Inpatient Single Dose Interventions for Alcohol Use Disorder
Status:
Recruiting
Trial end date:
2022-02-01
Target enrollment:
Participant gender:
Summary
Every year, alcohol use disorder (AUD) generates millions of emergency department (ED) visits
and hospital admissions, costing the U.S. health sector over $90 billion. These hospital
admissions are critical opportunities to start patients on addiction pharmacotherapy, but
factors like medication non-adherence and post-discharge relapse contribute to frequent
re-admissions. Two single-dose interventions are well suited to facilitate treatment
retention and prevent re-admissions due to their prolonged, adherence-independent effects:
extended-release (XR) naltrexone injection and intravenous (IV) ketamine infusion. These have
not been thoroughly investigated in the hospital setting among high-utilizer, safety-net
populations. Therefore, the investigators aim to:
1. Test the feasibility of randomizing hospitalized patients (n=45-60, age 18-65) with
multiple AUD-related admissions to treatment with either extended-release (XR)
naltrexone, intravenous (IV) ketamine, or no single-dose medication, all with enhanced
linkage to care. Feasibility outcomes such as recruitment rate, patient acceptability,
post-discharge follow-up rate, and adverse events will help to identify key lessons for
a future comparative effectiveness study.
2. Estimate the 30-day re-admission rate for patients randomized to treatment with XR
naltrexone, with IV ketamine, or no single-dose medication, all with enhanced linkage to
care. The investigators hypothesize that the re-admission rate will be lower for each of
the two single-dose medication groups than for the "linkage-alone" group.