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Active, not recruitingNCT04464980ClinicalTrials.gov record

Optimizing Retention, Duration and Discontinuation Strategies for Opioid Use Disorder Pharmacotherapy (RDD)

Opioid Use Disorder (OUD)

THE QUICK READ

What this study involves

The registry does not currently label this study as recruiting. Ask about its status before planning a screening visit.

Study type
Interventional
Phase
Phase 2
Age range
18 years - Not specified
Sex eligible
All sexes
Healthy volunteers
Not accepted
Participants
1516 Actual

These are starting points, not an eligibility decision. The research team must review the full requirements.

About the research

This is a two phase study investigating combinations of pharmacological and behavioral interventions to optimize the treatment of Opioid Use Disorder (OUD). The Retention Phase will assess strategies for improving retention on buprenorphine (BUP) and extended-release injectable naltrexone (XR-NTX). The Discontinuation Phase will assess which approaches are most likely to lead to long-term success (absence of relapse), and what characteristics of participants distinguish those who can safely discontinue Medications for Opioid Use Disorder (MOUD) from those who remain at risk of relapse and should not discontinue.

Read the full description

The main objectives of this study are:

1. To test strategies to improve retention in treatment on medications for opioid use disorder (MOUD), among patients initiating treatment for OUD.
2. To test strategies to improve outcomes among patients who have achieved stable remission on MOUD and want to discontinue MOUD.
3. To develop models to predict who is able to discontinue MOUD without relapse, based on patient characteristics, including duration of MOUD prior to discontinuation.

The study will have a multicenter, randomized, pragmatic non-blinded design. The study has two phases, a Retention Phase and a Discontinuation Phase.

Who may be able to participate?

The list below is the sponsor’s full registry wording. It can include conditions, prior treatment, test results and other requirements. A match in search does not mean you qualify.

Inclusion Criteria for Retention Phase:

1. 18 years of age or older;
2. Meet DSM-5 criteria for current opioid use disorder (heroin, fentanyl or other synthetic opioids, and/or prescription opioids);
3. Seeking treatment for opioid use disorder and choosing either buprenorphine (BUP) or extended-release injection naltrexone (XR-NTX);
4. If choosing buprenorphine, willing to be randomized to SL-BUP-16mg, SL-BUP-32mg, or XR-BUP;
5. Willing to be randomized to either MM (standard Medical Management plus counseling treatment as usual available at the site) or MMR (MM plus usual counseling and access to an app delivering CM + CBT);
6. In good-enough general health (meaning good enough health to be in outpatient treatment) as determined by the study medical clinician on the basis of medical history, review of systems, and physical/mental status exam, to permit treatment with XR-NTX or BUP;
7. Willing and able to provide written informed consent;
8. Able to speak English sufficiently to understand the study procedures;
9. If female of childbearing potential, willing to practice an effective method of birth control for the duration of participation in the study (participants who become pregnant during the study will continue to be followed; treatment may be modified consistent with pregnancy).

Exclusion Criteria for Retention Phase:

1. Serious medical, psychiatric, or co-occurring substance use disorder or concomitant medication that, in the opinion of the study medical clinician, makes the patient not appropriate for outpatient treatment with buprenorphine or XR-NTX, but instead requires a higher or different level of care. Examples include:

1. Disabling or terminal medical illness (e.g., uncompensated heart failure, cirrhosis or end-stage liver disease) as assessed by medical history, review of systems, physical exam and/or laboratory assessments;
2. Severe, untreated or inadequately treated psychiatric condition (e.g., active psychosis, uncontrolled bipolar disorder) as assessed by history and/or clinical interview, requiring a different level of care (e.g., hospitalization);
3. Current severe alcohol, benzodiazepine, or other depressant or sedative hypnotic use, requiring a different level of care (e.g., hospitalization);
2. Suicidal or homicidal ideation or behavior requiring a different level of care (e.g., hospitalization);
3. Known allergy or sensitivity to preferred medication or its components;
4. Maintenance on methadone at the time of signing consent;
5. For those preferring XR-NTX, presence of pain of sufficient severity as to require ongoing pain management with opioids;
6. For those preferring XR-NTX, body habitus that, in the judgment of the study physician, precludes safe intramuscular injection of XR-NTX (e.g., BMI\>40, excess fat tissue over the buttocks, emaciation);
7. If female, currently pregnant or breastfeeding or planning on conception;
8. 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;
9. Have used the reSET-O or CHESS Connections mHealth apps in the 3 months prior to consent;
10. Other major reasons that might prevent an individual from participating in the study (e.g., a planned move out of the area).

Inclusion Criteria for Discontinuation Phase:

1. 18 years of age or older;
2. Have been receiving buprenorphine for OUD for at least the past year or XR-NTX pharmacotherapy for OUD for at least the past 6 months prior to consent for the Discontinuation Phase;
3. Express the desire to discontinue MOUD after a shared decision-making discussion with the treating provider;
4. Meet stability criteria, i.e., have abstained from opioids (other than buprenorphine), cocaine, methamphetamine, and non-prescribed benzodiazepines for the past ≥12 weeks, and do not meet DSM-5 criteria for current (≥12 weeks) alcohol use disorder (participants with cannabis use will be eligible);
5. If currently taking buprenorphine, are willing to take either SL-BUP or XR-BUP if randomized to that condition;
6. Willing to be randomized to either MM or to MMD;
7. Able to provide written informed consent after discussion with their provider regarding the risks of discontinuation;
8. Able to speak English sufficiently to understand the study procedures;
9. If female of childbearing potential, willing to practice an effective method of birth control while in the study and taking study medication (participants who become pregnant during the study will continue to be followed; treatment may be modified consistent with pregnancy).

Exclusion Criteria for Discontinuation Phase:

1. Serious medical or psychiatric disorder or concomitant medication that, in the opinion of the study medical clinician, would make study participation hazardous to the participant or compromise study findings or would prevent the participant from completing the study. Examples include:

1. Disabling or terminal medical illness (e.g., uncompensated heart failure, cirrhosis or end-stage liver disease) as assessed by medical history, review of systems, physical exam and/or laboratory assessments;
2. Severe, untreated, or inadequately treated psychiatric condition (e.g., active psychosis, uncontrolled bipolar disorder) as assessed by history and/or clinical interview, requiring a different level of care (e.g., hospitalization);
2. Suicidal or homicidal ideation or behavior requiring a different level of care (e.g., hospitalization);
3. For participants entering the study taking buprenorphine, presence of pain requiring or likely requiring ongoing pain management with buprenorphine or other opioids;
4. If female, currently pregnant or breastfeeding or planning on conception;
5. Use of opioids (other than buprenorphine), cocaine, methamphetamine, or non-prescribed benzodiazepines in the past 12 weeks;
6. Meets current DSM-5 criteria for any current alcohol use disorder;
7. 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;
8. Have used the Connections mHealth app in the 3 months prior to consent (other than Connections in the Retention Phase);
9. Other major reasons that might prevent an individual from participating in the study (e.g., a planned move out of the area.

Understand screening

Treatment, groups and participation

The registry may describe treatments and study duration without a complete visit calendar. Ask the study team for the exact schedule, procedures, risks, costs and alternatives. Keep your usual care plan unless your treating clinician tells you otherwise.

Assignment
Random assignment
Masking
No masking
Retention: SL-BUP standard dose + MM

Standard dose sublingual buprenorphine-naloxone (SL-BUP) 16mg/day target plus MM, consisting of standard Medical Management and usual counseling at the treatment program.

Drug: SL-BUP · Behavioral: MM

Retention: SL-BUP high dose + MM

High dose sublingual buprenorphine-naloxone (SL-BUP) 32mg/day target plus MM, consisting of standard Medical Management and usual counseling at the treatment program.

Drug: SL-BUP · Behavioral: MM

Retention: XR-BUP + MM

Extended-release injectable buprenorphine (XR-BUP) plus MM, consisting of standard Medical Management and usual counseling at the treatment program.

Drug: XR-BUP · Behavioral: MM

Retention: XR-NTX + MM

Extended-release injectable naltrexone (XR-NTX) plus MM, consisting of standard Medical Management and usual counseling at the treatment program.

Drug: XR-NTX · Behavioral: MM

Retention: SL-BUP standard dose + MMR

Standard dose sublingual buprenorphine-naloxone (SL-BUP) 16mg/day target plus MMR, consisting of Medical Management and usual counseling, plus a technology-based behavioral component.

Drug: SL-BUP · Behavioral: MMR

Retention: SL-BUP high dose + MMR

High dose sublingual buprenorphine-naloxone (SL-BUP) 32mg/day target plus MMR, consisting of standard Medical Management and usual counseling, plus a technology-based behavioral component.

Drug: SL-BUP · Behavioral: MMR

Retention: XR-BUP + MMR

Extended-release injectable buprenorphine (XR-BUP) plus MMR, consisting of standard Medical Management and usual counseling, plus a technology-based behavioral component.

Drug: XR-BUP · Behavioral: MMR

Retention: XR-NTX + MMR

Extended-release injectable naltrexone (XR-NTX) plus MMR, consisting of standard Medical Management and usual counseling, plus a technology-based behavioral component.

Drug: XR-NTX · Behavioral: MMR

Discontinuation: Discontinue SL-BUP with SL-BUP + MM

Start on SL-BUP, taper with SL-BUP, plus MM, consisting of standard Medical Management and usual counseling at the treatment program.

Drug: SL-BUP · Behavioral: MM

Discontinuation: Discontinue SL-BUP with XR-BUP + MM

Start on SL-BUP, taper with XR-BUP, plus MM, consisting of standard Medical Management and usual counseling at the treatment program.

Drug: XR-BUP · Behavioral: MM

Discontinuation: Discontinue XR-BUP with XR-BUP + MM

Start on XR-BUP, taper with XR-BUP, plus MM, consisting of standard Medical Management and usual counseling at the treatment program.

Drug: XR-BUP · Behavioral: MM

Discontinuation: Discontinue XR-NTX with XR-NTX + MM

Start on XR-NTX, taper with XR-NTX, plus MM, consisting of standard Medical Management and usual counseling at the treatment program.

Drug: XR-NTX · Behavioral: MM

Discontinuation: Discontinue SL-BUP with SL-BUP + MMD

Start on SL-BUP, taper with SL-BUP, plus MMD, consisting of standard Medical Management and usual counseling, plus a technology-based behavioral component.

Drug: SL-BUP · Behavioral: MMD

Discontinuation: Discontinue SL-BUP with XR-BUP + MMD

Start on SL-BUP, taper with XR-BUP, plus MMD, consisting of standard Medical Management and usual counseling, plus a technology-based behavioral component.

Drug: XR-BUP · Behavioral: MMD

Discontinuation: Discontinue XR-BUP with XR-BUP + MMD

Start on XR-BUP, taper with XR-BUP, plus MMD, consisting of standard Medical Management and usual counseling, plus a technology-based behavioral component.

Drug: XR-BUP · Behavioral: MMD

Discontinuation: Discontinue XR-NTX with XR-NTX + MMD

Start on XR-NTX, taper with XR-NTX, plus MMD, consisting of standard Medical Management and usual counseling, plus a technology-based behavioral component.

Drug: XR-NTX · Behavioral: MMD

SL-BUP DRUG

Daily dosing of sublingual buprenorphine-naloxone

XR-BUP DRUG

Weekly/monthly dosing of extended-release injectable buprenorphine

XR-NTX DRUG

Monthly dosing of extended-release injectable naltrexone

MM BEHAVIORAL

MM consists of standard Medical Management and the usual counseling at the treatment program.

MMR BEHAVIORAL

MMR consists of Medical Management and usual counseling, plus a technology-based behavioral component.

MMD BEHAVIORAL

MMD consists of Medical Management and usual counseling, plus a technology-based behavioral component.

Prepare your questions

What researchers are measuring

Outcome measures describe what is being studied. They are not proof that a treatment works.

Primary measures

Retention: Continuous retention in MOUD treatment through 26 weeks

Time frame: Retention: from randomization through week 26

Binary (yes/no). Continuously enrolled in maintenance treatment on one or more of the evidence-based MOUD modalities (e.g., SL-BUP, XR-BUP, XR-NTX, or methadone maintenance) with no more than a 28-day gap on MOUD over the 26-week period.

Discontinuation: Completed Discontinuation without Relapse

Time frame: Discontinuation: from randomization through week 24 follow up

Binary (yes/no). Discontinuing MOUD during the taper period, no return to MOUD, and no relapse to opioid use, either during the taper (up to 48 weeks for those entering on BUP or 24 weeks for those entering on XR-NTX) or during the 24 weeks after MOUD is discontinued.

Secondary measures

Retention KS1: Weekly opioid abstinence

Time frame: Retention: from randomization through week 26

Weekly opioid abstinence (measured by Timeline Followback, not contradicted by toxicology test). Repeated yes/no measure for each of weeks 1 through 26.

Retention KS2: Treatment effectiveness

Time frame: Retention: at week 26

Retention treatment effectiveness, measured by the Treatment Effectiveness Assessment (TEA, Ling et. al, 2012); a brief instrument to assess patient progress in treatment and recovery along 4 domains (substance use, health, lifestyle and community) at week 26.

Retention KS3: Treatment by baseline severity

Time frame: Retention: at week 26

Treatment by baseline severity interaction where severity is indicated by the randomization stratum injection use (yes/no).

Discontinuation KS1: Completed Discontinuation

Time frame: Discontinuation: from randomization through week 24 follow up

Completed Discontinuation without regard to relapse status

Discontinuation KS2: Relapse

Time frame: Discontinuation: from randomization through week 24 follow up

Relapse - separate binary outcome without regard to discontinuation status

Discontinuation KS3: Safety

Time frame: Discontinuation: from randomization through week 24 follow up

Safety outcomes (binary, any one or more occurrences): overdoses, all non-fatal plus fatal.

Discontinuation KS4: Treatment effectiveness

Time frame: Discontinuation: at end of taper (EoT) and week 24 follow up

Discontinuation treatment effectiveness, measured by the Treatment Effectiveness Assessment (TEA, Ling et. al, 2012); a brief instrument to assess patient progress in treatment and recovery along 4 domains (substance use, health, lifestyle and community) at week 24. Measured at the end of taper (EOT): up to 24 weeks for tapers with XR-NTX and up to 48 weeks for tapers with BUP; and at the week 24 follow up (primary outcome timepoint).

No results are flagged as posted.

Review the complete result tables and limitations in the official record.

Open official results ↗

Research locations (21)

The overall study status and a local site’s status can differ. Confirm that location’s availability before traveling.

21 locations

University of Arkansas for Medical Sciences (UAMS) / Center for Addiction Services and Treatment (CAST)Little Rock, Arkansas, United StatesStatus unknown
Tarzana Treatment Centers, Inc.Tarzana, California, United StatesStatus unknown
Liberation Programs, Inc.Bridgeport, Connecticut, United StatesStatus unknown
Operation PARClearwater, Florida, United StatesStatus unknown
Gateway Community ServicesJacksonville, Florida, United StatesStatus unknown
Aspire Health PartnersOrlando, Florida, United StatesStatus unknown
Mountain Manor / Maryland Treatment CentersBaltimore, Maryland, United StatesStatus unknown
McLean HospitalBelmont, Massachusetts, United StatesStatus unknown
Stanley Street Treatment and Resources, Inc.Fall River, Massachusetts, United StatesStatus unknown
Square Medical Group, LLCNewton, Massachusetts, United StatesStatus unknown
Gibson Center for Behavioral ChangeCape Girardeau, Missouri, United StatesStatus unknown
Dartmouth Hitchcock - ATPLebanon, New Hampshire, United StatesStatus unknown
University of New Mexico Addiction and Substance Abuse ProgramAlbuquerque, New Mexico, United StatesStatus unknown
Bellevue Hospital CenterNew York, New York, United StatesStatus unknown
Adapt Integrated Health CareRoseburg, Oregon, United StatesStatus unknown
Adapt Integrated Health CareWinston, Oregon, United StatesStatus unknown
Center for Psychiatric and Chemical Dependency Services (CPCDS)Pittsburgh, Pennsylvania, United StatesStatus unknown
Internal Medicine Recovery Engagement Program (IM-REP)Pittsburgh, Pennsylvania, United StatesStatus unknown
Shoreline Behavioral Health ServicesConway, South Carolina, United StatesStatus unknown
Huntsman Mental Health Institute / University of UtahSalt Lake City, Utah, United StatesStatus unknown
Chestnut Ridge CenterMorgantown, West Virginia, United StatesStatus unknown

Study team and timeline

Lead sponsor
NYU Langone Health
Study start
Jun 8, 2021 Actual
Primary completion
Dec 31, 2026 Estimated
Study completion
Jan 31, 2027 Estimated
First posted
Jul 9, 2020 Actual
Last updated
Nov 10, 2026 Actual

Official study contacts

No central contact is listed. Check the locations and the official record.

Official study title

NIDA-CTN-0100: Optimizing Retention, Duration and Discontinuation Strategies for Opioid Use Disorder Pharmacotherapy (RDD)

A HUMAN NEXT STEP

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Source: ClinicalTrials.gov API v2. Information is submitted by sponsors and investigators. NLM does not approve the safety or science of all listed studies. Registry disclaimer.

Retrieved: Nov 12, 2026 · Last registry update: Nov 10, 2026