PEERS Program for Opioid Use Disorder

(PEERS Trial)

Overseen By Project Manager

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Geisinger Clinic

Must be taking: Opioid use disorder medications

Disqualifiers: Non-English proficiency, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

Duration: 6 months

12 Participants Needed

Trial Summary

What is the purpose of this trial?

The goal of this pilot study is to evaluate the feasibility and acceptability of implementing a peer recovery support program to support patient engagement in medication treatment for opioid use disorder (MOUD). The program, entitled "Promoting Enhanced Engagement through Recovery Support" (PEERS) was developed in collaboration with community and clinical partners for the MOUD outpatient setting. Information gathered during this pilot study will inform refinements to the program and study components for a future clinical trial that will evaluate the effectiveness of the peer recovery support program in increasing patient retention in MOUD. The investigators will recruit 12 participants to the pilot study, all of whom will receive the PEERS program. The study will take place in Geisinger outpatient addiction treatment clinics in northeast Pennsylvania. Patients initiating MOUD treatment at one of the clinics will be eligible for participation, and will be recruited via email, patient portal messages, and phone. Each participant will receive the PEERS program, entailing regular sessions with a Certified Recovery Specialist (CRS) for 6 months. Participants will also be asked to complete assessments at baseline and 12 weeks and will be invited to provide qualitative feedback on their experience with the program through an interview conducted between 8-12 weeks. As the focus of the pilot pertains to the feasibility and acceptability of the program and the study components, study outcomes focus on participant engagement in and acceptance of the program, CRS fidelity to the program, barriers to implementation, and feasibility of data collection.

Do I need to stop my current medications to join the trial?

The trial protocol does not specify whether you need to stop taking your current medications. However, since the study focuses on supporting patients already on medication for opioid use disorder, it seems likely that you can continue your current treatment.

What data supports the effectiveness of the PEERS Program treatment for opioid use disorder?

Research shows that peer recovery support services, which are part of the PEERS Program, can help people with opioid use disorder by engaging them in treatment and reducing relapse. Peer support models have been successful in both clinical and community settings, suggesting that having someone with similar experiences can be beneficial in recovery. ^{1 2 3 4 5}

How is the PEERS Program treatment for opioid use disorder different from other treatments?

The PEERS Program is unique because it involves peer support, where individuals with personal experience in recovery help others with opioid use disorder. This approach focuses on connecting patients to recovery services and providing ongoing support, which is different from traditional medical treatments that primarily rely on medication. ^{1 2 3 5 6}

Research Team

Melissa Poulsen, PhD

Principal Investigator

Geisinger Clinic

Eligibility Criteria

This trial is for adults over 18 who have recently started medication treatment for opioid use disorder at specific outpatient clinics. Participants must be willing to engage in the PEERS program and able to give consent.

Inclusion Criteria

I am willing and able to give my consent.

I started treatment for opioid addiction at a Geisinger clinic in the last 30 days.

I am willing to join the Peer Recovery Support program.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive the PEERS program, entailing regular sessions with a Certified Recovery Specialist for 6 months

6 months

Regular sessions (flexible schedule)

Assessment

Participants complete assessments at baseline and 12 weeks, and provide qualitative feedback through an interview conducted between 8-12 weeks

12 weeks

2 assessment visits

Follow-up

Participants are monitored for engagement and acceptability of the program, and CRS fidelity to the program

4 weeks

Treatment Details

Interventions

• PEERS Program

Trial Overview The study tests a peer recovery support program called PEERS, designed to help patients stick with their opioid addiction treatments. It involves regular sessions with a Certified Recovery Specialist over six months.

Participant Groups

Group I: Peer Recovery Support Pilot Program Implementation and Assessment Experimental Treatment 1 Intervention

Participants will be offered services from a certified recovery specialist (i.e., the Peer Recovery Support program). This will entail a CRS meeting one-on-one with the patient at regular intervals (e.g., weekly) to provide support to the participant for a 6-month period. CRS services are patient-centered and driven by a patient's own recovery goals, thus the frequency, timing, duration, modality (in-person, phone), and location of meetings (in the clinic or in a community setting such as a coffeeshop) are flexible and determined collaboratively by the CRS and patient.

Who Is Running the Clinical Trial?

Geisinger Clinic

Lead Sponsor

Trials

159

Recruited

1,976,000+

National Institute on Drug Abuse (NIDA)

Collaborator

Trials

2,658

Recruited

3,409,000+

UConn Health

Collaborator

Trials

218

Recruited

59,100+

Findings from Research

Peer recovery support services (PRSS) have been integrated into the recovery process for opioid use disorder (OUD), but their effectiveness on clinical outcomes remains unclear, as only 12 out of 123 studies met the inclusion criteria for review.

Most studies reported on PRSS engagement and medication for OUD (MOUD) initiation, but findings were inconsistent and varied due to the lack of standardized PRSS interventions and methodological limitations, indicating a need for further research before widespread implementation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of peer recovery support services on stages of the opioid use disorder treatment cascade: A systematic review. Gormley, MA., Pericot-Valverde, I., Diaz, L., et al.[2022]

A qualitative study involving 26 patients receiving methadone treatment found that a peer recovery specialist-delivered behavioral activation intervention (Peer Activate) was perceived as acceptable and feasible, particularly due to its flexibility and the supportive qualities of the peer specialists.

Participants highlighted the importance of connecting with the intervention content and building skills, while also noting stigma related to substance use and methadone treatment as barriers to engagement, suggesting that addressing these issues could enhance treatment retention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

"You rise up and then you start pulling people up with you": Patient experiences with a peer-delivered behavioral activation intervention to support methadone treatment. Kleinman, MB., Hines, AC., Anvari, MS., et al.[2023]

Emergency department-based peer support programs are effective in connecting individuals with opioid use disorder (OUD) to medication and recovery services, showing promise in addressing the opioid crisis.

The integration of peer support varies across programs, affecting how peers are alerted to potential patients and how they engage with them, highlighting the need for consistent reporting on these methods in future evaluations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Emergency department-based peer support for opioid use disorder: Emergent functions and forms. McGuire, AB., Powell, KG., Treitler, PC., et al.[2021]

The PEER program effectively identified clients with substance use disorders who had high needs for social support and were at risk of recidivism, demonstrating its potential to address complex health and social issues among this population.

Despite challenges in client contact and funding stability, the program's sustainability was rated as stable, suggesting that with adjustments to service delivery and risk stratification, it could be further optimized for effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Where It Really Counts: Feasibility and Potential of the Peer Engaged Empowered Recovery Program for Substance-Dependent Jail Inmates. Parekh, T., Cuellar, AE., Farina-Morse, M., et al.[2022]

Peer support models have been effective in helping individuals with opioid use disorder (OUD) start treatment and reduce relapse rates, highlighting their potential in addressing the opioid crisis.

Integrating peer coaches into online interventions within community settings shows promise for engaging people with OUD, suggesting a novel approach to enhance treatment accessibility and support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Role of Peer Coaches in Digital Interventions for MOUD Initiation and Maintenance. Garett, R., Young, SD.[2023]

The HEROES program successfully engaged 324 individuals with opioid use disorder, with 90.43% completing the 30-day treatment that included buprenorphine and behavioral support.

After the program, 63% of participants were linked to ongoing treatment, and there was a significant 36% improvement in health-related quality of life, indicating the program's effectiveness in retaining patients in care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility and outcomes from an integrated bridge treatment program for opioid use disorder. Langabeer, JR., Champagne-Langabeer, T., Yatsco, AJ., et al.[2022]

References

1. Ireland pubmed.ncbi.nlm.nih.gov

Effectiveness of peer recovery support services on stages of the opioid use disorder treatment cascade: A systematic review. [2022]

2. Netherlands pubmed.ncbi.nlm.nih.gov

"You rise up and then you start pulling people up with you": Patient experiences with a peer-delivered behavioral activation intervention to support methadone treatment. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Emergency department-based peer support for opioid use disorder: Emergent functions and forms. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

Where It Really Counts: Feasibility and Potential of the Peer Engaged Empowered Recovery Program for Substance-Dependent Jail Inmates. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Role of Peer Coaches in Digital Interventions for MOUD Initiation and Maintenance. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

Feasibility and outcomes from an integrated bridge treatment program for opioid use disorder. [2022]