for people ages 18 years and up (full criteria)
study started
completion around



The purpose of this study is to develop and then test an enhanced version of the parent study's collaborative care intervention for co-occurring disorders (CC-COD) to reduce the risk of suicide and overdose among individuals with opioid use disorder (OUD) in combination with PTSD/depression. The parent study is CLARO, Collaboration Leading to Addiction Treatment and Recovery from Other Stresses (NCT04559893).

Official Title

Competitive Revision for Improving Access and Treatment for Co-occurring Opioid Use Disorders and Mental Illness


People with OUD co-occurring with depression or PTSD (COD) may not seek out treatment for their substance use or mental health issues, but they do visit their primary care provider. However, because providers generally lack specialized training in substance use and mental illness and are focused on the immediate reason for the visit, patients' substance use and mental disorders often go unrecognized and untreated. This missed opportunity can have lethal consequences. Individuals with COD are at higher risk of dying from suicide or overdose than individuals with mental illness or OUD alone. The parent study (NCT04559893) will provide a definitive answer as to whether collaborative care (CC) improves access, quality, and outcomes of care for individuals with COD. While a primary goal is to improve access to and retention in medication treatment for OUD (MOUD) (which is linked to decreased mortality and overdose risk), the interventions CC-COD supports do not proactively address suicide or overdose risk, an important limitation. In addition, CC-COD does not include families in the patient's care. The investigators address these limitations and tackle the public health crisis of increasing deaths from suicide and overdose with this study. Because family members can play an important role in a patient's decision to engage with treatment and in overdose and suicide prevention, the study team investigates family members' views and use this information to strengthen CC-COD. This revision will develop and then test the incremental effectiveness of three additional CC-COD components. Care coordinators will (1) educate family members about MOUD with the goal of increasing patient retention in treatment; (2) train family members and the patient to administer naloxone and on how to reduce overdose risk behaviors; and (3) implement Caring Contacts, a suicide prevention intervention that sends compassionate mailed or text messages to individuals to decrease social isolation and reduce suicide risk.


Opioid-use Disorder, Addiction, Depression, Post Traumatic Stress Disorder, Suicidal Ideation, Collaborative care, Problem Solving Therapy, Written Exposure Therapy, Medication for addiction treatment, Opioid use disorder, Suicide prevention, Overdose prevention, Opioid-Related Disorders, Substance-Related Disorders, Traumatic Stress Disorders, Addictive Behavior, Post-Traumatic Stress Disorders, Collaborative care Plus


You can join if…

Open to people ages 18 years and up

  • 18 and older
  • Receiving primary care at one of the participating clinical sites
  • Has OUD and one or more specific co-occurring behavioral health disorders (depression and PTSD)

You CAN'T join if...

  • Under 18
  • Does not speak English or Spanish
  • Unable to consent
  • Receiving both MOUD and psychotropic medication from a provider outside of the primary care health system at which the patient is enrolled.
  • Not receiving primary care at one of the participating clinical sites


  • Providence Saint John's Health Center
    Santa Monica California 90404 United States
  • Hubert Humphrey Comprehensive Health Center
    Los Angeles California 90003 United States


in progress, not accepting new patients
Start Date
Completion Date
Study Type
Expecting 300 study participants
Last Updated