DOI: 10.1186/s13722-021-00276-0.Peer-Reviewed Original ResearchConceptsNon-medical opioid useOpioid use disorderOpioid useEmergency departmentED patientsED visitsPrescription medicationsMHealth platformUrban academic emergency departmentEligible adult patientsEmergency department patientsPathways of careTransitions of careAcademic emergency departmentAbsence of patientsElectronic surveyCollection of PROsMeasures of feasibilityOverdose risk behaviorsHalf of participantsMobile health platformNear-term outcomesElectronic health recordsAdult patientsHospital dischargeImplementation of Oral and Extended-Release Naltrexone for the Treatment of Emergency Department Patients With Moderate to Severe Alcohol Use Disorder: Feasibility and Initial Outcomes
Anderson ES, Chamberlin M, Zuluaga M, Ullal M, Hawk K, McCormack R, D'Onofrio G, Herring AA. Implementation of Oral and Extended-Release Naltrexone for the Treatment of Emergency Department Patients With Moderate to Severe Alcohol Use Disorder: Feasibility and Initial Outcomes. Annals Of Emergency Medicine 2021, 78: 752-758. PMID: 34353648, DOI: 10.1016/j.annemergmed.2021.05.013.Peer-Reviewed Original ResearchConceptsAlcohol use disorderSevere alcohol use disorderFormal addiction treatmentIntramuscular naltrexoneOral naltrexoneUse disordersAddiction treatmentED patientsExtended-release naltrexoneEffectiveness of naltrexoneEmergency department patientsED dischargeAdult patientsDepartment patientsNaltrexone treatmentEmergency departmentMean ageEffective treatmentNaltrexonePatientsClinical protocolsBrief interventionDescriptive studyDisordersInitial outcomesHigh-Dose Buprenorphine Induction in the Emergency Department for Treatment of Opioid Use Disorder
Herring AA, Vosooghi AA, Luftig J, Anderson ES, Zhao X, Dziura J, Hawk KF, McCormack RP, Saxon A, D’Onofrio G. High-Dose Buprenorphine Induction in the Emergency Department for Treatment of Opioid Use Disorder. JAMA Network Open 2021, 4: e2117128. PMID: 34264326, PMCID: PMC8283555, DOI: 10.1001/jamanetworkopen.2021.17128.Peer-Reviewed Original ResearchConceptsOpioid use disorderEmergency departmentBuprenorphine inductionRespiratory depressionAdverse eventsUse disordersUntreated opioid use disorderSerious adverse eventsFurther prospective investigationLength of stayUrban emergency departmentSafety-net hospitalAdvanced practice practitionersElectronic health recordsUnique cliniciansSublingual buprenorphineBuprenorphine doseED visitsED encountersCase seriesED patientsED physiciansSupplemental oxygenMedian lengthUnique patientsA 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
2019
Implementation 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 providers
2013
A Promising Approach For Emergency Departments To Care For Patients With Substance Use And Behavioral Disorders
Bernstein SL, D’Onofrio G. A Promising Approach For Emergency Departments To Care For Patients With Substance Use And Behavioral Disorders. Health Affairs 2013, 32: 2122-2128. PMID: 24301395, DOI: 10.1377/hlthaff.2013.0664.Peer-Reviewed Original ResearchConceptsEmergency departmentPrimary care systemSubstance useBehavioral disordersCare systemAcuity of illnessUS emergency departmentsHigh patient volumeNation's primary care systemMillions of patientsHealth care systemED patientsBody of evidenceBrief interventionPatientsPatient volumeSBIRTMotivational interviewingHealth of millionsDisordersRisky behaviorsCounseling techniquesReflective listeningDepartmentAcuity
2012
A Brief Intervention Reduces Hazardous and Harmful Drinking in Emergency Department Patients
D'Onofrio G, Fiellin DA, Pantalon MV, Chawarski MC, Owens PH, Degutis LC, Busch SH, Bernstein SL, O'Connor PG. A Brief Intervention Reduces Hazardous and Harmful Drinking in Emergency Department Patients. Annals Of Emergency Medicine 2012, 60: 181-192. PMID: 22459448, PMCID: PMC3811141, DOI: 10.1016/j.annemergmed.2012.02.006.Peer-Reviewed Original ResearchConceptsBrief Negotiation InterviewStandard careEmergency department patientsBrief interventionAlcohol consumptionDepartment patientsHarmful drinkersDrinking outcomesHarmful drinkingAssessment groupStandard care groupAdult ED patientsNegative health behaviorsSecondary outcomesPrimary outcomeED patientsCare groupED settingTelephone boosterBooster groupBinge episodesHealth behaviorsPatientsAlcohol useCare
2010
Integrating Project ASSERT: A Screening, Intervention, and Referral to Treatment Program for Unhealthy Alcohol and Drug Use Into an Urban Emergency Department
D’Onofrio G, Degutis LC. Integrating Project ASSERT: A Screening, Intervention, and Referral to Treatment Program for Unhealthy Alcohol and Drug Use Into an Urban Emergency Department. Academic Emergency Medicine 2010, 17: 903-911. PMID: 20670330, DOI: 10.1111/j.1553-2712.2010.00824.x.Peer-Reviewed Original ResearchConceptsSpecialized treatment facilitiesBrief Negotiation InterviewHealth promotion advocatesDrug useTreatment programUnhealthy alcoholED patientsEmergency departmentPercent of patientsAdult ED patientsAlcohol/drug useUrban emergency departmentLow-risk drinkingGeneral Health QuestionnaireAlcoholism guidelinesReferral completionUrban EDFacilitated referralDirect admissionHealth QuestionnaireUnhealthy drinkingAlcohol abusePatientsSeverity of useAlcohol consumption
2009
Alcohol, Tobacco, and Other Drugs: Future Directions for Screening and Intervention in the Emergency Department
Cunningham RM, Bernstein SL, Walton M, Broderick K, Vaca FE, Woolard R, Bernstein E, Blow F, D’Onofrio G. Alcohol, Tobacco, and Other Drugs: Future Directions for Screening and Intervention in the Emergency Department. Academic Emergency Medicine 2009, 16: 1078-1088. PMID: 20053226, DOI: 10.1111/j.1553-2712.2009.00552.x.Peer-Reviewed Original ResearchConceptsEmergency departmentBrief interventionED patientsSubstance useLarge public health impactEffectiveness of screeningMultiple risk behaviorsAvailable community servicesMental health treatmentPublic health impactOptimal delivery methodEffective brief interventionsPractical screening instrumentAcademic Emergency Medicine consensus conferenceMedical care systemCost-effectiveness researchED settingPatient subgroupsInterventional studyTreatment referralPreventive servicesEffectiveness trialReferral strategiesTobacco useInjury prevention
1998
Patients with Alcohol Problems in the Emergency Department, Part 1: Improving Detection*
D'Onofrio G, Bernstein E, Bernstein J, Woolard R, Brewer P, Craig S, Zink B, Force F. Patients with Alcohol Problems in the Emergency Department, Part 1: Improving Detection*. Academic Emergency Medicine 1998, 5: 1200-1209. PMID: 9864134, DOI: 10.1111/j.1553-2712.1998.tb02696.x.Peer-Reviewed Original ResearchConceptsAlcohol problemsEmergency medicine practiceBusy ED settingBrief screening toolSubsequent morbidityED patientsAcute complaintsED settingEmergency departmentPatient populationEarly interventionMedicine practicePatientsScreening toolAlcohol useDependent drinkersEarly detectionTask ForceMorbidityMortalityComplaintsDrinkers