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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new support program for individuals starting medication treatment for opioid use disorder. The PEERS Program pairs participants with a Certified Recovery Specialist for regular support sessions over six months. The goal is to determine if this support helps individuals adhere to their treatment. Those who recently began medication for opioid use disorder at a Geisinger clinic and are open to additional support might be suitable candidates. Participant feedback will help refine the program for future use. As an unphased trial, this study provides a unique opportunity to contribute to the development of innovative support strategies for opioid use disorder.

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 prior data suggests that the PEERS Program is safe for participants?

Research has shown that peer support programs are generally safe and well-received. In these programs, trained peers assist individuals with opioid use disorder (OUD) in staying engaged with their treatment. Studies have found that this type of support can significantly improve treatment retention and may reduce opioid-related deaths by up to 50%. Although specific data on negative effects from peer support is lacking, its focus on emotional and motivational support suggests it is low risk.

The PEERS program does not use medication or involve any medical procedures. Instead, it employs Certified Recovery Specialists (CRS) to support participants through regular meetings. Because this method relies on conversation and support, it is considered safe for participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

The PEERS Program for Opioid Use Disorder stands out because it offers personalized, peer-driven support through certified recovery specialists. Unlike traditional treatments that may rely heavily on medication or structured therapy sessions, this program emphasizes flexibility and patient-centered care. Participants work one-on-one with a recovery specialist to tailor their sessions, choosing when, where, and how often they meet, whether that's in a clinic or at a local coffee shop. Researchers are excited about this approach because it empowers individuals to take charge of their recovery journey, potentially leading to more sustainable outcomes.

What evidence suggests that the PEERS Program is effective for opioid use disorder?

Research has shown that peer recovery support programs can greatly help people with opioid use disorder (OUD). One study found that these programs improved participation in treatment and increased the chances of staying in recovery. Another study showed that peer support in emergency rooms helped lower the risk of future overdoses. In this trial, participants will receive services from a certified recovery specialist through the Peer Recovery Support program. This approach connects patients with individuals who have faced similar challenges, providing understanding and encouragement. Such social support is crucial for overcoming substance use disorders. ^{1 4 6 7 8}

Who Is on the Research Team?

Melissa Poulsen, PhD

Principal Investigator

Geisinger Clinic

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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]

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]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11322658/

Peer support for patients with opioid use disorder in the ... Faced with a growing opioid overdose crisis, emergency departments (EDs) are increasingly hiring peers—people with lived experiences of ...

2. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0376871621006189

Effectiveness of peer recovery support services on stages ... In 2019, approximately 1.6 million Americans (12 years and older) reported an Opioid Use Disorder (OUD) (Substance Abuse and Mental Health ...

3. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2816733

Emergency Department Peer Support Program and Patient ... Objective To examine the association of the Opioid Overdose Recovery Program (OORP), an ED peer recovery support service, with postdischarge ...

4. harmreductionjournal.biomedcentral.com harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-024-01041-7

Is peer support a tipping point for the opioid use disorder crisis ... The present commentary highlights the pressing need for systematic research to assess the implementation and effectiveness of medications ...

5. recoveryanswers.org recoveryanswers.org/research-post/what-is-the-evidence-for-peer-recovery-support-services/

What is the Evidence for Peer Recovery Support Services? The roles of social support and mutual-help groups in promoting healthy outcomes among individuals with substance use disorder (SUD) suggests peer recovery ...

6. cdc.gov cdc.gov/pcd/issues/2020/19_0380.htm

Evaluation of an Education and Peer Program on Opioid ... Results found student knowledge of opioid misuse and use disorder improved following a pharmacy-implemented intervention. However, spillover benefits were not ...

7. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2817002

Public Health Interventions and Overdose-Related ... The model projected decreases of up to 35.2% in nonfatal and 36.6% in fatal opioid-involved overdoses among persons with OUD.

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10993074/

Public Health Interventions and Overdose-Related ... This decision analytical model estimates the projected 3-year association between public health interventions and opioid overdose-related outcomes