Effectiveness of a Hospital Addiction Service in Treating Opioid and Alcohol Addiction (H-SOAP)

Women's College Hospital

Status: Unknown

Conditions: Opiate Addiction; Alcohol Addiction

Treatments: Other: Delayed Intervention (DI); Other: Rapid Intervention (RI)

Study type: Interventional

Funder types: Other

Identifiers

NCT01934751

BRIDGES

MOHLTC (Other Identifier)

Details and patient eligibility

About

Hypothesis: Patients who are addicted to opioids or alcohol will have reduced substance use, health care utilization if they have immediate and convenient access to pharmacotherapy and addiction counselling.

Summary: This randomized trial will compare two different interventions for 124 alcohol and opioid-addicted patients admitted to either Women's Own Detox (WOD) at the University Health Network or the Withdrawal Management Service (WMS) at Saint Michael's Hospital (SMH. The Delayed Intervention group will receive a card with contact information for the St. Michael's Hospital and Women's College Hospital addiction medicine services. The Rapid Intervention group will be seen by an addiction physician from one of these services, within a day or two of their admission to the WOD or the SMH WMS. The addiction physician will prescribe buprenorphine or anti-alcohol medications, and the physician, nurse and/or therapist will provide ongoing counseling, follow-up and shared care with the family physician. Outcomes (measured at 6 and 12 months) include treatment retention, health care utilization and cost, medications prescribed, and alcohol and opioid use.

Enrollment: 124 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• a possible alcohol use disorder, as determined by a score of 8 or above on the AUDIT (Alcohol Use Disorders Identification Test); or, a possible opioid use disorder, as determined by positive responses on the eligibility form: within the past 30 days, opioid use has been a problem, and at least one harmful consequence of opioid use has been present, eg withdrawal symptoms, or problems with family, friends, work, money etc. If the addiction physician who assesses the patient at the first visit to the addiction service concludes that these screening tests were falsely positive and the patient does not have an alcohol or opioid use disorder, the physician will contact the RA to discharge the patient from the study.
• Interested in receiving treatment at an addiction medicine service.
• is alert and able to provide informed consent (ie is not confused, agitated, hostile, intoxicated, sedated or in severe withdrawal)
• Has attended a hospital Emergency Department or has been admitted to hospital in Ontario within the past year.
• Can speak and read English.

Exclusion criteria

• Pregnant
• Currently receiving methadone or buprenorphine treatment
• Cognitively impaired
• Unable to speak or read English

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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124 participants in 2 patient groups

Opioid dependent

Other group

Description:

Subjects with a possible opioid use disorder, as determined by positive responses on the eligibility form: has used opioids within the past 30 days, opioid use has been a problem, and at least one harmful consequence of opioid use has been present (eg. withdrawal symptoms, or problems with family, friends, work, money etc.).

Treatment:

Other: Delayed Intervention (DI)

Other: Rapid Intervention (RI)

Alcohol dependent

Other group

Description:

Patients who indicate they have a problem with alcohol will be asked to complete the AUDIT, a validated, 10-item instrument that measures the severity of an alcohol problem. The AUDIT enquires about core features of alcohol dependence, such as failure to fulfill obligations. A score of 8 or more indicates possible alcohol dependence.

Treatment:

Other: Delayed Intervention (DI)

Other: Rapid Intervention (RI)