CRP + S&A for Substance Use Disorders

(CRP and S&A Trial)

Overseen By Elizabeth J Santa Ana, PhD MA BA

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: VA Office of Research and Development

Disqualifiers: Auditory impairment, Visual impairment, Acutely psychotic

No Placebo Group

Trial Summary

What is the purpose of this trial?

The purpose of this study is to evaluate how well three types of treatments work to improve the outcomes for people with substance use problems. Veterans admitted to the Charleston VA Psychiatric inpatient unit may be invited to participate. The three types of treatments that will be evaluated are: 1. Combined Recovery Program (CRP), a six-session treatment group delivered on the inpatient unit. 2. A Home Telehealth program, called Stable and Able (S\&A), provided just prior to discharge and provides additional support for up to 3 months 3. Treatment-as-usual (TAU), which is the treatment currently provided on the unit, consisting of various mental health topics and sessions designed to help with recovery. Participation begins on the inpatient unit, beginning with CRP and/or TAU, and may continue with S\&A post discharge. Participants will be followed up at 1 and 3- months post treatment.

Do I have to stop taking my current medications for the trial?

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.

What data supports the effectiveness of the treatment CRP + S&A for Substance Use Disorders?

Collegiate Recovery Programs (CRPs) have shown promising outcomes, such as low relapse rates and above-average academic achievement, by providing peer-driven support on college campuses for students recovering from substance use issues. This suggests that similar supportive and structured environments, like CRP + S&A, could be effective in promoting recovery. ^{1 2 3 4 5}

How is the Combined Recovery Program (CRP) treatment for substance use disorders different from other treatments?

The Combined Recovery Program (CRP) is unique because it is a peer-driven recovery support model specifically designed for college students, providing a supportive community on campus to help maintain sobriety and encourage academic success, which is not typically a focus of other substance use disorder treatments. ^{1 2 3 6 7}

Research Team

Elizabeth J. Santa Ana, PhD MA BA

Principal Investigator

Ralph H. Johnson VA Medical Center, Charleston, SC

Eligibility Criteria

This trial is for veterans with substance use problems who are inpatients at the Charleston VA Psychiatric unit. Participants must understand English, be able to consent, complete assessments, and commit to therapy sessions and follow-ups. They should have used substances within the last 30 days and meet criteria for a current substance use disorder.

Inclusion Criteria

You have used drugs or alcohol in the 30 days before being admitted to the study.

You currently have a diagnosis of alcohol or drug addiction according to certain guidelines.

I am willing to attend 6 therapy sessions and follow-up assessments.

Exclusion Criteria

You have hearing or vision problems that will make it difficult to participate in the study.

You cannot speak or understand English.

You are currently experiencing severe mental confusion or delusions.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Inpatient Treatment

Participants receive the Combined Recovery Program (CRP) and/or Treatment-as-usual (TAU) on the inpatient unit

6 sessions

Inpatient stay

Home Telehealth Program

Participants receive the Stable and Able (S&A) telehealth program for additional support post-discharge

3 months

Follow-up

Participants are monitored for treatment engagement and substance use outcomes at 1 and 3 months post-treatment

3 months

Follow-up at 1 and 3 months

Treatment Details

Interventions

• Combined Recovery Program (Behavioral Intervention)
• Stable & Able (S&A) (Behavioral Intervention)

Trial Overview The study compares three treatments: Combined Recovery Program (CRP) with six group sessions on the unit; Stable & Able (S&A), a telehealth program before discharge providing support up to 3 months; and Treatment-as-usual (TAU), which includes various recovery-related mental health topics.

Participant Groups

Group I: Combined Recovery Program (CRP)+Treatment-as-usual (TAU) Experimental Treatment 1 Intervention

Combined Recovery Program (CRP) is a six-session motivational enhancement and daily living skills therapy workshop provided while on the inpatient unit. Attendance of CRP will be in addition to Treatment as Usual (TAU), that is, standard inpatient programming.

Group II: CRP+ Stable & Able (S&A)+TAU Active Control 2 Interventions

Combined Recovery Program (CRP) a six-session motivational enhancement and daily living skills therapy workshop provided while on the inpatient unit, plus a home telehealth program (Stable \& Able) which begins on day 1 of hospital discharge. Attendance of CRP and S\&A will be in addition to TAU, that is, standard inpatient programming.

Group III: Treatment-as-usual only (TAU): Active Control 1 Intervention

TAU will only receive the usual care on the inpatient unit including medical and medication management.

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Findings from Research

A study involving 486 students from 29 Collegiate Recovery Programs (CRPs) revealed that many students, averaging 26 years old and sober for about 3 years, credit CRPs with enabling their college attendance, with one-third stating they wouldn't be in college without such support.

The primary motivations for joining CRPs included the desire for peer support from others in recovery and the need to navigate the challenges of maintaining sobriety in a college environment, highlighting the importance of these programs in supporting students' educational goals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

In college and in recovery: Reasons for joining a Collegiate Recovery Program. Laudet, AB., Harris, K., Kimball, T., et al.[2018]

Collegiate Recovery Programs (CRPs) support college students with substance use and recovery needs, with data collected from 861 students showing that a significant majority had prior treatment for substance use disorders (82%) or mental health issues (77%).

Students involved in CRPs demonstrated improved academic performance, as indicated by GPA increases in three out of four sites that provided GPA data, highlighting the potential effectiveness of these programs in promoting recovery and academic success.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A multi-site study of emerging adults in collegiate recovery programs at public institutions. Hennessy, EA., Tanner-Smith, EE., Nichols, LM., et al.[2021]

Collegiate Recovery Programs (CRPs) are emerging as effective peer-driven support systems on college campuses, showing promising outcomes such as low relapse rates and above-average academic performance among students in recovery.

Despite the growth of CRPs across the U.S., there is a significant lack of systematic research and data on their effectiveness, highlighting the need for further studies to better understand their impact and improve recovery support services.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Collegiate Recovery Communities Programs: What do we know and what do we need to know? Laudet, A., Harris, K., Kimball, T., et al.[2023]

A review of 25 studies from 1981 to 2019 shows that service providers are more likely to accept non-abstinence treatment goals for clients with less severe substance use issues, viewing them as intermediate steps towards eventual abstinence.

Acceptance of non-abstinence goals varies by substance type, with higher endorsement for alcohol and cannabis compared to more severe drugs like cocaine and heroin, and is more common in outpatient settings than in residential treatment facilities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acceptance of Non-Abstinence as an Outcome Goal for Individuals Diagnosed With Substance Use Disorders: A Narrative Review of Published Research. Rosenberg, H., Grant, J., Davis, AK.[2020]

Long-term recovery should be the primary goal in treating moderate to severe substance use disorders, emphasizing the need for a clear definition of recovery in treatment plans.

Sustained post-treatment support, including monitoring, peer support, and drug testing, is essential for preventing relapse and ensuring successful long-term management of substance use disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The three missing elements in the treatment of substance use disorders: Lessons from the physician health programs. DuPont, RL., Seppala, MD., White, WL.[2016]

Recovery support services (RSS) are becoming a key part of substance use disorder (SUD) treatment, emphasizing a comprehensive care model to help individuals in recovery.

There is a need for further evaluation of the effectiveness and cost-effectiveness of RSS, as well as the development of a skilled workforce to deliver these services, to ensure they are integrated into a patient-centered healthcare system.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Promoting recovery in an evolving policy context: what do we know and what do we need to know about recovery support services? Laudet, AB., Humphreys, K.[2023]

The Community Reinforcement Approach (CRA) has been shown to effectively reduce opioid use and improve various aspects of life, such as legal status and social functioning, in patients undergoing methadone maintenance and withdrawal.

Combining CRA with vouchers and medications like buprenorphine and naltrexone can enhance treatment retention and support sustained abstinence from opioids.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A review of the community reinforcement approach in the treatment of opioid dependence. Abbott, PJ.[2019]

References

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

In college and in recovery: Reasons for joining a Collegiate Recovery Program. [2018]

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

A multi-site study of emerging adults in collegiate recovery programs at public institutions. [2021]

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

Collegiate Recovery Communities Programs: What do we know and what do we need to know? [2023]

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

Acceptance of Non-Abstinence as an Outcome Goal for Individuals Diagnosed With Substance Use Disorders: A Narrative Review of Published Research. [2020]

5. England pubmed.ncbi.nlm.nih.gov

The three missing elements in the treatment of substance use disorders: Lessons from the physician health programs. [2016]

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

Promoting recovery in an evolving policy context: what do we know and what do we need to know about recovery support services? [2023]

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

A review of the community reinforcement approach in the treatment of opioid dependence. [2019]