Summary

Eligibility
for people ages 18-99 (full criteria)
Location
at UCSF
Dates
study started
completion around
Principal Investigator
by Paula Lum, MD (ucsf)Andy Tompkins, MD (ucsf)
Headshot of Paula Lum
Paula Lum
Headshot of Andy Tompkins
Andy Tompkins

Description

Summary

The purpose of this clinical trial is to compare the effectiveness of office-based methadone with pharmacy administration and/or dispensing to office-based buprenorphine for the treatment of opioid use disorder. This study will also examine factors influencing the implementation of office-based methadone.

Official Title

Office-based Methadone Versus Buprenorphine to Address Retention in Medication for Opioid Use Disorder Treatment - A Pragmatic Hybrid Effectiveness/Implementation Trial

Details

This study is a randomized, pragmatic hybrid type 1 effectiveness/implementation multisite (approximately 6 sites) trial to determine whether office-based methadone with pharmacy administration and/or dispensing or buprenorphine (BUP) results in greater treatment retention in approximately 600 patients with opioid use disorder (OUD). This trial will also identify implementation barriers, facilitators and acceptability at the patient, provider and health-systems level for office-based methadone with pharmacy administration and/or dispensing.

Keywords

Opioid Use Disorder, Methadone, Buprenorphine, Opioid-Related Disorders, Substance-Related Disorders, Buprenorphine (BUP), Office-based methadone, Office-based buprenorphine (BUP)

Eligibility

You can join if…

Open to people ages 18-99

  • 18 years of age or older;
  • Meet Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria for OUD;
  • Are initiating a new MOUD treatment episode

You CAN'T join if...

  • Have been prescribed (and ingested) or been administered more than 72 hours of MOUD in the 7 days prior to randomization as a "bridge" to the new OUD treatment episode. Such MOUD may include prescribed (and ingested) or administered medically managed withdrawal (aka detoxification).
  • Known contraindication to methadone or BUP
  • Unwilling to pursue or continue pre-natal care or pregnancy counseling if determined pregnant by urine human chorionic gonadotropin (hCG) testing at the screening assessment
  • Be actively suicidal or severely cognitively impaired (e.g., dementia, untreated psychosis) precluding informed consent as determined by site clinician
  • Current severe comorbid substance use disorder requiring residential or inpatient treatment services as determined by site clinician
  • Be unable or unwilling to provide reliable locator information including 2 or more contacts in addition to themselves
  • Be unwilling to follow study procedures (e.g., unwilling to receive treatment from site clinician, use the study pharmacy, unwilling to be randomized to BUP or methadone, or will be unavailable for the follow-up assessments) including allowing the researchers to access their record in the EMR and state's prescription drug monitoring program
  • Have previously enrolled in CTN-0131
  • Currently enrolled in another research study which will conflict with study procedures
  • Are currently in jail, prison or other overnight facility as required by a court of law or have pending legal action that could prevent participation in study activities
  • Unable to conduct research assessments in English as determined by Site PI or their designee.

Locations

  • Outpatient Buprenorphine Induction Clinic, University of California, San Francisco accepting new patients
    San Francisco California 94103 United States
  • Highland Hospital Bridge Clinic at Alameda Health System accepting new patients
    Oakland California 94602 United States

Lead Scientists at University of California Health

  • Paula Lum, MD (ucsf)
    Paula J. Lum, MD MPH is Professor of Clinical Medicine and founding Program Director of the UCSF Primary Care Addiction Medicine Fellowship. She has been a faculty member in the Division of HIV, Infectious Diseases and Global Medicine at San Francisco General Hospital since 1999.
  • Andy Tompkins, MD (ucsf)
    Professor, Psychiatry, School of Medicine. Authored (or co-authored) 47 research publications

Details

Status
accepting new patients
Start Date
Completion Date
(estimated)
Sponsor
Yale University
ID
NCT06323824
Phase
Phase 4 research study
Study Type
Interventional
Participants
Expecting 600 study participants
Last Updated