Submit one-page concept by May 31, 2019

The Center for the Clinical Trials Network is pleased to announce plans for a Journal of Substance Abuse Treatment Supplement reviewing the first two decades of the CTN with a focus on the past 10 years.

Dennis McCarty (Western States) and Dennis Donovan (Pacific Northwest) have volunteered to serve as guest editors.

The issue will reflect on the development of the CTN with commentary, and will include integrative summaries of the work the CTN has supported to close the gap between practice and research for the treatment of drug use disorders. A point of emphasis will be the extension of CTN from specialty addiction treatment services to general medical settings and healthcare systems. An additional focus will be research embedded in clinical care which utilizes pragmatic designs, leverages existing clinical staff, and evaluates strategies or approaches for advancing evidence-based care that can be sustainably implemented and disseminated in these settings.

To participate in the issue, email a one-page concept of potential papers by Friday, May 31st to Dennis McCarty (mccartyd@ohsu.edu) and Dennis Donovan (ddonovan@uw.edu), with a copy to Udi Ghitza (ghitzau@nida.nih.gov) and Landhing Moran (landhing.moran@nih.gov) in the Center for the Clinical Trials Network, for review and approval to proceed before drafting a full manuscript. CTN policy requires papers to be reviewed in the CTN publication committee before submission to JSAT. All manuscripts submitted to JSAT will undergo peer review.

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FDA Safety Announcement: Serious Harms Reported After Sudden Discontinuation of Opioid Medications

The FDA has released a new Safety Announcement identifying harms reported from sudden discontinuation of opioid pain medications and requiring label changes to guide prescribers on gradual, individualized tapering.

Reported harms include serious withdrawal symptoms, uncontrolled pain, psychological distress, and suicide.

Read (and share!) the announcement here. The document includes information about safe tapering of opioid medicines for both health care providers and patients.

CTN Trial Progress

Randomizations for Active Studies as of the May 7 trial Progress Report.

CTN-0067 - CHOICES Scale-Up. Enrolled 112

CTN-0068 - ADAPT-2 for Methamphetamine Use Disorder. Enrolled 403

CTN-0069 - OUD in the Emergency Department. Enrolled 486

CTN-0075 - Physician-Pharmacist Collaboration - OUD
Enrolled 76

CTN-0079 - ED-CONNECT
Enrolled 47

Total randomizations in active trials: 1124

News from the Nodes

Northeast Node

The Northeast Node is pleased to announce CTN-0103, entitled “Expanding Clinical Research Training on Implementing the Evidence-based Hub and Spoke Model of Medication-Assisted Treatment for Opioid Use Disorder.”

The Vermont Hub and Spoke Model (VT HSM) of substance use disorder care allows providers to initiate medication treatment for persons with opioid use disorder with assistance from local opioid treatment programs (Hubs) and then support ongoing care of patients through office-based treatment (Spokes) (with flexible movement back into Hubs for patients in need of additional stabilization).

The Node will collaborate with its partner, the New Hampshire (NH) Citizens Health Initiative, that helps lead the Northern New England (NNE) Project ECHO (Extension for Community Healthcare Outcomes) Network across ME, NH, and VT. The NNE ECHO is an expansive collaborative designed to implement a regional network of telehealth services for sharing of knowledge from multidisciplinary expert mentors and teams across a virtual network using the Project ECHO model. This model uses web-supported case-based learning to provide direct education and support to clinicians and communities addressing the opioid epidemic to improve access, care delivery, outcomes and health.

As part of this ongoing teleECHO learning collaborative (LC), CTN-0103 will expand clinical research training in evidence-based quality improvement (QI) methods that were central to delivering and sustaining science-based medication-assisted treatment for opioid use disorder (MOUD) within the VT HSM with fidelity.

To do so, participating primary care practices will be trained in the use of a study-developed toolkit of research and evaluation methods that have been shown to be critical to the impact of the HSM, and the Northeast Node will systematically evaluate the impact of this training. The toolkit will initially be offered to NH providers in the NNE Project ECHO, with the potential to expand to other states.

In addition to the learning provided by the ECHO modules, the study will train participating practices to systematically track standardized outcome metrics and regularly share their practice’s data with other LC members. Practices can then use this information to refine their care model over time, with goals of improving fidelity to best practices for MOUD, promoting optimal patient outcomes, targeting areas for improvement, and giving practices additional tools to sustain the learning provided in the ECHO.

Over the course of the ECHO LC, the study will measure changes in providers’ knowledge about best practices for MOUD, their comfort in caring for OUD patients with MOUD, and their performance on relevant standardized outcome metrics.

Overall, this initiative will support training in clinical research and evaluation methods to best implement and sustain the evidence-based HSM of MOUD. TeleECHO offers considerable promise for supporting a broad learning collaborative/training mechanism within the HSM among geographically-dispersed providers, such as those in rural NH.

You can follow the Northeast Node on Twitter and Facebook.

Texas Node

It’s springtime in Texas and we are thrilled to announce that we have reached our target of 400 randomizations for ADAPT-2 as of 4/8/2019!

We want to offer thanks and congratulations to all of our dedicated ADAPT-2 sites for their hard work! Our teams continue to improve across all performance metrics and now that enrollment is closed they will focus heavily on retention and medication adherence.

We want to recognize some of our sites for their outstanding achievements on the ADAPT-2 trial. Congrats to UCLA and UT Southwestern, who have had consistently high availability of primary outcome data and overall treatment exposure!

We also want to recognize SURU for being a very close runner up to UCLA and UT Southwestern. Congrats to CODA for being the first to reach their site’s randomization target! Well done, everyone! As the weather gets warmer all our sites will continue utilizing creative strategies for keeping active participants engaged and help them complete the study with flying colors!

Happy spring everyone!

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From the ATTC & SAMHSA

ATTC/NIATx Blog Posts:

Why Understanding and Involving the Customer Matters in Behavioral Health
Mat Roosa, LCSW-R, NIATx Coach

ECHO-CMU for ATTC 25th Anniversary: SEA-HATTC's Expansion of New Learning Strategies
ATTC Network

Workplace Learning: Helping Practitioners Work Wiser
Nancy Roget, Joyce Hartje & Terra Hamblin. Pacific Southwest ATTC

New at SAMHSA:

Evidence-Based Practices Resource Center
The new SAMHSA Evidence-Based Practices Resource Center aims to provide communities, clinicians, policy-makers, and others in the field with the information and tools they need to incorporate EBPs into their communities or clinical settings. Find a collection of scientifically-based resources for a broad range of audiences, including Treatment Improvement Protocols, toolkits, resource guides, clinical practice guidelines, and other science-based resources.

Find the Resource Center here!

Upcoming Events

2019 Addiction Health Services Research Conference, October 16-18, 2019:
The 2019 AHSR conference website is now live, with updates on the call for abstracts, registration, and the meeting venue. Check it out and start making your plans here!

Workshop: Interpersonal Violence Syndemics and Co-Occurring Epidemics - Preventing Violence in the Context of Opioid Misuse, Suicide, Social Disparities, and HIV (National Academy of Sciences)
May 16-18, 2019, Washington DC. Will be live-streamed and recorded for those who cannot attend. Find out more here. . .

Also of Interest

Hazelden Betty Ford Seeking New Director for Butler Center for Research
This senior leadership role will lead Hazelden's institutional and clinical research activities to improve treatment effectiveness and fulfill the goals of the organization's strategic plan. Find out more here. . .

NIH Template for Research Protocols Measuring Social or Behavioral Outcomes in Humans
This new protocol template will help behavioral and social science researchers better prepare research protocols for human studies measuring social or behavioral outcomes. Find out more here. . .