Continuum of Care for Opioid Use Disorder

(CHOICE-STAR Trial)

This trial aims to determine if a special clinic, the Integrated Infectious Diseases and Medication for Opioid Use Disorder Clinic, can improve health outcomes for individuals hospitalized with infections from injecting opioids or stimulants. It compares this approach to the usual hospital treatment. The trial seeks participants who have injected opioids or stimulants in the last 90 days and are currently hospitalized with specific infections, such as bone infections or abscesses. Participants will receive either integrated clinic care or standard hospital care to assess which is more effective. As an unphased trial, this study offers a unique opportunity to contribute to innovative care strategies that could enhance treatment for future patients.

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

Studies have shown that combining care for infectious diseases and substance use in one clinic can improve health for people who inject drugs. This approach initiates treatment for opioid addiction and ensures necessary antibiotic use. These outcomes indicate safety and effectiveness.

Research indicates that connecting people with opioid addiction to proven treatments reduces illegal drug use and the risk of overdose. This suggests that the care provided in these clinics is both safe and beneficial.

Researchers are excited about the Integrated Infectious Diseases and Substance Use Disorder Clinic (IC) because it offers a holistic approach to treating opioid use disorder (OUD) that stands out from traditional treatment methods. Unlike standard care, which often separates the treatment of infections and substance use disorders, the IC combines these services into a single, co-located appointment. This integrated model not only aims to treat OUD and related infections like HIV and HCV but also focuses on preventing future infections through accessible care. Additionally, the clinic's weekly care coordination meetings ensure seamless collaboration between infectious disease and substance use disorder providers, enhancing patient outcomes and accessibility.

This trial will compare different approaches to treating opioid use disorder and related infections. Research has shown that integrating care for infectious diseases and substance use disorder (SUD), as implemented in the Integrated Infectious Diseases and Substance Use Disorder Clinic (IC) arm of this trial, can significantly improve health outcomes. Studies have found that when healthcare teams provide both services together, individuals use healthcare more effectively, more people start medications for opioid use disorder (MOUD), and more complete their antibiotics for infections from injecting drugs. Evidence strongly supports the success of MOUD, which includes medications like methadone, buprenorphine, and naltrexone, in treating opioid addiction. Furthermore, connecting individuals with opioid addiction to treatment reduces drug use and the risk of overdose. Overall, this combined approach aims to offer accessible and well-coordinated care, which is crucial for improving health in those with drug-related infections.¹³⁵⁶⁷