Supportive Services for Substance Use Disorders

(SRC Trial)

Overseen By David O Meltzer, MD, PhD

Age: 18+

Sex: Male

Trial Phase: Academic

Sponsor: University of Chicago

Disqualifiers: Females, Under 18, No acute needs

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

Compensation: Varies

Number of Visits: Unknown

Duration: Immediate post-discharge period

15195 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Supportive Services for Substance Use Disorders?

Research shows that day treatment programs can significantly reduce alcohol, drug, legal, and social problems over time, and these improvements can be maintained for up to 18 months. Additionally, residential treatment programs have been found to help individuals maintain abstinence and improve housing stability, suggesting that supportive services can be effective in addressing substance use disorders. ^{1 2 3 4 5}

Is the treatment generally safe for humans?

The research articles reviewed do not provide specific safety data for the treatment under the names APN Appointment, SRC Overnight Stay, TASC Service Linkages - Discharge Area Only, or TASC Services Linkages - SRC Onsite. Therefore, no relevant safety information is available from these sources. ^{6 7 8 9 10}

How is the SRC Overnight Stay treatment for substance use disorders different from other treatments?

The SRC Overnight Stay treatment is unique because it involves a temporary supportive housing environment that allows patients to participate in intensive hospital-based treatment, providing a stable and supportive setting that may not be available in traditional inpatient care. ^{11 12 13 14 15}

What is the purpose of this trial?

The Supportive Release Center (SRC) is a collaboration between the University of Chicago Urban Health Lab, Treatment Alternatives for Safe Communities, Heartland Alliance Health, and the Cook County Sheriff's office. The aim of the SRC is to identify individuals with mental illnesses, substance use disorders, and other vulnerabilities as they are released from the Cook County Jail (CCJ), provide an improved environment to assess needs of these individuals, and facilitate effective linkages with social services following release, including medical care and substance use or mental health treatment. The SRC improves the current standard of care offered at the CCJ by introducing mechanisms to facilitate engagement with post-release services and address individuals' immediate acute needs. The primary objective of this randomized controlled trial is to evaluate the impact of assignment to the SRC on the number of arrests within one year of study enrollment among eligible men being released from the Cook County Jail. Researchers hypothesize that the SRC is more effective than usual care at facilitating and ensuring receipt of transition services and care, and that receipt of this treatment will decrease the number of arrests within one year of study enrollment.

Research Team

David Meltzer, MD, PhD

Principal Investigator

University of Chicago

Harold Pollack, PhD

Principal Investigator

University of Chicago

Eligibility Criteria

This trial is for male adults leaving Cook County Jail who feel they need help with mental health, substance use disorders, or other vulnerabilities. They must be interested in receiving services to support their release.

Inclusion Criteria

You require additional services or assistance.

You are a male adult who has been released from Cook County Jail.

You want to receive the services being offered.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants are randomized to either the Supportive Release Center (SRC) or usual care, with services including needs assessment, service linkages, and access to an Advanced Practice Nurse for those in the SRC group.

Immediate post-discharge period

Follow-up

Participants are monitored for re-arrests, emergency department visits, and engagement with homelessness services over a 365-day period.

365 days

Data Collection and Analysis

Data on arrests, healthcare utilization, and service engagement are collected and analyzed to evaluate the impact of the SRC intervention.

Ongoing throughout the follow-up period

Treatment Details

Interventions

• APN Appointment
• SRC Overnight Stay
• TASC Service Linkages - Discharge Area Only
• TASC Services Linkages - SRC Onsite

Trial Overview The study tests if the Supportive Release Center (SRC) helps reduce arrests within a year after release by providing an environment to assess needs and link individuals to social services like medical care and treatment for substance abuse or mental health issues.

Participant Groups

Group I: Supportive Release Center (Treatment) Experimental Treatment 4 Interventions

These individuals will receive SRC services: an overnight stay at the SRC, linkages to community-based services made at the SRC or in the discharge area of the CCJ if they choose not to visit the SRC facility, and access to an Advanced Practice Nurse. Individuals randomized on days Heartland Alliance Health recruits at SRC for non-SRC study are excluded from population. Receives: TASC Service Linkages - Discharge Area Only -OR- SRC Overnight Stay, TASC Services Linkages - SRC Onsite, APN Appointment

Group II: Usual Care (Control) Active Control 1 Intervention

Usual care. These individuals will receive linkages to community-based services only. These linkages will be made while in the Discharge Area of the Cook County Jail. Individuals randomized on days Heartland Alliance Health recruits at SRC for non-SRC study are excluded from population. Receives: TASC Service Linkages - Discharge Area Only

Who Is Running the Clinical Trial?

University of Chicago

Lead Sponsor

Trials

1,086

Recruited

844,000+

Center for the Advancement of Critical Time Intervention

Collaborator

Trials

2

Recruited

15,300+

Sheriff's Office of Cook County, Illinois

Collaborator

Trials

1

Recruited

15,200+

Robert R McCormick Foundation

Collaborator

Trials

1

Recruited

15,200+

Laura and John Arnold Foundation

Collaborator

Trials

13

Recruited

30,500+

Pritzker Family Foundation

Collaborator

Trials

3

Recruited

15,200+

Treatment Alternatives for Safe Communities Inc

Collaborator

Heartland Health Research Alliance

Collaborator

Trials

1

Recruited

2,600+

TASC INC

Collaborator

Trials

1

Recruited

15,200+

Heartland Health Outreach Inc

Collaborator

Trials

1

Recruited

15,200+

Findings from Research

The study followed 149 homeless mothers over 18 months and found that those in residential substance abuse treatment had lower dropout rates compared to those in nonresidential services.

Both residential and nonresidential groups showed improvements in alcohol and drug issues and housing stability, indicating that residential placements can enhance engagement in treatment programs for homeless mothers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Eighteen-month follow-up data on a treatment program for homeless substance abusing mothers. Smith, EM., North, CS., Fox, LW.[2022]

In a study involving 127 homeless individuals with substance use disorders, those receiving day treatment plus contingency management (DT+) were 2.1 times more likely to achieve positive treatment outcomes compared to those receiving only day treatment (DT).

The findings suggest that using diagnostic changes alongside traditional measures like drug toxicology and self-reports can enhance the assessment of treatment effectiveness in substance use disorder interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Diagnostic compared with abstinence outcomes of day treatment and contingency management among cocaine-dependent homeless persons. Schumacher, JE., Milby, JB., Wallace, D., et al.[2022]

References

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

A randomized trial comparing day and residential drug abuse treatment: 18-month outcomes. [2019]

2. England pubmed.ncbi.nlm.nih.gov

Eighteen-month follow-up data on a treatment program for homeless substance abusing mothers. [2022]

3. England pubmed.ncbi.nlm.nih.gov

Clients entering drug abuse day treatment: 18-month outcomes. [2019]

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

A comparison of long-term and short-term residential treatment programs for dual diagnosis patients. [2019]

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

Diagnostic compared with abstinence outcomes of day treatment and contingency management among cocaine-dependent homeless persons. [2022]

6. England pubmed.ncbi.nlm.nih.gov

Emergency Department Use, Hospitalization, and Their Sociodemographic Determinants among Patients with Substance-Related Disorders: A Worldwide Systematic Review and Meta-Analysis. [2023]

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

Program Outcomes and Health Care Utilization of People Experiencing Homelessness and Substance Use Disorder after Transitional Care Program Engagement. [2022]

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

Patients with substance use disorders receiving continued care in skilled nursing facilities following hospitalization. [2023]

9. England pubmed.ncbi.nlm.nih.gov

Supervised consumption sites: a nuanced assessment of the causal evidence. [2020]

10. England pubmed.ncbi.nlm.nih.gov

Mental distress following inpatient substance use treatment, modified by substance use; comparing voluntary and compulsory admissions. [2018]

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

Comparative outcomes and costs of inpatient care and supportive housing for substance-dependent veterans. [2006]

12. England pubmed.ncbi.nlm.nih.gov

Voices of hope: A feasibility study of telephone recovery support. [2021]

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

A model for sober housing during outpatient treatment. [2021]

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

Association of facility characteristics and substance use disorder outcomes at discharge from residential treatment. [2023]

15. England pubmed.ncbi.nlm.nih.gov

Improved drug-use patterns at 6 months post-discharge from inpatient substance use disorder treatment: results from compulsorily and voluntarily admitted patients. [2018]