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

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Auditory impairment, Visual impairment, Acutely psychotic

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

Compensation: Varies

Number of Visits: 1

195 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests the effectiveness of three treatments in improving recovery outcomes for individuals with substance use problems. The treatments include a group therapy program called the Combined Recovery Program (CRP), a home telehealth support program called Stable and Able (S&A), and the standard care provided on the inpatient unit, known as Treatment-as-usual (TAU). The study is open to veterans who have used substances like alcohol or drugs in the past 30 days and are receiving inpatient care at the Charleston VA Psychiatric unit. Participants will begin with CRP and/or TAU and may continue with S&A after discharge, with follow-ups at 1 and 3 months post-treatment. As an unphased trial, this study offers veterans the chance to explore innovative treatments that could enhance their recovery journey.

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.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that group treatments for substance use disorders, such as the Combined Recovery Program (CRP), are generally well-received. One study found that these group treatments effectively help many individuals with drug use issues. The research mentions no specific safety concerns, suggesting they are safe for participants.

For the Stable & Able (S&A) telehealth program, research indicates that similar methods can significantly reduce substance use. Studies report no major negative effects, suggesting these programs are safe. This type of support appears to be a promising and safe option for those looking to reduce substance use.

Both treatments aim to support recovery with minimal risks based on available evidence. Participants can feel confident about the safety of these programs. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Combined Recovery Program (CRP) with Stable & Able (S&A) because it offers a fresh approach to treating substance use disorders. Unlike the standard treatment-as-usual (TAU), which mainly focuses on medical and medication management during inpatient care, CRP adds a motivational enhancement and daily living skills workshop. Additionally, the S&A component introduces a telehealth program that supports patients from the first day of their hospital discharge, providing a continuous care model that extends beyond the inpatient setting. This holistic and extended support could potentially improve recovery outcomes by addressing both the immediate and ongoing challenges faced by individuals with substance use disorders.

What evidence suggests that this trial's treatments could be effective for substance use disorders?

Research has shown that the Combined Recovery Program (CRP), which participants in this trial may receive, can significantly aid recovery from substance use disorders. One study found that the relapse rate decreased from 25% to 12% with this program. Additionally, more participants remained in the program for at least three months, indicating positive engagement. The Stable and Able (S&A) program, another treatment option in this trial, is part of a home telehealth initiative that starts after hospital discharge. Research indicates that treatments for substance use disorders can be very effective over time, with fewer relapses as patients continue treatment. Although specific data for S&A is limited, similar treatments have demonstrated a decrease in substance use over extended periods. Both CRP and S&A offer promising support for those seeking recovery from substance use disorders. ^{4 6 7 8 9}

Who Is on the Research Team?

Elizabeth J. Santa Ana, PhD MA BA

Principal Investigator

Ralph H. Johnson VA Medical Center, Charleston, SC

Are You a Good Fit for This Trial?

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.

Timeline for a Trial Participant

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

What Are the Treatments Tested in This Trial?

Interventions

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

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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]

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]

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]

Citations

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pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC4852860/

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The percentage of people 12 or older with a drug use disorder in the past year increased from 8.7% in 2021 to 9.8% in 2024. The percentage of ...