2022
Models for Implementing Emergency Department–Initiated Buprenorphine With Referral for Ongoing Medication Treatment at Emergency Department Discharge in Diverse Academic Centers
Whiteside LK, D'Onofrio G, Fiellin DA, Edelman EJ, Richardson L, O'Connor P, Rothman RE, Cowan E, Lyons MS, Fockele CE, Saheed M, Freiermuth C, Punches BE, Guo C, Martel S, Owens PH, Coupet E, Hawk KF. Models for Implementing Emergency Department–Initiated Buprenorphine With Referral for Ongoing Medication Treatment at Emergency Department Discharge in Diverse Academic Centers. Annals Of Emergency Medicine 2022, 80: 410-419. PMID: 35752520, PMCID: PMC9588652, DOI: 10.1016/j.annemergmed.2022.05.010.Peer-Reviewed Original ResearchConceptsOpioid use disorderUse disordersEmergency Department-Initiated BuprenorphineEmergency department dischargeEmergency department patientsElectronic medical record integrationAcademic medical centerBuprenorphine programDepartment patientsTreatment initiationMedication treatmentEmergency physiciansMedical CenterAmerican CollegeClinical practiceImplementation facilitationQuality improvement processBuprenorphineCommon facilitatorsRecord integrationPatientsReferralED cultureEducational disseminationDisordersThe Impact of Access to Addiction Specialist on Attitudes, Beliefs and Hospital-Based Opioid Use Disorder Related Care: A Survey of Hospitalist Physicians
Calcaterra SL, Binswanger IA, Edelman EJ, McNair BK, Wakeman SE, O'Connor P. The Impact of Access to Addiction Specialist on Attitudes, Beliefs and Hospital-Based Opioid Use Disorder Related Care: A Survey of Hospitalist Physicians. Substance Use & Addiction Journal 2022, 43: 143-151. PMID: 32267807, PMCID: PMC7541600, DOI: 10.1080/08897077.2020.1748169.Peer-Reviewed Original ResearchConceptsOpioid use disorderAddiction specialistsLocal treatment resourcesLife-saving treatmentBuprenorphine initiationMultivariable analysisOUD careScreening practicesHospitalist physiciansUse disordersClinical practicePatientsRelated careTreatment resourcesHospitalistsHarm reductionCareTreatmentUnited StatesSpecialistsOnline surveyHospitalizationBuprenorphineComplicationsPrescribing
2020
Validating 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 numberTherapyPopulationMethodsIn
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 Research
2017
Interpreting quantitative urine buprenorphine and norbuprenorphine levels in office-based clinical practice
Donroe JH, Holt SR, O’Connor P, Sukumar N, Tetrault JM. Interpreting quantitative urine buprenorphine and norbuprenorphine levels in office-based clinical practice. Drug And Alcohol Dependence 2017, 180: 46-51. PMID: 28866369, DOI: 10.1016/j.drugalcdep.2017.07.040.Peer-Reviewed Original ResearchConceptsOpioid use disorderUrine buprenorphineNorbuprenorphine levelsUrine adulterationAddiction treatment clinicsTreatment clinicsBuprenorphine medicationSublingual buprenorphineBuprenorphine treatmentTreatment cohortsRetrospective studyUrine specimenBuprenorphineUse disordersPatientsClinical practiceUrine samplesUrineClinicTreatmentMedicationsLevelsNorBUPCohortSuspicionCost‐effectiveness of emergency department‐initiated treatment for opioid dependence
Busch SH, Fiellin DA, Chawarski MC, Owens PH, Pantalon MV, Hawk K, Bernstein SL, O'Connor PG, D'Onofrio G. Cost‐effectiveness of emergency department‐initiated treatment for opioid dependence. Addiction 2017, 112: 2002-2010. PMID: 28815789, PMCID: PMC5657503, DOI: 10.1111/add.13900.Peer-Reviewed Original ResearchConceptsCost-effectiveness acceptability curvesOpioid dependenceCommunity-based treatmentBrief interventionAcceptability curvesPast weekHealth care system costsHealth care system perspectiveAddiction treatmentOpioid-dependent patientsPatient time costsHealth care useFormal addiction treatmentBuprenorphine treatmentUrban EDEmergency departmentPrimary carePatient engagementTreatment engagementPatientsReferralSecondary analysisBuprenorphineNumber of daysInterventionCorrigendum to “The Starting Treatment for Ethanol in Primary care Trials (STEP Trials): Protocol for three parallel multi-site stepped care effectiveness studies for unhealthy alcohol use in HIV-positive patients” [Contemp. Clin. Trials 52 (2017) 80–90]
Edelman EJ, Maisto SA, Hansen NB, Cutter CJ, Dziura J, Fiellin LE, O'Connor PG, Bedimo R, Gibert C, Marconi VC, Rimland D, Rodriguez-Barradas MC, Simberkoff MS, Justice AC, Bryant KJ, Fiellin DA. Corrigendum to “The Starting Treatment for Ethanol in Primary care Trials (STEP Trials): Protocol for three parallel multi-site stepped care effectiveness studies for unhealthy alcohol use in HIV-positive patients” [Contemp. Clin. Trials 52 (2017) 80–90]. Contemporary Clinical Trials 2017, 60: 125. PMID: 28712767, DOI: 10.1016/j.cct.2017.06.016.Peer-Reviewed Case Reports and Technical NotesEmergency 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
Implementation 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
2014
The impact of buprenorphine/naloxone treatment on HIV risk behaviors among HIV-infected, opioid-dependent patients
Edelman EJ, Chantarat T, Caffrey S, Chaudhry A, O’Connor P, Weiss L, Fiellin DA, Fiellin LE. The impact of buprenorphine/naloxone treatment on HIV risk behaviors among HIV-infected, opioid-dependent patients. Drug And Alcohol Dependence 2014, 139: 79-85. PMID: 24726429, PMCID: PMC4029496, DOI: 10.1016/j.drugalcdep.2014.03.006.Peer-Reviewed Original ResearchConceptsBuprenorphine/naloxone treatmentOpioid-dependent patientsHIV risk behaviorsBuprenorphine/naloxoneNon-condom useNaloxone treatmentRisk behaviorsTreatment initiationViral loadHIV-1 RNA viral loadCocaine/amphetaminesTime-updated variablesRNA viral loadMajor risk factorOpioid-dependent populationsCochran-Armitage trend testSexual risk behaviorsOlder patientsHIV infectionOpioid dependenceRisk factorsHeroin useHIVPatientsTargeted interventions
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 effectsA 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
2011
Hepatic Safety and Lack of Antiretroviral Interactions With Buprenorphine/Naloxone in HIV-Infected Opioid-Dependent Patients
Vergara-Rodriguez P, Tozzi MJ, Botsko M, Nandi V, Altice F, Egan JE, O'Connor PG, Sullivan LE, Fiellin DA. Hepatic Safety and Lack of Antiretroviral Interactions With Buprenorphine/Naloxone in HIV-Infected Opioid-Dependent Patients. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2011, 56: s62-s67. PMID: 21317596, DOI: 10.1097/qai.0b013e31820a820f.Peer-Reviewed Original ResearchConceptsBuprenorphine/naloxoneOpioid-dependent patientsMedian aspartate aminotransferasePharmacodynamic interactionsAspartate aminotransferaseBup/ALT valuesAlanine aminotransferaseBUP/NXOpioid-dependent HIVProspective cohort studyHepatic safetyHepatitis CCohort studyHepatic toxicityHIVPatientsAtazanavirNaloxonePrior reportsExposure measuresSignificant decreaseAminotransferaseSignificant changesTreatmentDrug 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 studyPatientsNaloxoneMedications for unhealthy alcohol use: across the spectrum.
O'Malley SS, O'Connor PG. Medications for unhealthy alcohol use: across the spectrum. Alcohol Research 2011, 33: 300-12. PMID: 23580015, PMCID: PMC3860540.Peer-Reviewed Original ResearchConceptsUnhealthy alcohol useSpecialty careCare settingsAlcohol useAdvent of pharmacotherapyPrimary care providersPrimary care settingSpectrum of careHealth care settingsPrimary careCare providersHazardous drinkersEarly interventionExcessive drinkingCareAlcohol problemsTreatmentMedicationsPharmacotherapyPatientsCliniciansPrevalenceSettingDrinkers
2009
The Association between Cocaine Use and Treatment Outcomes in Patients Receiving Office‐Based Buprenorphine/Naloxone for the Treatment of Opioid Dependence
Sullivan LE, Moore BA, O'Connor PG, Barry DT, Chawarski MC, Schottenfeld RS, Fiellin DA. The Association between Cocaine Use and Treatment Outcomes in Patients Receiving Office‐Based Buprenorphine/Naloxone for the Treatment of Opioid Dependence. American Journal On Addictions 2009, 19: 53-58. PMID: 20132122, PMCID: PMC3107713, DOI: 10.1111/j.1521-0391.2009.00003.x.Peer-Reviewed Original ResearchConceptsOpioid-negative urinesBuprenorphine/naloxoneUrine toxicology testsWeeks of treatmentWorse treatment outcomesTreatment outcomesCocaine useTreatment retentionMean weekBuprenorphine/naloxone maintenanceGreater percentageToxicology testsUrine toxicology resultsOpioid dependenceToxicology resultsPatientsTargeted interventionsWeeksNaloxoneOutcomesTreatmentBaselineUrineAssociationPercentage
2008
Cost analysis of clinic and office-based treatment of opioid dependence: Results with methadone and buprenorphine in clinically stable patients
Jones ES, Moore BA, Sindelar JL, O’Connor P, Schottenfeld RS, Fiellin DA. Cost analysis of clinic and office-based treatment of opioid dependence: Results with methadone and buprenorphine in clinically stable patients. Drug And Alcohol Dependence 2008, 99: 132-140. PMID: 18804923, PMCID: PMC2646001, DOI: 10.1016/j.drugalcdep.2008.07.013.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultBuprenorphineCohort StudiesCost of IllnessCosts and Cost AnalysisData Interpretation, StatisticalFemaleHealth PersonnelHumansMaleMethadoneMiddle AgedNarcoticsOpioid-Related DisordersPhysicians' OfficesSocioeconomic FactorsSubstance Abuse DetectionSubstance Abuse Treatment CentersTreatment OutcomeYoung AdultConceptsOffice-based treatmentOpioid dependencePatient costsClinical contactMonthly medication costsOffice-based buprenorphineOffice-based methadoneMonths of treatmentAnalysis of treatmentTotal monthly costsChi-square testMonths of maintenanceStable patientsMedication costsPatientsMethadoneMonthly costBuprenorphineTreatmentMonthsStatistical comparisonCost estimatesClinic