Peer-Delivered Behavioral Activation to Improve Medication Adherence and Reduce Polysubstance Use in Telemedicine Opioid Treatment

What this Trial Is About

This research aims to evaluate a peer-led, brief behavioral intervention designed to improve medication adherence for opioid use disorder MOUD and reduce polysubstance use among patients with opioid use disorder OUD and polysubstance use in underserved areas. The study focuses on a behavioral activation BA approach delivered by trained peer recovery specialists PRSs and compares it to treatment as usual TAU over a 12-month period. The trial addresses challenges in OUD treatment retention, especially in communities with limited access to addiction care and rising stimulant use. Participants will be randomly assigned to either the Peer Activate intervention or enhanced treatment as usual. Those in the Peer Activate group will receive about six weekly core sessions, lasting 30 minutes to one hour, led by PRSs teaching behavioral activation and problem-solving skills. Additionally, up to six optional booster sessions are available to reinforce these skills. The TAU group receives standard telemedicine services enhanced with community referrals and follow-ups, plus regular meetings with addiction medicine physicians and PRSs for general support. Throughout the study, participants will be monitored with urinalysis and self-reports to assess polysubstance use, treatment retention, and medication adherence over six months. Researchers will also track intervention attendance, uptake, and fidelity. The trial includes multiple assessments to measure problems related to substance use and the effectiveness of peer-delivered behavioral activation in improving outcomes for patients receiving telemedicine buprenorphine treatment. Total participation and follow-up last at least 12 months.

Peer Recovery to Improve Polysubstance Use and Mobile Telemedicine Retention