Houston Emergency Opioid Engagement System (HEROES)

The University of Texas System (UT)

Status and phase

Invitation-only

Phase 4

Conditions

Opioid Use Disorder

Treatments

Behavioral: Brief counseling in the ED

Behavioral: Referral to outpatient treatment

Drug: Suboxone

Behavioral: Follow-up coaching

Study type

Interventional

Funder types

Other

Identifiers

NCT03396276

HSC-SBMI-17-1021

Details and patient eligibility

About

The Houston Emergency Response Opioid Engagement System (HEROES) is a community-based research program integrating assertive outreach, medication-assisted treatment, behavioral counseling, peer recovery support, and paramedic follow-up in Houston Texas. The objective is to compare differences in engagement and retention in treatment for individuals with opioid use disorder.

Full description

The Houston Emergency Response Opioid Engagement System (HEROES) is a non-randomized cohort study based at the University of Texas Health Science Center of Houston. This study seeks to develop an emergency- initiated opioid system of care for individuals with prior opioid overdose and opioid use disorder. The study involves both assertive outreach on individuals who have recent overdoses within the last 72 hours, as well as individuals who are admitted to local hospital emergency departments. The study explores the effect of the combination of assertive outreach, same-day induction into medication-assisted treatment, ongoing maintenance treatment, behavioral counseling, peer recovery support, and paramedic follow-up on patient outcomes. The primary outcome is engagement and retention outpatient treatment. Secondary outcomes include quality of life assessment as well as subsequent relapses and overdoses. The hypothesis is that patients with earlier induction into MAT treatment in the emergency department, who receive routine follow-up, are more likely to engage and be retained in a longer-term treatment program for their addiction.

Enrollment

3,000 estimated patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

In otherwise good health based on physician assessment and medical history
Tests positive in urine sample for opioids
Patients express a willingness to stop opioid use
Meet Diagnostic and Statistical Manual of Mental Disorders - Text Revision (DSM-IV-TR) criteria for opioid dependence
Patients must be able to speak English
Be agreeable to and capable of signing informed consent

Exclusion criteria

Non-English-speaking patients
Have a known sensitivity to buprenorphine or naloxone
Be physiologically dependent on alcohol, benzodiazepines or other drugs of abuse that require immediate medical attention. Other substance use diagnoses are not exclusionary.
Have a medical condition that would, in the opinion of the study physician, make participation medically hazardous, including unstable cardiovascular disease, neurological deficits, trauma, acute hepatitis, stroke, and liver or renal disease)
Be acutely psychotic, severely depressed, and in need of inpatient treatment, or is an immediate suicide risk
Be a nursing or pregnant female