Implementing addiction treatment trials in medical settings in (NIDA’s) National Drug Abuse Treatment Clinical Trials Network.

Many people with addictions receive health care but never receive specialty addictions treatment. With movement toward integrating addiction treatment into medical care, the National Drug Abuse Treatment Clinical Trials Network (CTN) began conducting protocols in medical settings such as primary care and emergency departments (ED). This poster describes the implementation process of the first CTN trial conducted in medical emergency departments, the six-site “Screening, Motivational Assessment, Referral and Treatment in the Emergency Department (SMART-ED)” protocol (CTN-0047). The SMART-ED trial presented unique challenges because of its ED setting. Several implementation components were particularly important in the SMART-ED trial: 1. Site selection (ED department and staff buy-in was central to decisions on which sites were chosen to participate); 2. Staff selection (interventionists/RAs needed to possess the empathy necessary to deliver an motivational interviewing-based intervention); 3. RA and interventionist training and ongoing coaching (in-person and webinar trainings ensured that research staff understood and were able to follow protocol procedures and be certified to deliver the intervention. Ongoing telephone coaching is successful in preventing drift); 4. Site preparation (prior to beginning the main trial, each site also had real-world practice conducting study procedures through standardized patient visits); 5. Data collection (the screening data is collected using direct entry into tablet computers to facilitate rapid screening and mobility within the ED setting). In conclusion, some of the procedures used in this clinical trial may be useful in the successful implementation of future addiction trials conducted in medical settings.

Related protocols: CTN-0047