ED-Initiated Standard Versus High Dose Buprenorphine Induction
Yale University
Summary
This study is a multisite double-blind, double-dummy, randomized clinical trial enrolling ED patients with untreated moderate to severe opioid use disorder (OUD) to compare Standard Dose Induction (SDI) and High Dose Induction (HDI) on rates of participation in OUD treatment within 10 days post randomization, and opioid withdrawal symptoms, opioid craving, and use of illicit and non-prescribed drugs.
Description
This study will recruit, train, and provide resources to approximately 4 ED systems throughout the U.S. to recruit ED patients presenting with OUD not receiving medications for opioid use disorder (MOUD) as part of an RCT to compare SDI (Zubsolv 5.7/1.4 mg buprenorphine/naloxone\* plus 2 placebo tablets) with HDI (three Zubsolv 5.7/1.4 mg\* buprenorphine/naloxone tablets) to evaluate rate of participation in OUD treatment within 10 days post-randomization and differences in outcomes of tolerability, opioid withdrawal symptoms, craving, and use of illicit drugs.
Eligibility
- Age range
- 18–65 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: All patients enrolled into the study must: 1. Be 18-65 years of age. 2. Be treated in the ED during study screening hours. 3. Meet DSM-5 diagnostic criteria for moderate to severe OUD. 4. Have a Clinical Opiate Withdrawal Scale (COWS) score of ≥8 at enrollment (including 2 objective signs of withdrawal at enrollment). 5. Have a urine toxicology test that is positive for opioids. 6. Be able to speak English sufficiently to understand the study procedures and provide written informed consent to participate in the study. Exclusion Criteria: All patients enrolled into the s…
Interventions
- DrugBuprenorphine
All patients will receive 3 pills and will be observed for 2 hours post-study medication administration with repeated COWS at approximately hours 1 and 2. All participants will be given a referral for ongoing MOUD and will be discharged with a prescription for 16 mg daily of buprenorphine daily.
Locations (5)
- Highland HospitalOakland, California
- San Leandro HospitalSan Leandro, California
- Maine Medical CenterPortland, Maine
- Cooper University HospitalCamden, New Jersey
- University of Utah HospitalSalt Lake City, Utah