RECRUITING

High Dose Buprenorphine (BUP) Induction in the Emergency Department (ED)

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

This project, involving two distinct clinical trials, tests whether induction to a higher than currently recommended buprenorphine (BUP) induction dose is safe and can improve the proportion of patients who engage in comprehensive addiction services within 7-day of induction. Trial 1 is a head-to-head comparison of the safety, tolerability and feasibility of high dose BUP induction (32 mg). The study involves two cohorts, (1) a 12mg cohort (standard) to determine baseline data and (2) a 32 mg (high dose) cohort. If the 32mg is intolerable, a 24 mg dose may be evaluated. Trial 2 is a small pilot multicenter randomized, double blinded, clinical trial in 80 participants (randomized 1:1) that will provide preliminary information on efficacy with the primary outcome being engagement in comprehensive addiction treatment 7-days post BUP induction. In collaboration with National Institute on Drug Abuse (NIDA), the research team have determined that there must be a minimum increase in engagement in comprehensive addiction treatment of 15% at 7-days in the high dose induction group to justify a larger future clinical trial.

Official Title

Safety and Efficacy of High Dose Buprenorphine Induction in Fentanyl Positive Emergency Department Patients

Quick Facts

Study Start:2023-04-10
Study Completion:2025-09
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT05589181

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. * Evidence of a personally signed and dated informed consent document indicating that the participant has been informed of all pertinent aspects of the study
  2. * Treated in the ED during screening hours
  3. * Meet DSM-5 diagnostic criteria for moderate to severe OUD
  4. * Clinical Opioid Withdrawal Score (COWS) score ≥ 8
  5. * Urine toxicology positive for fentanyl
  6. * Able to speak English or Spanish sufficiently to understand study procedures
  1. * UDS positive for methadone.
  2. * Be pregnant determined by urine human chorionic gonadotropin (uHCG) testing
  3. * Have an unstable medical or psychiatric condition including suicidality requiring hospitalization
  4. * Require ongoing opioids for pain management
  5. * Be enrolled in formal addition treatment including by court order anytime within the last 30 days. Patients enrolled in formal addiction treatment not receiving Medications for Opioid Use Disorder (MOUD) are eligible
  6. * Be a prisoner or in custody at the time of the index visit
  7. * Have any pending legal status or pending legal action that could prohibit full participation in or compliance with study procedures.
  8. * Unable to provide one additional point of contact other than themselves
  9. * Unwilling to follow study procedures
  10. * Have prior enrollment in the current study
  11. * Have a known allergy or hypersensitivity to BUP
  12. * Have been engaged in formal addiction treatment in the 30-days prior to the ED visit (this does not include addiction treatment or residential programs where MOUD is not given (e.g. behavioral counseling, abstinence programs, NA)
  13. * Have received naloxone in the 60-minutes prior to the anticipated first transmucosal (TM) BUP administration
  14. * Is undergoing concurrent treatment with another investigational agent or enrolment in another clinical study

Contacts and Locations

Study Contact

Ethan Cowan, MD, MS
CONTACT
212-420-2652
ethan.cowan@mountsinai.org
Clare O'Brien-Lambert
CONTACT
347-415-5407
clare.obrien-lambert@mountsinai.org

Principal Investigator

Ethan Cowan, MD, MS
PRINCIPAL_INVESTIGATOR
Icahn School of Medicine

Study Locations (Sites)

UCLA Olive View
Sylmar, California, 91342
United States
Barnes Jewish Hospital Emergency Department
Saint Louis, Missouri, 63110
United States
Mount Sinai Beth Israel
New York, New York, 10003
United States
Mount Sinai Hospital
New York, New York, 10029
United States
Rhode Island Hospital Emergency Department
Providence, Rhode Island, 02903
United States

Collaborators and Investigators

Sponsor: Icahn School of Medicine at Mount Sinai

  • Ethan Cowan, MD, MS, PRINCIPAL_INVESTIGATOR, Icahn School of Medicine

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2023-04-10
Study Completion Date2025-09

Study Record Updates

Study Start Date2023-04-10
Study Completion Date2025-09

Terms related to this study

Additional Relevant MeSH Terms

  • Opioid Use Disorder