Treatment Navigation for Opioid Use Disorder

Not Applicable

Completed

Interventions: Other: Control
Behavioral: Treatment Navigation (Intervention)

Brief Summary: The investigators will conduct a pilot randomized controlled trial (RCT) study of 100 people with a history of opioid use disorder releasing to WA Department of Corrections (DOC) community corrections supervision in King County. Half of the subjects will receive treatment as usual (e.g. referral to treatment or outpatient drug counseling by DOC community corrections staff) and half will receive 6 months of intervention. The intervention involves treatment decision making, in which the study interventionists help subjects understand treatment choices, decide on the treatment that is best for them, get enrolled in treatment and remain in treatment. The study does not provide treatment, but works with treatment providers to facilitate access to care.

The aims of this study are to determine: 1) whether study procedures can be implemented with as designed, 2) whether offenders can be enrolled and maintained in the study, 3) which medications/treatment options subjects select and their experiences and satisfaction with the interventions, and 4) preliminary intervention effect size on outcomes of interest including recidivism, drug use, hospitalization, and treatment enrollment and retention.

Recruitment & Eligibility

Inclusion Criteria

Meets Diagnostic and Statistical Manual (DSM-5) criteria for opioid use disorder (at least 2 criteria) or were receiving treatment for opioid use disorder in the 12 months prior to incarceration.
Released to community corrections, not currently incarcerated.
Able to understand and provide informed consent.
Has access to phone (voice or text) or email to communicate with research staff.

Exclusion Criteria

Under age 18 or over age 70 at time of recruitment.
Currently enrolled in an opioid treatment program using medications.
Has not used opioids (prescription type or heroin) in the past 6 months prior to incarceration.
Unwilling to allow access to medical or drug treatment records, criminal history or criminal activity records.
Inability to communicate in English verbally.
Inability to provide adequate contact information to assist with follow-up.
Not planning on being in King County or reporting to community corrections in King County for 6 months.
Violent or overtly hostile/threatening towards research staff.
Entering a controlled environment for 31 days or more in the next 6 months.

Arm && Interventions

Group	Intervention	Description
Control	Control	Referrals to treatment from corrections staff.
Intervention	Treatment Navigation (Intervention)	Initial discussion regarding opioid treatment options followed by 6 months of treatment navigation.

Primary Outcome Measures

Name	Time	Method
Intervention Feasibility	6 months	The number of potentially eligible subjects self-referred or identified by Department of Corrections whom study staff were able to contact, screen, determine to be eligible and enroll in the study at Community Corrections facilities.

Secondary Outcome Measures

Name	Time	Method
Criminal Activity	6 months	The rate of arrests, charges and/or convictions for the comparison group versus the intervention group accounting for various potential residual confounders.
Relapse Prevention Medication Prescriptions	6 months	The rate of medication initiation for the comparison group versus the intervention group accounting for various potential residual confounders.
Hospitalizations	6 months	The rate of hospitalizations for the comparison group versus the intervention group accounting for various potential residual confounders.
Treatment Enrollment	6 months	The rate of treatment enrollment for the comparison group versus the intervention group accounting for various potential residual confounders.