Automated Recovery Line for Medication Assisted Treatment
| Status: | Recruiting |
|---|---|
| Conditions: | Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | November 2015 |
| End Date: | June 2016 |
| Contact: | Brent Moore, Ph.D. |
| Email: | brent.moore@yale.edu |
| Phone: | 203-285-2700 |
If shown to be effective, the Recovery Line would provide an inexpensive, transportable, and
easy to use treatment to improve substance abuse outcomes for medication assisted treatment.
Given the high costs of relapse and continued drug use, improvement of treatment outcomes
would provide substantial health, economic, and societal benefits.
easy to use treatment to improve substance abuse outcomes for medication assisted treatment.
Given the high costs of relapse and continued drug use, improvement of treatment outcomes
would provide substantial health, economic, and societal benefits.
Dependence on heroin and prescription pain relievers has almost tripled since 2000,
resulting in dramatic increases in opioid dependence treatment admissions. However, among
agonist-maintained patients continued drug use is common and associated with high rates of
relapse and treatment drop-out. Although counseling has been shown to be effective, it is
costly and some patients dislike counseling, others have responsibilities that make
attendance difficult, and patients in rural settings often have limited access to
psychotherapy. Thus, there is a clear need to develop additional acceptable and
cost-effective treatments. Interactive Voice Response (IVR) systems, which have been shown
to effectively augment brief interventions for substance abuse, are automated,
computer-based systems delivered via phone and use voice or keys to access different menus.
IVR systems can be accessed from any phone rather than only specified technology (e.g.,
smartphones), and offer advantages of low cost, consistent delivery, expanded access, and
24-hour availability of immediate therapeutic intervention. The Recovery Line is a Cognitive
Behavioral Therapy (CBT)-based IVR system to reduce substance use in patients receiving
opioid agonist maintenance. We recently completed a pilot randomized 4-week trial which
showed significant reduction in cocaine use and increased coping skill efficacy, but
patients called less time than expected, suggesting methods to improve patient use may
further improve efficacy. This Stage Ib application proposes three phases to develop system
functions to increase patient system use and to test those functions. The initial two phases
will develop customized recommendations and reminders to be used in Phase 3 pilot clinical
trial. The Phase 3 trial is a 12-week pilot randomized (N=60), clinical trial with a 3 month
post-treatment follow-up to obtain data regarding the feasibility, acceptability and
efficacy of the developed Recovery Line (compared to TAU). Efficacy will be evaluated for
the two primary outcome domains of the proportion of urine screens negative for illicit
drugs and monthly days of illicit drug abstinence. Secondary outcome measures will be
retention in treatment and coping skills efficacy.
resulting in dramatic increases in opioid dependence treatment admissions. However, among
agonist-maintained patients continued drug use is common and associated with high rates of
relapse and treatment drop-out. Although counseling has been shown to be effective, it is
costly and some patients dislike counseling, others have responsibilities that make
attendance difficult, and patients in rural settings often have limited access to
psychotherapy. Thus, there is a clear need to develop additional acceptable and
cost-effective treatments. Interactive Voice Response (IVR) systems, which have been shown
to effectively augment brief interventions for substance abuse, are automated,
computer-based systems delivered via phone and use voice or keys to access different menus.
IVR systems can be accessed from any phone rather than only specified technology (e.g.,
smartphones), and offer advantages of low cost, consistent delivery, expanded access, and
24-hour availability of immediate therapeutic intervention. The Recovery Line is a Cognitive
Behavioral Therapy (CBT)-based IVR system to reduce substance use in patients receiving
opioid agonist maintenance. We recently completed a pilot randomized 4-week trial which
showed significant reduction in cocaine use and increased coping skill efficacy, but
patients called less time than expected, suggesting methods to improve patient use may
further improve efficacy. This Stage Ib application proposes three phases to develop system
functions to increase patient system use and to test those functions. The initial two phases
will develop customized recommendations and reminders to be used in Phase 3 pilot clinical
trial. The Phase 3 trial is a 12-week pilot randomized (N=60), clinical trial with a 3 month
post-treatment follow-up to obtain data regarding the feasibility, acceptability and
efficacy of the developed Recovery Line (compared to TAU). Efficacy will be evaluated for
the two primary outcome domains of the proportion of urine screens negative for illicit
drugs and monthly days of illicit drug abstinence. Secondary outcome measures will be
retention in treatment and coping skills efficacy.
Inclusion Criteria:
1. are at least 18 years old
2. currently receiving methadone maintenance treatment
3. illicit drug use in the past 14 days or a positive urine screen for any tested
illicit drug.
Exclusion Criteria:
1. Current suicide or homicide risk
2. meet criteria for Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV
current psychotic disorder, or bipolar disorder
3. Unable to read or understand English
4. Unable to complete the study because of anticipated incarceration or move
5. Life-threatening or unstable medical problems.
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