Peer Intervention to Link Overdose Survivors to Treatment (PILOT): Protocol for a National Institute on Drug Abuse Clinical Trials Network multi-site, randomized controlled trial of peer coaching to reduce overdose risk (Preprint)

UNSTRUCTURED The increase in opioid-related overdoses has caused a decrease in average life expectancy, highlighting the need for effective interventions to reduce overdose risk. Peer Support Specialists (PSS) offer an appealing strategy to engage overdose survivors and reduce subsequent overdose risk, but randomized controlled trials are needed to evaluate effectiveness. This National Institute on Drug Abuse Clinical Trials Network (NIDA CTN) study is a multi-site, prospective, randomized (1:1) controlled pilot trial (CTN-0107) that aims to evaluate the effectiveness of an Emergency Department (ED)-initiated peer-delivered intervention tailored for opioid overdose survivors (Peer Intervention to Link Overdose survivors to Treatment [PILOT]), compared to treatment as usual (TAU). This study evaluates the effectiveness of the 6-month PILOT intervention compared to TAU on the primary outcome of reducing overdose risk behavior at 6 months post-enrollment. Adults (ages 18+; N=150) with a recent opioid-related overdose are approached in the ED, screened, enrolled and then are asked to complete study visits at months 1, 3, 6 (end of intervention), and 7 (follow-up). Participants randomized to the PILOT intervention receive a 6-month PSS-led intervention that is tailored to each participant’s goals to reduce their overdose risk behavior (e.g., overdose harm reduction, housing, medical, and substance use treatment or recovery goals). This paper describes the study protocol and procedures, design and inclusion decisions, and the peer-led PILOT intervention, as well as current study status. Results from this trial will inform ED-initiated PSS-led overdose risk reduction interventions including implementation of PSS services and research in medical settings.