Sara Becker, PhD
With overdoses and deaths due to opioid use disorders (OUDs) having reached epidemic proportions in the state of Rhode Island, there is a critical need for highly effective OUD treatments. There are currently five FDA-approved medication formulations, which relative to placebo have demonstrated effectiveness in helping patients attain abstinence from opioids. Nonetheless, patients’ opioid abstinence rates are sub-optimal: even when treated with the newest extended-release formulations only about 40% of patients maintain abstinence from opioids during the first 6-months of treatment. Contingency management (CM; i.e., motivational incentives for achieving pre-defined treatment goals) is the only behavioral intervention shown to improve patient abstinence from opioids when combined with FDA-approved pharmacotherapy. Unfortunately, however, very few OUD treatment centers provide CM due to a myriad of organization- and provider-level barriers. In response to the urgent need for effective OUD treatments, as well as the need to identify the best strategies to implement evidence-based innovations within real-world settings, this project component initially proposed partnering with 12 opioid treatment programs to test the best way to implement CM as an adjunct to pharmacotherapy. The Project Director was awarded independent R01 level funding within one month of the start of project activities. As a result, project funds were used to support the conduct of formative qualitative research with front-line treatment providers and leaders across the 12 opioid treatment programs. Data collected from these qualitative interviews is currently being used to inform the Project Director’s first R01 grant, a large-scale cluster randomized trial with 30 opioid treatment programs throughout New England.