Implementing Contingency Management for Stimulant Use in Specialty Addiction Treatment Organizations (Center for Dissemination and Implementation Science at Stanford, Research Component #2)
Northwestern University
Summary
Stimulants constitute a new and deadly fourth wave of the opioid epidemic. Contingency management is the most effective intervention for stimulant use and is an evidence-based adjunct to medication for opioid use disorder. Yet, uptake of contingency management in opioid treatment programs that provide medication for opioid use disorder remains low; in fact, access to contingency management is arguably one of the greatest research-to-practice gaps in the addiction treatment services field. The goal of this study is to conduct a type III hybrid effectiveness-implementation trial to evaluate a multi-level implementation strategy, the Science of Service Laboratory, to install contingency management for stimulant use in opioid treatment programs. The Science of Service Laboratory has three core components: didactic training, performance feedback, and external facilitation. Utilizing a stepped wedge design, a cohort of public sector addiction specialty treatment programs will be randomized to receive Science of Service Laboratory across four cohorts. Each of the programs will provide de-identified electronic medical record data from all available patient charts on contingency management delivery and patient outcomes. Staff from each program will provide feedback on contextual determinants influencing implementation. This study will rigorously evaluate whether a multi-level implementation strategy developed by one of the longest-standing national intermediary purveyor organizations-the SAMHSA Technology Transfer Centers, will improve both implementation and patient outcomes.
Description
Stimulant use among persons with opioid use disorder is associated with an array of serious consequences. Among those with opioid use disorder, stimulant use has been associated with more persistent opioid use; higher risk of HIV infection; higher levels of family, medical, legal, and vocational problems; and increased risk of fatal overdose. Contingency management is an evidence-based intervention for stimulant use and an evidence-based adjunct to medication for opioid use disorders. Medication for opioid use disorder is the first-line, evidence-based treatment for opioid use disorder, but do…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
* Opioid Treatment Program Counselors: * Inclusion criteria: 1) provide ongoing psychosocial support to medication for opioid use disorder patients (e.g., intake sessions, individual counseling, and/or group counseling sessions), and 2) have an active caseload * Exclusion criteria: Younger than 18 years of age, unable to provide informed consent * Persons on Medication for Opioid Use Disorder \[Not recruited, via electronic medical records only\] * Inclusion criteria: must be newly initiated on medication for opioid use disorders (within the past 30 days) and have concurrent stimulant…
Interventions
- BehavioralScience to Service Laboratory
The Science of Service Laboratory implementation strategy consists of: didactic training (contingency management workshops; monthly contingency management coaching calls), performance feedback (practice sessions and electronic medical record feedback); and facilitation (monthly facilitation calls).
Locations (9)
- ACCESS Community Health NetworksChicago, Illinois
- Lawndale Christian Health CenterChicago, Illinois
- Healthcare Alternative SystemsChicago, Illinois
- Community Outreach Intervention ProjectsChicago, Illinois
- Family Guidance CentersChicago, Illinois
- Rosecrance Health NetworkRockford, Illinois