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Randomized Controlled Trial
. 2025 Sep 1:274:112785.
doi: 10.1016/j.drugalcdep.2025.112785. Epub 2025 Jul 9.

Effects of the Communities That HEAL intervention on initiation, retention, and linkage to medications for opioid use disorder (MOUD): A cluster randomized wait-list controlled trial

Jennifer L Brown  1 , Marc R Larochelle  2 , Laura C Fanucchi  3 , Deirdre C Calvert  4 , Aimee N C Campbell  5 , Redonna K Chandler  6 , Daniel J Feaster  7 , LaShawn M Glasgow  8 , Erin B Gibson  9 , JaNae Holloway  8 , Michelle R Lofwall  10 , Aimee Mack  11 , Nicole Mack  8 , Edward V Nunes  5 , Jeffery C Talbert  12 , Sylvia Tan  8 , Nathan Vandergrift  8 , Jennifer Villani  6 , Kat Asman  8 , Hermik Babakhanlou-Chase  4 , Sarah M Bagley  13 , Tracy A Battaglia  13 , Derek Blevins  5 , Carly Bridden  14 , Debbie M Cheng  15 , Mia Christopher  8 , Lindsay W Cogan  16 , Chinazo O Cunningham  17 , Barry Eggleston  8 , Naleef Fareed  18 , Soledad Fernandez  18 , Darcy A Freedman  19 , Caroline E Freiermuth  20 , Bridget Freisthler  21 , Louisa Gilbert  22 , Lindsey Hammerslag  23 , Daniel Harris  24 , Timothy Hunt  22 , Shazia Hussain  17 , Phuong Huynh  18 , Rebecca D Jackson  18 , Emily B Kauffman  18 , Charles Knott  8 , Hannah K Knudsen  10 , R Craig Lefebvre  8 , Frances R Levin  5 , Rick Massatti  25 , Ann Scheck McAlearney  18 , Jake R Morgan  26 , Rosie Munoz Lopez  13 , David W Lounsbury  27 , Lisa Newman  8 , Katrina Nickels  28 , Emmanuel A Oga  8 , Devin A Oller  28 , Theodore V Parran  29 , Maria Quinn  30 , Kelly S Ramsey  31 , Bruce D Rapkin  27 , Pamela Salsberry  32 , Michael Stein  26 , Jessica L Taylor  2 , Julie Teater  18 , Scott T Walters  33 , Gary A Zarkin  8 , Nabila El-Bassel  22 , T John Winhusen  34 , Jeffrey H Samet  35 , Sharon L Walsh  10
Affiliations
Randomized Controlled Trial

Effects of the Communities That HEAL intervention on initiation, retention, and linkage to medications for opioid use disorder (MOUD): A cluster randomized wait-list controlled trial

Jennifer L Brown et al. Drug Alcohol Depend. .

Abstract

Medications for opioid use disorder (MOUD) can reduce opioid use and overdose deaths. This study examined whether the Communities That HEAL (CTH) intervention increased MOUD initiation, retention, and linkage. The HEALing Communities Study was a multi-site, 2-arm, parallel, community-level, cluster-randomized, unblinded, wait-list controlled trial conducted in 67 communities (n = 34 intervention, n = 33 control). Using Prescription Drug Monitoring Programs and Medicaid claims data, we compared mean community-level rates of MOUD outcomes during the 1-year comparison period (July 2021-June 2022) for: (a) MOUD receipt at least once; (b) continuous MOUD receipt for 180 days; and (c) MOUD linkage within 31 days following an opioid-related emergency department or hospital encounter. For intervention and control communities, adjusted rates of receiving MOUD at least once were 578 (95 % CI: 562, 594) and 596 (95 % CI: 572, 621) per 1000 Medicaid enrollees, respectively [adjusted Relative Rate (aRR)= 0.97 (95 % CI: 0.93, 1.01)]. Adjusted rates of receiving MOUD for 180 consecutive days (retention) were 614 (95 % CI: 595, 634) and 620 (95 % CI: 603, 638) per 1000 Medicaid enrollees receiving MOUD at least once for intervention and control communities, respectively [aRR= 0.99 (95 % CI: 0.95, 1.04)]. The adjusted rate of linkage was 280 (95 % CI: 254, 310) and 252 (95 % CI: 226, 281) per 1000 encounters for intervention and control communities, respectively [aRR= 1.11 (95 % CI: 0.96, 1.28). Compared to control communities, communities that received the CTH intervention did not demonstrate higher rates of MOUD use, retention, or linkage. Additional efforts are needed to improve uptake and sustained use of MOUD. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04111939.

Keywords: Communities That HEAL intervention; HEALing Communities Study; Medications for opioid use disorder; Opioid use disorder.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Michelle Lofwall reported serving as a research consultant to Berkshire Biomedical, Braeburn, Titan, and Journey Colab. Dr. Sharon Walsh reported serving as a scientific consultant to Titan, Opiant, Braeburn, Astra Zeneca, and Cerevel. Dr. Levin reported receiving grant support from US World Meds and research support from Aelis Pharmaceuticals. Dr. Frances Levin also reported receiving medication from Indivior for research and royalties from APA publishing. Dr. Levin reported serving on the National Advisory Council on Alcohol Abuse and Alcoholism. In addition, Dr. Levin reported serving as a nonpaid member of a Scientific Advisory Board for Alkermes, Atai Life Science, Boehringer Ingelheim, Indivior, Novartis, Teva, and US WorldMeds and is a consultant to Major League Baseball.

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