Beginning Early and Assertive Treatment for Methamphetamine Use Disorder

Study Overview
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Brief Summary
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The overall goal of the study is to evaluate the effectiveness of a secondary prevention strategy implemented at a systems-level to prevent stimulant related overdoses.

Detailed Description
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To date, a public health systems approach to enhance linkage and engagement in care for stimulant use disorders is lacking. This shortcoming arises in part from the lack of effective treatments for stimulant use disorders (StUD), the specific pathology of methamphetamine use, and gaps in epidemiologic knowledge related to methamphetamine use disorder. Unlike opioid use disorders, for which medications relieve dysphoric symptoms of acute withdrawal and prevent relapse, patients with StUD present to care with methamphetamine-induced psychosis and may be combative, agitated, and poorly insightful to their need for treatment. In response to community demands, our team at Denver Health recently established a pilot program, Beginning Early and Assertive Treatment for Methamphetamine Use Disorder (BEAT Meth), to protocolize the assessment and treatment of patients with methamphetamine-induced psychosis.The current research project aims to develop and conduct process and outcomes evaluations of a linkage intervention aimed at increasing continuation and engagement in treatment for stimulant use disorder.

Official Title
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Beginning Early and Assertive Treatment for Methamphetamine Use Disorder (BEATMeth): A Comprehensive Systems-level Secondary Prevention Strategy to Prevent Stimulant Related Overdoses

Conditions
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Methamphetamine Use Disorder

Intervention / Treatment
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* Behavioral: care navigation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years of age and older identified in the Denver Health healthcare system who have had a methamphetamine-related encounter at Denver Health Exclusion Criteria: unable to complete the interview in English intoxicated or impaired and unable to consent to participate in the project and/or respond to the interview currently under residential involuntary psychiatric or substance treatment order (i.e., mental health hold, emergency commitment, or short-term certification) received any type of substance use treatment at DHHA in the last 90 days planning to enter substance treatment unable to complete the research visits in the next 90 days

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>Dedicated care navigator to address social support needs | Behavioral: care navigation<br>* Dedicated care navigation throughout study enrollment and follow-up period. Care navigation consists of addressing social support needs (e.g. transportation, communication, housing).<br>|
| No Intervention: Usual care<br>Standard of care. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of participants who entered treatment for methamphetamine use disorder | Treatment entry as defined as attendance at an outpatient addiction treatment appointment within 30 days of BEAT Meth discharge | within 30 of study enrollment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of participants retained in treatment at 30 days | Retention in treatment at 30 days | 30 days | 
| Number of participants who overdosed | non-fatal overdose as self-reported and fatal overdose from medical examiner | through study completion, an average of 1 year | 
| Number of participants retained in treatment at 90 days | Retention in treatment at 90 days | 90 days |