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Collaborating to Heal Addiction and Mental Health in Primary care is a real-world clinical trial sponsored by the National Institute of Mental Health (NIMH) through the Helping to End Addiction Long-term Initiative, or HEAL Initiative. This study is conducted by the Department of Psychiatry and Behavioral Sciences, Division of Population Health and the AIMS Center.

Medication Assisted Treatment, with buprenorphine, methadone, or naltrexone, represents the gold-standard intervention for Opioid Use Disorder (OUD) and significantly reduces risk for overdose or death.  However, only 20% of Americans with OUD received any formal or informal addiction treatment in the past year. Even in addiction treatment settings, only 32% of patients with OUD received Medication Assisted Treatment.  Lack of access and engagement in Medication Assisted Treatment is driving poor OUD outcomes, especially in rural areas lacking specialty addiction services. To close this engagement gap, more patients with OUD need access to Medication Assisted Treatment in primary care settings.

The purpose of this trial is to test whether Collaborative Care (CoCM) that addresses both mental health disorders (MHD) and co-occurring opioid use disorder (OUD) can improve patient lives. This trial will also examine the effectiveness of screening for Opioid Use Disorder (OUD) and effectiveness of high or low sustainment support.

The trial will be conducted in 24 primary care clinics with existing CoCM programs or a commitment to initiate a CoCM program in the next 6 months.  Clinics will be randomized to either adding OUD to their Collaborative Care program or maintaining Collaborative Care for mental health disorders only.

Our target is to enroll and treat 1200 eligible patients who screen positive for OUD and MHD over an 18 month period.