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Opioid Use DisorderPhase 4NCT06323824

Office-based Methadone Versus Buprenorphine to Address Retention in Medication for Opioid Use Disorder Treatment.

A Phase 4 study testing Methadone and Buprenorphine (BUP) in people with Opioid Use Disorder, run by Yale University at 6 sites in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The purpose of this clinical trial is to compare the effectiveness of office-based methadone with pharmacy administration and/or dispensing to office-based buprenorphine for the treatment of opioid use disorder. This study will also examine factors influencing the implementation of office-based methadone. Read more about this study

Who is it for?
Ages 18 to 99 years
Conditions the study is for
Opioid Use Disorder
What is being tested?
Methadone and Buprenorphine (BUP)
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
600 participants
Where
6 sitesUnited States
Study dates
4 Jun 2024to Dec 2028
Phase
Phase 4
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 99 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 18 years of age or older;
  • Meet Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria for OUD;
  • Are initiating a new MOUD treatment episode

Who cannot join

  • Have been prescribed (and ingested) or been administered more than 72 hours of MOUD in the 7 days prior to randomization as a "bridge" to the new OUD treatment episode. Such MOUD may include prescribed (and ingested) or administered medically managed withdrawal (aka detoxification).
  • Known contraindication to methadone or BUP
  • Unwilling to pursue or continue pre-natal care or pregnancy counseling if determined pregnant by urine human chorionic gonadotropin (hCG) testing at the screening assessment
  • Be actively suicidal or severely cognitively impaired (e.g., dementia, untreated psychosis) precluding informed consent as determined by site clinician
  • Current severe comorbid substance use disorder requiring residential or inpatient treatment services as determined by site clinician
  • Be unable to provide locator information including one or more contacts in addition to themselves
Show all 11Show fewer
  • Be unwilling to follow study procedures (e.g., unwilling to receive treatment from site clinician, use the study pharmacy, unwilling to be randomized to BUP or methadone, or will be unavailable for the follow-up assessments) including allowing the researchers to access their record in the EMR and state's prescription drug monitoring program
  • Have previously enrolled in CTN-0131
  • Currently enrolled in another research study which will conflict with study procedures
  • Are currently in jail, prison or other overnight facility as required by a court of law or have pending legal action that could prevent participation in study activities
  • Unable to conduct research assessments in English as determined by Site PI or their designee.

Trial locations and contacts

6 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Jessica Research Associate contact

203-785-6821

j.mckenzie@yale.edu

6 sites in 1 country

United States6 sites, 6 recruiting
  • Officed Based Addiction Treatment Program, Boston Medical Center

    Boston, Massachusetts, 02118

    Emily Oot, 857-283-7620, EMBOSS@bmc.org

    Zoe Weinstein, MD

    Recruiting
  • Rapid Start Clinic, Kaiser Permanente Colorado

    Denver, Colorado, 80205

    Jennifer Barrow, (303)-739-3666, EMBOSS@kp.org

    Ingrid Binswanger, MD

    Recruiting
  • Marshall University Division of Addiction Sciences P.R.O.A.C.T

    Huntington, West Virginia, 25703

    Brynn M Taylor, 740-302-0845, taylor975@marshall.edu

    Zachary Hansen, MD

    Recruiting
  • Hennepin Healthcare Addiction Medicine

    Minneapolis, Minnesota, 55415

    Fiona Giles, (763) 568-2785, EMBOSSstudy@bermancenter.org

    Gavin Bart, MD

    Recruiting
  • Highland Hospital Bridge Clinic at Alameda Health System

    Oakland, California, 94602

    Jhoselyn Pineda, (510)214-3649, emboss.ctn0131@gmail.com

    Monish Ullal, MD

    Recruiting
  • Outpatient Buprenorphine Induction Clinic, University of California, San Francisco

    San Francisco, California, 94103

    Kristina Toma, 415-254-0398, EMBOSS@ucsf.edu

    Paula Lum, MD

    Recruiting

Other trials in United States

About this study

Official title: Office-based Methadone Versus Buprenorphine to Address Retention in Medication for Opioid Use Disorder Treatment - A Pragmatic Hybrid Effectiveness/Implementation Trial

The purpose of this clinical trial is to compare the effectiveness of office-based methadone with pharmacy administration and/or dispensing to office-based buprenorphine for the treatment of opioid use disorder. This study will also examine factors influencing the implementation of office-based methadone.

Read the detailed description

This study is a randomized, pragmatic hybrid type 1 effectiveness/implementation multisite (approximately 6 sites) trial to determine whether office-based methadone with pharmacy administration and/or dispensing or buprenorphine (BUP) results in greater treatment retention in approximately 600 patients with opioid use disorder (OUD). This trial will also identify implementation barriers, facilitators and acceptability at the patient, provider and health-systems level for office-based methadone with pharmacy administration and/or dispensing.

An ancillary extended study was added to this trial in January of 2026. A sub-set of current participants that were receiving office based methadone as of day 168 of the parent study will continue to be followed for other pre-specified outcomes.

Being tested
Methadone, Buprenorphine (BUP)
Keywords
Opioid Use Disorder, Methadone, Buprenorphine
Medical subject headings
Opioid-Related Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • MethadoneDrug

    Drug: Methadone

    Possible formulations:

    10 and 50 mg tablets

  • Buprenorphine (BUP)Drug

    Drug: Buprenorphine (BUP)

    Possible formulations:

    1. Buprenorphine, 225 mcg to 24 mg, 225 mcg to 32 mg per day,
    2. Buprenorphine (Extended release), 300 mg q 28 days (Sublocade), 100 mg q 28 days (Sublocade), 8 mg q 7 days (Brixadi), 16 mg q 7 days (Brixadi), 24 mg q 7 days (Brixadi), 32 mg q 7 days (Brixadi), 64 mg q 28 days (Brixadi), 96 mg q 28 days (Brixadi), 128 mg q 28 days (Brixadi),
Study groups in NCT06323824
Study groupRoleWhat they receive
Office-based methadoneExperimentalUnder special Drug Enforcement Administration (DEA) exception, Clinician prescribes methadone and oral methadone is administered and/or dispensed at a pharmacy which also has an exception to do so. All randomized controlled trial (RCT) participants are offered additional behavioral treatments (e.g., individual, group, telehealth, phone-based).
Receives: Drug: Methadone
Office-based buprenorphine (BUP)Active comparatorClinician prescribes BUP formulations that are dispensed at a pharmacy or administered in the office (e.g., extended-release formulations). All RCT participants are offered additional behavioral treatments (e.g., individual, group, telehealth, phone-based).
Receives: Drug: Buprenorphine (BUP)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of days of continuous treatment with site clinician-prescribed methadone or buprenorphine, as randomized, during the 168 days post-randomization among RCT participants.

    This measure is based on PDMP data for methadone and non-injectable buprenorphine and EMR data for injectable buprenorphine formulations

    Measured: up to Day 168

Secondary outcomes (17)
  1. Number of self-reported continuous treatment days in any FDA-approved formulation of MOUD treatment during the 168 days post-randomization.

    This measure is assessed using the MOUD Calendar Based Recall Recall Instruments.

    Measured: up to Day 168

  2. Number of self-reported continuous treatment days in formal OUD treatment, according to American Society of Addiction Medicine (ASAM) levels of care 1-4, during the 168 days post-randomization.

    This measure is assessed using one or more of the following:

    The Health Services Utilization instrument, a brief structured interview regarding health care utilization (inpatient and outpatient) collecting information on the type and amount of services received, Timeline Followback Medications, MOUD Calendar Based Recall, and Treatment Dates instruments.

    Measured: up to Day 168

  3. Total number of days receiving any FDA-approved MOUD formulation during the 168 days post-randomization.

    This measure is assessed using EMR (for injectable MOUD formulations) and PDMP data.

    Measured: up to Day 168

  4. The longest duration of continuous treatment episode with MOUD, as randomized, during the 168 days post randomization.

    This measure is based on PDMP and/or EMR data.

    Measured: up to Day 168

  5. Total number of days receiving methadone or buprenorphine, during the 168 days post-randomization.

    This measure is assessed using EMR (for injectable MOUD formulations) and PDMP data.

    Measured: up to Day 168

  6. Total number of days of self-reported non-prescribed opioid use during each 28-day assessment period.

    This measure is assessed by the Opioid Use Calendar Based Recall instruments.

    Measured: up to Day 168

  7. Total number of days of self-reported non-prescribed stimulant use during each 28-day assessment period.

    This measure is assessed by the Timeline Followback instrument.

    Measured: up to Day 168

  8. Total number of days of self-reported non-prescribed benzodiazepine use during each 28-day assessment period.

    This measure is assessed by the Timeline Followback instrument.

    Measured: up to Day 168

  9. Urine toxicology

    Total number of monthly (28 days) urines negative for non-prescribed opioids during the 168 days post-randomization. Non-prescribed opioids will be determined using the Opioid Use Calendar Based Recall instrument.

    Measured: up to Day 168

  10. Participant satisfaction with MOUD

    Proportion of RCT participants who report at the assessment scheduled to be collected on day 28 that the medication they received was at least "Somewhat helpful" on the Satisfaction with MOUD Provider Scale instrument.

    Measured: up to Day 168

  11. Total number of self-reported overdose events per total number of participant days at risk.

    The Overdose Calendar Recall instrument collects overdose events.

    Measured: up to Day 168

  12. Total number of self-reported injection drug use related events during each 28-day assessment period.

    Assessment of Infectious or Other Complications of Injection Drug Use assess for skin abscesses, ulcers , cellulitis, osteoarticular septic arthritis, osteomyelitis, epidural infection , endovascular, new injection-related viral infections diagnosis of Hepatitis or HIV.

    Measured: Up to Day 168

  13. Mean score Pain measured using Pain, Enjoyment of Life and General Activity (PEG) Scale (PEG-3)

    Mean scores on the PEG-3 instrument over time. The PEG-3 instrument is collected every 28 days. The mean score is the average of the three 0-10 rated items. Total score range 0-10. Higher scores indicate worse pain.

    Measured: Up to Day 168

  14. Total number of self-reported days with acute care utilization (ED or hospitalization) during each 28-day assessment period.

    The Health Services Utilization instrument is a brief, structured interview regarding health care utilization (inpatient and outpatient) collecting information on the type and amount of services received. This includes ED visits, hospitalizations, primary medical care visits (excluding those for BUP treatment) and self-help sources of support (e.g., NA). Also assessed are receipt of formal and informal addiction and mental health treatment services RCT participants might have received outside the study interventions.

    Measured: Up to Day 168

  15. Total number of behavioral counseling service visits attended per participant during each 28-day assessment period.

    Assessed by EMR extraction and the Health Services Utilization.

    Measured: Up to Day 168

  16. Total number of planned prescriber visits attended during each 28-day assessment period.

    Assessed by EMR extraction.

    Measured: Up to Day 168

  17. Pharmacist practice fidelity

    Assessed by MOUD Visit Checklist completion over time. The MOUD Visit Checklist collects clinical activities that might be performed by a pharmacist at each pharmacy, such as performing medication reconciliation; conducting safety assessments, adverse effects of methadone, recent overdose events, checking the patient's controlled medications prescription status using the PDMP before dispensing methadone; providing patient education/counseling; communicating with the clinician regarding any concern; and administering one methadone dose at the pharmacy and/or dispensing methadone according to the prescription.

    Measured: Up to Day 168

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Mar 2024
  2. Study start4 Jun 2024
  3. Primary completionDec 2028 (estimated)
  4. Study completionDec 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
The comparative effectiveness of two strategies to address retention in medication for opioid use disorder (MOUD) treatment will be tested over a 168-day period. Behavioral treatments offered to patients are designed to be similar across the two medication conditions. Office-based methadone where the clinician prescribes methadone and oral methadone is administered and/or dispensed at a pharmacy. Providers and Randomized Control Trial (RCT) participants will have flexibility to use behavioral and pharmacological services as clinically indicated. Office-based buprenorphine (BUP) where the clinician prescribes BUP formulations that are dispensed at a pharmacy or administered in the office (e.g., extended-release formulations). Providers and RCT participants will have flexibility to use behavioral and pharmacological services as clinically indicated.
Masking
None (open label)
Enrolment
600 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06323824
Sponsor's protocol ID
2000033271
Other IDs
CTN-0131, 5UG1DA015831-21
Status last verified
Sep 2026
First submitted
13 Mar 2023
Last updated
14 Sep 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: The National Institute on Drug Abuse (NIDA) Data Share web site is an electronic environment that allows data from completed clinical trials to be distributed to investigators and the public in order to promote new research, encourage further analyses, and disseminate information to the community. Secondary analyses produced from data sharing multiply the scientific contribution of the original research. NIH expects and supports the timely release and sharing of final research data from NIH-supported studies for use by other researchers to expedite the translation of research results into knowledge, products and procedures to improve human health.

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Methadone and Buprenorphine (BUP) in people with Opioid Use Disorder, run by Yale University at 6 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 14 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Jessica Research Associate (203-785-6821, j.mckenzie@yale.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of days of continuous treatment with site clinician-prescribed methadone or buprenorphine, as randomized, during the 168 days post-randomization among RCT participants. (time frame: up to Day 168). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Sep 2026.

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