Trial Summary
What is the purpose of this trial?This trial tests if trained peers can help low-income, minority individuals with opioid addiction stick to their medication by encouraging positive activities. The goal is to see if this approach improves medication adherence.
Is Peer-Delivered Behavioral Activation a promising treatment for opioid addiction?Yes, Peer-Delivered Behavioral Activation is a promising treatment for opioid addiction. It involves people who have experienced addiction themselves helping others, which can improve retention in treatment programs like methadone. This approach can also help reduce stigma and make treatment more accessible, especially for those in minority communities.13579
What data supports the idea that Peer-Delivered Behavioral Activation for Opioid Addiction is an effective treatment?The available research shows that Peer-Delivered Behavioral Activation, also known as Peer Activate, can help improve retention in methadone treatment for opioid addiction. This is important because staying in treatment is a big challenge for many people. The studies suggest that when peers, who have personal experience with addiction and recovery, deliver this treatment, it can be effective. They are able to connect with patients in a way that helps them stick with their methadone treatment. This approach seems promising, especially for people from low-income and minority backgrounds who might face more barriers to staying in treatment.14679
What safety data exists for Peer-Delivered Behavioral Activation for opioid addiction?The provided research does not explicitly mention safety data for Peer-Delivered Behavioral Activation or its variants. However, the studies focus on the feasibility, patient experiences, and effectiveness of the intervention, suggesting it is being explored in clinical settings. More specific safety data might be available in detailed study reports or future publications.23789
Do I have to stop taking my current medications for this trial?The trial does not specify if you need to stop taking your current medications. However, it focuses on improving adherence to methadone, so you may need to continue taking methadone if you are already on it.
Eligibility Criteria
This trial is for adults over 18 in Baltimore with opioid use disorder who have started methadone treatment at the study site within the last three months or have had trouble sticking to their methadone regimen. It's not for those with untreated severe mental health issues, non-English speakers, or pregnant individuals.Inclusion Criteria
I am at least 18 years old.
Treatment Details
The 'Peer Activate' program, led by peer recovery specialists using behavioral activation techniques, aims to improve how well participants stick to their medication-assisted treatment for opioid addiction compared to usual care. The effectiveness and implementation will be studied over six months.
2Treatment groups
Experimental Treatment
Active Control
Group I: Peer-Delivered Behavioral Activation ("Peer Activate")Experimental Treatment1 Intervention
Participants in the Peer Activate intervention will receive a PRS-delivered behavioral activation intervention to address barriers to retention in methadone treatment and increase substance-free, positive reinforcement to support retention.
Group II: Treatment As UsualActive Control1 Intervention
Participants in the TAU group will receive treatment as usual (weekly group and individual counseling with an addiction counselor in addition to referral to other available services in the community through study contact).
Find a clinic near you
Research locations nearbySelect from list below to view details:
University of Maryland Baltimore (UMD Drug Treatment Center)Baltimore, MD
University of Maryland College ParkCollege Park, MD
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Who is running the clinical trial?
University of Maryland, College ParkLead Sponsor
Henry Ford Health SystemCollaborator
University of Maryland, BaltimoreCollaborator
References
Emergency department-based peer support for opioid use disorder: Emergent functions and forms. [2021]Emergency department (ED)-based peer support programs aimed at linking persons with opioid use disorder (OUD) to medication for addiction treatment and other recovery services are a promising approach to addressing the opioid crisis. This brief report draws on experiences from three states' experience with such programs funded by the SAMHSA Opioid State Targeted Repose (STR) grants. Core functions of such programs include: Integration of peer supports in EDs; Alerting peers of eligible patients and making the patient aware of peer services; and connecting patients with recovery services. Qualitative data were analyzed using a general inductive approach conducted in 3 steps in order to identify forms utilized to fulfill these functions. Peer integration differed in terms of peer's physical location and who hired and supervised peers. Peers often depend on ED staff to alert them to potential patients while people other than the peers often first introduce potential patients to programming. Programs generally schedule initial appointments for recovery services for patients, but some programs provide a range of other services aimed at supporting participation in recovery services. Future effectiveness evaluations of ED-based peer support programs for OUD should consistently report on forms used to fulfill core functions.
Real-world reduction in healthcare resource utilization following treatment of opioid use disorder with reSET-O, a novel prescription digital therapeutic. [2022]Buprenorphine medication assisted treatment (B-MAT) adherence for opioid use disorder (OUD) is suboptimal. reSET-O, an FDA-cleared prescription digital therapeutic, delivers neurobehavioral therapy (community-reinforcement approach+fluency training+contingency management) to B-MAT-treated OUD patients.
Feasibility and outcomes from an integrated bridge treatment program for opioid use disorder. [2022]With a significant proportion of individuals with opioid use disorder not currently receiving treatment, it is critical to find novel ways to engage and retain patients in treatment. Our objective is to describe the feasibility and preliminary outcomes of a program that used emergency physicians to initiate a bridge treatment, followed by peer support services, behavioral counseling, and ongoing treatment and follow-up.
Effectiveness of peer recovery support services on stages of the opioid use disorder treatment cascade: A systematic review. [2022]Peer recovery support services (PRSS) have been increasingly incorporated during the recovery process for opioid use disorder (OUD), yet little is known about the effects of PRSS on clinical outcomes of individuals who misuse opioids. This study systematically synthesized existing literature reporting the effectiveness of PRSS interventions on stages of the OUD treatment cascade.
"In their mind, they always felt less than": The role of peers in shifting stigma as a barrier to opioid use disorder treatment retention. [2023]A substantial, national need exists for culturally acceptable, accessible opioid use disorder (OUD) treatment. Medication for opioid use disorder (MOUD) is regarded as effective in treating OUD; however, retention in MOUD programs remains low nationally. One known barrier to MOUD retention is stigma, particularly within ethno-racial minority communities. Peer recovery specialists (PRSs), individuals with shared experience in substance use and recovery, may be particularly well suited to support patients in MOUD treatment, and may have capacity to play a key role in decreasing stigma-related barriers to MOUD retention.
Patient Activation of Persons With Opioid Use Disorder in Intensive Outpatient Treatment. [2022]High patient activation is associated with a variety of positive health outcomes. Although increasing patient activation in persons with opioid use disorder (OUD) in intensive outpatient treatment (IOT) programs may increase engagement and improve outcomes, little is known about how patient activation is manifested in these programs.
Peer recovery specialist-delivered, behavioral activation intervention to improve retention in methadone treatment: Results from an open-label, Type 1 hybrid effectiveness-implementation pilot trial. [2023]Despite the efficacy of methadone to treat opioid use disorder (OUD), retention is an urgent priority, particularly among low-income, minoritized populations. Peer recovery specialists are well-positioned to engage vulnerable patients, particularly when trained in an evidence-based intervention to promote retention. This hybrid effectiveness-implementation pilot trial aimed to demonstrate the proof of concept of a peer recovery specialist-delivered behavioral activation and problem solving-based approach (Peer Activate) to improve methadone retention.
A Peer Recovery Coach Intervention for Hospitalized Patients with Opioid Use Disorder: A Pilot Randomized Controlled Trial. [2023]Patients with opioid use disorder (OUD) are increasingly being hospitalized for acute medical illnesses. Despite initiation of medications for OUD (MOUDs), many discontinue treatment after discharge. To evaluate whether a psychosocial intervention can improve MOUD retention after hospitalization, we conducted a pilot randomized controlled trial of a peer recovery coach intervention.
"You rise up and then you start pulling people up with you": Patient experiences with a peer-delivered behavioral activation intervention to support methadone treatment. [2023]Although medications for opioid use disorder (MOUD) are efficacious treatments for opioid use disorder, retention remains low. Peer recovery specialists (PRSs), individuals with lived substance use and recovery experience, may be particularly well-suited to support patients receiving MOUD. While PRSs are rarely trained in evidence-based behavioral interventions other than motivational interviewing, preliminary evidence suggests that peers can deliver brief behavioral interventions, such as behavioral activation, with efficacy and fidelity. This qualitative study sought to explore patient perspectives on receiving an adapted PRS-delivered behavioral activation intervention (Peer Activate) to support patients receiving methadone treatment.