Collaborative Care for Polysubstance Use in Primary Care Settings (Co-Care)
The Research Need
People with risky use of opioids and other substances often face complex clinical problems. Many of these individuals receive care in primary care settings, which are typically an ideal context for diagnosis and treatment. However, few patients are identified by primary care providers, pointing to a need to increase primary care-based adoption of effective, evidence-based practices.
About the Program
This program will design and test a primary care setting-based, multidisciplinary treatment model to serve patients with unhealthy use of opioids and alcohol, stimulants, and/or sedatives. Researchers will first plan, develop, and define a treatment model and pilot test its feasibility and acceptability. They will next conduct a large, randomized, controlled efficacy-effectiveness trial. This research aims to identify approaches for reducing polysubstance use, problem behaviors, and overdose risk, and create linkages to substance use disorder treatment.
The program will build upon existing components such as the Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS) screening tool, which has been validated in a National Drug Abuse Treatment Clinical Trials Network-funded research project, as well as components of the Prevention of Progression to Moderate or Severe Opioid Use Disorder (STOP) and Optimizing Care for People with Opioid Use Disorder and Mental Health Conditions studies, funded by the Helping to End Addiction Long-term® Initiative, or NIH HEAL Initiative®. The trial will be conducted in four to six health systems with an estimated 500 patients.
Through the NIH HEAL Initiative®, NIH has awarded research grants and administrative supplements to conduct this trial.
This research will be carried out through the National Drug Abuse Treatment Clinical Trials Network (CTN), which brings together medical and specialty treatment providers, researchers, patients, and the National Institute on Drug Abuse.
The CTN supports rigorous, multisite trials to determine the effectiveness of treatment strategies in a broad range of treatment settings and diverse patient populations and to ensure the timely transfer of research results to clinicians, providers, and their patients. The expansion of the CTN, supported by the NIH HEAL Initiative, enhances the network’s scientific and clinical research capabilities and allows increased coverage in geographic regions most affected by the drug overdose epidemic.
The program will conduct a two-phase project to design and evaluate a primary care setting-based, multidisciplinary treatment model to serve patients with unhealthy use of opioids and alcohol, stimulants, and/or sedatives.
The two-phase project will:
Plan, develop, and define a treatment model and pilot test its feasibility and acceptability
Conduct a large, randomized, controlled efficacy-effectiveness trial
Participating NIH Institutes, Centers, and Offices
Geetha Subramaniam, Ph.D.
View Other Research Programs in This Focus Area
- Optimizing Care for People with Opioid Use Disorder and Mental Health Conditions
- Optimizing the Duration, Retention, and Discontinuation of Medication Treatment for Opioid Use Disorder
- Preventing Opioid Use Disorder
- Prevention of Progression to Moderate or Severe Opioid Use Disorder (STOP)
- Randomized, Double-Blind, Placebo-controlled Trial of Monthly Injectable Buprenorphine for Methamphetamine Use Disorder (MURB)
- Sleep Dysfunction as a Core Feature of Opioid Use Disorder and Recovery