Peer Recovery to Improve Polysubstance Use and Mobile Telemedicine Retention

Last updated: April 18, 2025
Sponsor: University of Maryland, College Park
Overall Status: Active - Recruiting

Phase

N/A

Condition

Stimulant Use Disorder

Opioid Use Disorder

Treatment

Peer-Delivered Behavioral Activation ("Peer Activate")

Clinical Study ID

NCT05973838
1953327
R01DA057443
  • Ages > 18
  • All Genders

Study Summary

The purpose of this study is to evaluate the feasibility and effectiveness of a peer-led, brief, behavioral intervention to improve adherence to medication for opioid use disorder (MOUD) and reduce polysubstance use among patients with OUD and polysubstance use in an underserved, rural area. The intervention is based on behavioral activation (BA) and is specifically designed to be implemented by a trained peer recovery specialist. In this hybrid, Type-1 effectiveness-implementation randomized controlled trial (RCT), the investigators will evaluate the effectiveness and implementation of Peer Activate vs. treatment as usual (TAU) over twelve months.

Eligibility Criteria

Inclusion

Inclusion Criteria:

Patient participants in the RCT must be 18 or older; receive OUD treatment as part of the telemedicine program; and exhibit polysubstance use within the past three-months (i.e., use of one or more non-prescribed substances (excluding opioids and/or tobacco) by urine toxicology or self-report.

Exclusion

Exclusion Criteria:

  • Demonstrating active, unstable or untreated psychiatric symptoms, including maniaand/or psychosis that would interfere with study participation

  • Inability to understand the study and provide informed consent in English

Study Design

Total Participants: 180
Treatment Group(s): 1
Primary Treatment: Peer-Delivered Behavioral Activation ("Peer Activate")
Phase:
Study Start date:
June 15, 2023
Estimated Completion Date:
September 01, 2027

Study Description

There is a significant burden of opioid and polysubstance use, disproportionately affecting underserved, rural areas of the US. Yet many rural communities are poorly equipped to meet the pressing need for addiction treatment, including medications for OUD (MOUD) and evidence-based interventions (EBIs) to address the rise in opioid use disorder (OUD) and co-occurring stimulant use.The availability of telemedicine aboard a mobile treatment unit (TM-MTU), led by University of Maryland Baltimore in partnership with Maryland Department of Health, has helped fill the void of rural practitioners by providing buprenorphine for OUD treatment in rural areas, however, OUD treatment retention remains an ongoing challenge, with polysubstance use and stimulant use exacerbating this. Peer recovery specialists (PRSs), trained individuals with their own lived experience with substance use disorder (SUD) and recovery, are a promising strategy to improve OUD treatment retention and polysubstance use via the TM-MTU using a reinforcement-based approach.

Behavioral activation (BA) may be a feasible, scalable, reinforcement-based approach for improving OUD treatment retention and reducing polysubstance use in rural areas. By targeting increases in positive reinforcement, BA has been found to be effective for improving SUD treatment retention, preventing future relapse, including for stimulant use specifically, and improving medication adherence (i.e., for HIV) among low-income, minority populations with SUD as well as depression, which is a barrier to MOUD retention. BA has been shown to be feasibly delivered by peers and community health workers.

This study proposes to evaluate the effectiveness, implementation, and cost-effectiveness of an adapted PRS-delivered BA approach on the TM-MTU ("Peer Activate-MTU") compared to enhanced treatment as usual (ETAU; facilitated referrals and general PRS support) for patients with OUD and other polysubstance use. The investigators propose a randomized Type 1 hybrid effectiveness-implementation trial (n=180) to evaluate Peer Activate-MTU compared to ETAU. Specific aims are to evaluate the effectiveness of Peer Activate-MTU over 12-months on polysubstance use, as well as OUD treatment retention and buprenorphine adherence. The investigators will also evaluate the implementation of Peer-Active-MTU, including feasibility, acceptability, fidelity, and adoption guided by RE-AIM.

Connect with a study center

  • University of Maryland Baltimore (UMD Drug Treatment Center)

    Baltimore, Maryland 21223
    United States

    Site Not Available

  • University of Maryland, College Park

    College Park, Maryland 20742
    United States

    Site Not Available

  • Caroline County Behavioral Health

    Denton, Maryland 21629
    United States

    Active - Recruiting

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