Young Houston Emergency Opioid Engagement System

Purpose

The Houston Emergency Response Opioid Engagement System for Youths and Adolescents (Young HEROES) is a community-based research program integrating assertive outreach, medication for opioid use disorder (MOUD), behavioral counseling, and peer recovery support. The objective is to compare differences in engagement and retention in treatment for individuals with opioid use disorder. The investigators also intend to understand the prevalence of opioid overdoses and OUD among youth in Houston.

Conditions

  • Opioid-use Disorder
  • Opioid Dependence
  • Opioid Overdose
  • Opioid Use
  • Substance Use Disorders

Eligibility

Eligible Ages
Between 13 Years and 17 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • In otherwise good health based on physician assessment and medical history - Drug screen positive for opioids - Patients express a willingness to stop opioid use - Meet Diagnostic and Statistical Manual of Mental Disorders - Text Revision (DSM-IV-TR) criteria for opioid dependence - Patients must be able to speak English - Be agreeable to and capable of signing the informed consent and assent (parent or guardian must consent, minor must assent)

Exclusion Criteria

  • Non-English-speaking patients - Have a known sensitivity to buprenorphine or naloxone - Be physiologically dependent on alcohol, benzodiazepines, or other drugs of abuse that require immediate medical attention. Other substance use diagnoses are not exclusionary. - Have a medical condition that would, in the opinion of the study physician, make participation medically hazardous, including unstable cardiovascular disease, neurological deficits, trauma, acute hepatitis, stroke, and liver or renal disease) - Be acutely psychotic, severely depressed, and in need of inpatient treatment, or is an immediate suicide risk - Be a nursing or pregnant female

Study Design

Phase
Phase 4
Study Type
Interventional
Allocation
N/A
Intervention Model
Single Group Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
MOUD induction and behavioral interventions among opioid-dependent youths 		Induction into medication for opioid use disorder (MOUD) treatment and behavioral interventions
  • Drug: Buprenorphine, Naloxone Drug Combination
    8mg of buprenorphine/2mg of naloxone to initiate MOUD treatment and bridge, if necessary, until referral to MOUD clinic can be made for ongoing treatment
    Other names:
    • Suboxone
  • Behavioral: Individual Counseling
    One-on-one counseling with a licensed chemical dependency counselor
    Other names:
    • Therapy
  • Behavioral: Peer Recovery Support Services
    24/7 support from our team of certified peer recovery support specialists to assist with emotional support and case management
    Other names:
    • Peer Coaching
    • Recovery Coaching
  • Behavioral: Support Group
    Referrals to youth-focused support groups and eventual creation of in-house youth-focused support groups
    Other names:
    • Group Therapy
  • Behavioral: Referral to Medication Management
    Study staff will refer patients to long-term MOUD providers in the community
  • Behavioral: Assertive Outreach
    The investigators will conduct weekly outreach to youths who experienced an opioid overdose and attempt to initiate treatment. Outreach is completed by a paramedic and peer coach.
    Other names:
    • Community Outreach

Recruiting Locations

The University of Texas Health Science Center at Houston
Houston, Texas 77030
Contact:
James R Langabeer, PhD
713-500-3925
james.r.langabeer@uth.tmc.edu

More Details

Status
Recruiting
Sponsor
The University of Texas Health Science Center, Houston

Study Contact

James R Langabeer, PhD
713-500-3925
james.r.langabeer@uth.tmc.edu

Detailed Description

The Houston Emergency Response Opioid Engagement System for Youths and Adolescents (Young HEROES) is a non-randomized cohort study based at the University of Texas Health Science Center of Houston. This study recruits participants through three avenues: assertive community outreach with a peer coach and paramedic following and opioid overdose, community referrals, and emergency department referrals. The study explores the effect of the combination of assertive outreach, same-day induction into medication for opioid use disorder, ongoing maintenance treatment, behavioral counseling, peer recovery support, and paramedic follow-up on patient outcomes. The primary outcome is engagement and retention in outpatient treatment. Secondary outcomes include quality of life assessment as well as subsequent relapses and overdoses. The hypothesis is that patients with earlier induction into MOUD treatment who receive routine follow-up, are more likely to engage and remain in treatment long-term.