The Western States Node's (WSN) research agenda for the National Drug Abuse Treatment Clinical Trials Network (CTN) competing renewal tests interventions to fill gaps in the Addiction Care Cascade, where progressively fewer people with drug use engage in treatment, receive pharmacotherapy, are retained in care, and experience sustained recovery. The Node proposes to continue the successful partnership between Oregon Health & Science University (OHSU; Todd Korthuis, MPI) and University of California San Francisco (UCSF; James Sorensen, Co-I), and adds Stanford University/Palo Alto VA (Keith Humphreys, MPI) to the collaboration. Six diverse health systems participate in WSN: 1) OCHIN, 2) The Palo Alto VA and national Veterans Healthcare Administration, 3) The OHSU health system, 4) Stanford Hospital and Clinics, 5) ProtoCall Services, Inc., and 6) Health Share and Trillium Medicaid managed care organizations. The WSN tests novel interventions that expand access to medications for opioid use disorder (MOUD). The overarching goal of the WSN's competing renewal application is to conduct collaborative research within the CTN that fills gaps in the Addiction Care Cascade and thereby enhances the lives of people living with drug use disorders. Our Addiction Care Cascade-focused research agenda developed through conversations with diverse investigators and stakeholders including people who use drugs. Two research themes (medication trials and hybrid implementation trials to close gaps in the Addiction Care Cascade) provide four examples of CTN studies that could help close treatment gaps. In Research Theme 1 (medication trials), Medication Trial 1 targets people with OUD who are not interested in currently available MOUD and randomizes them to receive long acting oral hydromorphone versus facilitated referral methadone or buprenorphine to improve engagement and retention in treatment. Medication Trial 2 is a multisite phase 3 trial of mirtazapine versus placebo for people with methamphetamine use disorder to reduce methamphetamine use. In Research Theme 2 (hybrid implementation trials), two trials compare strategies to enhance engagement and retention on MOUD. Hybrid Effectiveness-Implementation Trial 1 is a cluster- randomized trial of telephonic + mHealth behavioral support services to improve retention on buprenorphine in primary care. Hybrid Effectiveness-Implementation Trial 2 tests a telementoring peer support intervention versus weekly peer supervision to improve peer success in engaging and retaining people who use drugs in treatment. We suffuse this research agenda with the Node's infrastructure and expertise in vulnerable populations, health systems, electronic health records research, data science and clinical trials management. WSN offers these resources to the CTN network for use in future CTN protocols. Finally, WSN continues to use the CTN as a platform for training, dissemination, and research applications.

Public Health Relevance

The Western States Node renewal application to participate in the Clinical Trials Network has broad public health implications, developing and testing strategies to close gaps in the addiction treatment cascade. The research agenda seeks to repurpose medications and uses electronic health records to collect data in hybrid effectiveness-implementation trials.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Clinical Research Cooperative Agreements - Single Project (UG1)
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Special Emphasis Panel (ZDA1)
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Dobbins, Ronald
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Oregon Health and Science University
Internal Medicine/Medicine
Schools of Medicine
United States
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Holton, Dwight; White, Elizabeth; McCarty, Dennis (2018) Public Health Policy Strategies to Address the Opioid Epidemic. Clin Pharmacol Ther 103:959-962
Anastas, Tracy; Waddell, Elizabeth Needham; Howk, Sonya et al. (2018) Building Behavioral Health Homes: Clinician and Staff Perspectives on Creating Integrated Care Teams. J Behav Health Serv Res :
McCarty, Dennis; Gu, Yifan; Renfro, Stephanie et al. (2018) Access to treatment for alcohol use disorders following Oregon's health care reforms and Medicaid expansion. J Subst Abuse Treat 94:24-28
Sorensen, James L; Llamas, Jasmin D (2018) Process Evaluation of a Community Outpatient Program Treating Substance Use Disorders. J Community Psychol 46:844-855
Springer, Sandra A; Korthuis, P Todd; Del Rio, Carlos (2018) Integrating Treatment at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics in Medical Settings: A Call for Action After a National Academies of Sciences, Engineering, and Medicine Workshop. Ann Intern Med 169:335-336
Campbell, Aimee N C; Barbosa-Leiker, Celestina; Hatch-Maillette, Mary et al. (2018) Gender differences in demographic and clinical characteristics of patients with opioid use disorder entering a comparative effectiveness medication trial. Am J Addict 27:465-470
McCarty, Dennis; Priest, Kelsey C; Korthuis, P Todd (2018) Treatment and Prevention of Opioid Use Disorder: Challenges and Opportunities. Annu Rev Public Health 39:525-541
Winhusen, Theresa; Feaster, Daniel J; Duan, Rui et al. (2018) Baseline Cigarette Smoking Status as a Predictor of Virologic Suppression and CD4 Cell Count During One-Year Follow-Up in Substance Users with Uncontrolled HIV Infection. AIDS Behav 22:2026-2032
Havens, Jennifer R; Walsh, Sharon L; Korthuis, P Todd et al. (2018) Implementing Treatment of Opioid-Use Disorder in Rural Settings: a Focus on HIV and Hepatitis C Prevention and Treatment. Curr HIV/AIDS Rep 15:315-323
Kohno, Milky; Dennis, Laura E; McCready, Holly et al. (2018) A preliminary randomized clinical trial of naltrexone reduces striatal resting state functional connectivity in people with methamphetamine use disorder. Drug Alcohol Depend 192:186-192

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