Stigma Reduction for Substance Use Disorder

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Wayne State University

Disqualifiers: Tobacco use disorder, Legal issues, others

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

Compensation: Varies

Number of Visits: 14

12 Participants Needed

Trial Summary

What is the purpose of this trial?

This cluster randomized trial develops and pilot tests a multi-level substance use stigma intervention that leverages organizational policy and professional education to address structural and professional drivers of stigma in outpatient mental health (MH) services. The investigators will generate preliminary data to determine whether adding an organizational policy to a professional stigma training may reduce measures of provider-based stigma towards substance use and improve care quality and patient outcomes to a greater degree than simply conducting training alone. The investigators hypothesize that providers at a MH site implementing an organizational policy change in addition to providing professional training will demonstrate greater improvement to health services for people who use drugs compared to a site where providers receive training alone.

Eligibility Criteria

This trial is for mental health service providers. It aims to reduce stigma towards patients with substance use disorders. Providers who are willing to participate in educational training and potentially adopt a new policy agreement on controlled substances can join.

Inclusion Criteria

Existing and new patients with alcohol use disorder (AUD)/opioid use disorder (OUD) will be included in the EHR data sample

The other half of the survey sample (n=20) will include patients who do have an ICD-10 code for SUD in their chart

Psychiatrists or psychiatric NPs employed at the participating LSH site are eligible to participate

Exclusion Criteria

Patients with SUD diagnosis only for a tobacco use disorder will be excluded from the SUD-stratified portion of the survey sample

Patients unable or unwilling to give written informed consent will be excluded

Patients who are currently in jail, prison or other overnight facility as required by court of law or have pending legal action that could prevent participation in study activities will be excluded

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Implementation of educational training and organizational policy change to reduce stigma in mental health services

3 months

Ongoing visits as part of mental health services

Follow-up

Participants are monitored for changes in stigma and service provision effectiveness

6 weeks

Surveys conducted within 14 days pre-training, post-training, and 6 weeks post-training

Treatment Details

Interventions

• Multi-level stigma reduction intervention: educational training plus controlled substance agreement policy change
• Single-level stigma reduction intervention: educational training

Trial Overview The study tests if adding an organizational policy change to professional stigma-reduction training improves attitudes toward drug users and patient care more than just the training alone. Mental health sites will be randomly chosen to either implement both interventions or just the education.

Participant Groups

Group I: Experimental arm: educational training plus a policy change for controlled substance agreements Experimental Treatment 1 Intervention

This arm received both 1) an educational training for mental health professionals about substance use-related stigma; and 2) a policy change that replaced the standard LifeStance Health system's "controlled substance agreement" (CSA) with a new agreement integrating principles of shared decision-making and offering prescribers a communication tool with suggestions for how to implement principles of shared decision-making and patient centered care in their use of the new CSA

Group II: Control arm: educational training only Active Control 1 Intervention

This arm received only an educational training for mental health professionals about substance use-related stigma

Who Is Running the Clinical Trial?

Wayne State University

Lead Sponsor

Trials

318

Recruited

111,000+

LifeStance Health

Collaborator

Trials

1

Recruited

10+

Loyola University Chicago

Collaborator

Trials

23

Recruited

13,100+

University of New Mexico

Collaborator

Trials

393

Recruited

3,526,000+