Study of Long-Term Community Treatment for Opioid Use Disorder Using Employment-Based Drug Abstinence Support

What this Trial Is About

This research focuses on adults with opioid use disorder who are unemployed and living in poverty, aiming to evaluate a low-cost Therapeutic Workplace intervention. The study seeks to address the chronic challenges of opioid addiction and poverty by developing a community-based program that promotes drug abstinence and employment through wage incentives. The trial is a Stage III randomized controlled study conducted in partnership with a community clinic to test the real-world impact of this approach. Participants will be randomly assigned to one of three groups after a 4-week induction period Usual Care Control, Initiation Only, or Initiation and Maintenance. All receive methadone or buprenorphine treatment and support from an employment specialist for 48 weeks. The Initiation Only and Initiation and Maintenance groups can earn high-magnitude abstinence-contingent wage supplements during the first 24 weeks. The Initiation and Maintenance group will continue to receive lower-magnitude incentives during weeks 25 to 48 to sustain abstinence and employment. Participants will be assessed every four weeks during the Maintenance period to measure drug abstinence and employment rates. The study includes a 4-week induction, followed by 48 weeks of support, focusing on long-term drug abstinence, employment maintenance, and poverty reduction. Researchers will monitor urine samples for drug use, employment status via pay stubs, and provide counseling and employment services as part of care. The goal is to determine if this community-adapted Therapeutic Workplace can be a sustainable intervention for opioid use disorder.

Long-Term Treatment of Opioid Use Disorder