Effectiveness of a Hospital Addiction Service in Treating Opioid and Alcohol Addiction

Summary

Hypothesis: Patients who are addicted to opioids or alcohol will have reduced substance use, health care utilization if they have immediate and convenient access to pharmacotherapy and addiction counselling.

Summary: This randomized trial will compare two different interventions for 124 alcohol and opioid-addicted patients admitted to either Women's Own Detox (WOD) at the University Health Network or the Withdrawal Management Service (WMS) at Saint Michael's Hospital (SMH. The Delayed Intervention group will receive a card with contact information for the St. Michael's Hospital and Women's College Hospital addiction medicine services. The Rapid Intervention group will be seen by an addiction physician from one of these services, within a day or two of their admission to the WOD or the SMH WMS. The addiction physician will prescribe buprenorphine or anti-alcohol medications, and the physician, nurse and/or therapist will provide ongoing counseling, follow-up and shared care with the family physician. Outcomes (measured at 6 and 12 months) include treatment retention, health care utilization and cost, medications prescribed, and alcohol and opioid use.

Conditions

• Alcohol Addiction
• Opiate Addiction

Interventions

OTHER

Delayed Intervention (DI)

Subjects randomized to the DI group will be given a card with the number for the usual Substance Use Service, where they will be seen within 2-4 weeks (standard practice). If they attend the Substance Use Service they will be offered supportive counseling, pharmacotherapy, and information on community treatment resources.

OTHER

Rapid Intervention (RI)

Subjects randomized to the RI group will be seen in the Substance Use Service at within 1-2 days of study enrolment. The Research Assistant will book the appointment and arrange transportation. At the Substance Use Service they will be offered supportive counseling, pharmacotherapy, and information on community treatment resources.

Sponsors & Collaborators

• Unity Health Toronto

  collaborator OTHER

• University Health Network, Toronto

  collaborator OTHER

• Women's College Hospital

  lead OTHER

Principal Investigators

• Meldon Kahan, MDCCFP FRCPC · Women's College Hospital

• Anita Srivastava, MD MSc CCFP · St. Joseph's Health Centre Toronto

• Rajesh Gupta, MD MEd FRCPC · Unity Health Toronto

• Leslie Buckley, MD, MPH · University Health Network, Toronto

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2013-09-30

Primary Completion

2015-04-30

Completion

2015-04-30

Countries

• Canada

Study Locations