Office-based Methadone Versus Buprenorphine to Address Retention in Medication for Opioid Use Disorder Treatment.

NCT ID: NCT06323824

Last Updated: 2025-10-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

600 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-06-04

Study Completion Date

2029-05-31

Brief Summary

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The purpose of this clinical trial is to compare the effectiveness of office-based methadone with pharmacy administration and/or dispensing to office-based buprenorphine for the treatment of opioid use disorder. This study will also examine factors influencing the implementation of office-based methadone.

Detailed Description

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This study is a randomized, pragmatic hybrid type 1 effectiveness/implementation multisite (approximately 6 sites) trial to determine whether office-based methadone with pharmacy administration and/or dispensing or buprenorphine (BUP) results in greater treatment retention in approximately 600 patients with opioid use disorder (OUD). This trial will also identify implementation barriers, facilitators and acceptability at the patient, provider and health-systems level for office-based methadone with pharmacy administration and/or dispensing.

Conditions

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Opioid Use Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The comparative effectiveness of two strategies to address retention in medication for opioid use disorder (MOUD) treatment will be tested over a 168-day period. Behavioral treatments offered to patients are designed to be similar across the two medication conditions.

Office-based methadone where the clinician prescribes methadone and oral methadone is administered and/or dispensed at a pharmacy. Providers and Randomized Control Trial (RCT) participants will have flexibility to use behavioral and pharmacological services as clinically indicated.

Office-based buprenorphine (BUP) where the clinician prescribes BUP formulations that are dispensed at a pharmacy or administered in the office (e.g., extended-release formulations). Providers and RCT participants will have flexibility to use behavioral and pharmacological services as clinically indicated.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Office-based methadone

Under special Drug Enforcement Administration (DEA) exception, Clinician prescribes methadone and oral methadone is administered and/or dispensed at a pharmacy which also has an exception to do so. All randomized controlled trial (RCT) participants are offered additional behavioral treatments (e.g., individual, group, telehealth, phone-based).

Group Type EXPERIMENTAL

Methadone

Intervention Type DRUG

Drug: Methadone

Possible formulations:

10 and 50 mg tablets

Office-based buprenorphine (BUP)

Clinician prescribes BUP formulations that are dispensed at a pharmacy or administered in the office (e.g., extended-release formulations). All RCT participants are offered additional behavioral treatments (e.g., individual, group, telehealth, phone-based).

Group Type ACTIVE_COMPARATOR

Buprenorphine (BUP)

Intervention Type DRUG

Drug: Buprenorphine (BUP)

Possible formulations:

A. Buprenorphine 225 mcg to 24 mg 225 mcg to 32 mg per day

B. Buprenorphine (Extended release) 300 mg q 28 days (Sublocade) 100 mg q 28 days (Sublocade) 8 mg q 7 days (Brixadi) 16 mg q 7 days (Brixadi) 24 mg q 7 days (Brixadi) 32 mg q 7 days (Brixadi) 64 mg q 7 28 days (Brixadi) 96 mg q 7 28 days (Brixadi) 128 mg q 7 28 days (Brixadi)

Interventions

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Methadone

Drug: Methadone

Possible formulations:

10 and 50 mg tablets

Intervention Type DRUG

Buprenorphine (BUP)

Drug: Buprenorphine (BUP)

Possible formulations:

A. Buprenorphine 225 mcg to 24 mg 225 mcg to 32 mg per day

B. Buprenorphine (Extended release) 300 mg q 28 days (Sublocade) 100 mg q 28 days (Sublocade) 8 mg q 7 days (Brixadi) 16 mg q 7 days (Brixadi) 24 mg q 7 days (Brixadi) 32 mg q 7 days (Brixadi) 64 mg q 7 28 days (Brixadi) 96 mg q 7 28 days (Brixadi) 128 mg q 7 28 days (Brixadi)

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* 18 years of age or older;
* Meet Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria for OUD;
* Are initiating a new MOUD treatment episode

Exclusion Criteria

* Have been prescribed (and ingested) or been administered more than 72 hours of MOUD in the 7 days prior to randomization as a "bridge" to the new OUD treatment episode. Such MOUD may include prescribed (and ingested) or administered medically managed withdrawal (aka detoxification).
* Known contraindication to methadone or BUP
* Unwilling to pursue or continue pre-natal care or pregnancy counseling if determined pregnant by urine human chorionic gonadotropin (hCG) testing at the screening assessment
* Be actively suicidal or severely cognitively impaired (e.g., dementia, untreated psychosis) precluding informed consent as determined by site clinician
* Current severe comorbid substance use disorder requiring residential or inpatient treatment services as determined by site clinician
* Be unable to provide locator information including one or more contacts in addition to themselves
* Be unwilling to follow study procedures (e.g., unwilling to receive treatment from site clinician, use the study pharmacy, unwilling to be randomized to BUP or methadone, or will be unavailable for the follow-up assessments) including allowing the researchers to access their record in the EMR and state's prescription drug monitoring program
* Have previously enrolled in CTN-0131
* Currently enrolled in another research study which will conflict with study procedures
* Are currently in jail, prison or other overnight facility as required by a court of law or have pending legal action that could prevent participation in study activities
* Unable to conduct research assessments in English as determined by Site PI or their designee.
Minimum Eligible Age

18 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institutes of Health (NIH)

NIH

Sponsor Role collaborator

National Institute on Drug Abuse (NIDA)

NIH

Sponsor Role collaborator

The Emmes Company, LLC

INDUSTRY

Sponsor Role collaborator

University of California, San Francisco

OTHER

Sponsor Role collaborator

Boston Medical Center (BMC)

UNKNOWN

Sponsor Role collaborator

Hennepin Healthcare Research Institute

OTHER

Sponsor Role collaborator

Alameda Health System

OTHER

Sponsor Role collaborator

Marshall Health

UNKNOWN

Sponsor Role collaborator

Kaiser Permanente

OTHER

Sponsor Role collaborator

Yale University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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David Fiellin, MD

Role: PRINCIPAL_INVESTIGATOR

Yale University

Locations

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Highland Hospital Bridge Clinic at Alameda Health System

Oakland, California, United States

Site Status RECRUITING

Outpatient Buprenorphine Induction Clinic, University of California, San Francisco

San Francisco, California, United States

Site Status RECRUITING

Rapid Start Clinic, Kaiser Permanente Colorado

Denver, Colorado, United States

Site Status RECRUITING

Officed Based Addiction Treatment Program, Boston Medical Center

Boston, Massachusetts, United States

Site Status RECRUITING

Hennepin Healthcare Addiction Medicine

Minneapolis, Minnesota, United States

Site Status RECRUITING

Marshall University Division of Addiction Sciences P.R.O.A.C.T

Huntington, West Virginia, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Jessica Research Associate

Role: CONTACT

203-785-6821

Melissa Gordon

Role: CONTACT

203-937-3486 ext. 7415

Facility Contacts

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Jhoselyn Pineda

Role: primary

510-214-3649

Kristina Toma

Role: primary

415-254-0398

Jennifer Barrow

Role: primary

303-739-3666

Emily Oot

Role: primary

857-283-7620

Dat Nguyen

Role: primary

763-568-2785

Mary Edwards

Role: primary

304-908-9244

Other Identifiers

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CTN-0131

Identifier Type: OTHER

Identifier Source: secondary_id

5UG1DA015831-21

Identifier Type: NIH

Identifier Source: secondary_id

View Link

2000033271

Identifier Type: -

Identifier Source: org_study_id

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