Coordinated Access for Addiction Recovery and Equity in VA Supportive Housing

NCT07141394 | Not Yet Recruiting

• 2 other identifiers: QUX 25-001QUE 25-013
• Study Type: interventional
• Target: 7,908
• Locations: 1 country
• Sites: 1

Brief Summary

The Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH) Program provides subsidized permanent housing with case management to homeless-experienced Veterans (HEVs). Up to 40% of Veterans exit HUD-VASH within two years of attaining housing; substance use disorders (SUDs) are one of the largest causes of returns to homelessness for HEVs. CARE-VASH QUERI proposes to implement and evaluate two evidence-based SUD services - Medications for addiction treatment (MAT) and cognitive behavioral therapy for SUDs (CBT-SUD) - among Veterans in HUD-VASH.

Conditions

Homelessness; Substance Use Disorder (SUD)

Keywords

Homeless; Substance Use Disorder; Permanent Supportive Housing; Implementation Science

Outcome Measures

Primary Outcomes (6)

• Reach of MAT (Medications for Addiction Treatment)

  * (percent of) Veterans who used Medications for Opioid Use Disorder (MOUD) for OUD, ≥1 prescription * (percent of) Veterans who used MOUD for OUD for 180 days since initial prescription (without a break ≥14 days in supply) * (percent of) Veterans who used Medications for Alcohol Use Disorder (MAUD) for AUD, ≥1 prescription * (percent of) Veterans who used MAUD for AUD for 180 days since initial prescription (without a break ≥14 days in supply)

  18 months post-implementation

• Reach of CBT-SUD (Cognitive Behavioral Therapy-Substance Use Disorders)

  * (percent of) Veterans with stimulant use disorder who had ≥1 visit for Cognitive Behavioral Therapy-Substance Use Disorders (CBT-SUD) or contingency management * (percent of) Veterans with substance use disorder with ≥1 CBT-SUD visit * (percent of) Veterans with substance use disorder with ≥9 CBT-SUD visits

  18 months post-implementation

• Adoption of MAT (Medications for Addiction Treatment)

  % (percent of) Department of Housing and Urban Development - VA Supportive Housing (HUD-VASH) and mental health prescribers engaged with Veterans who ordered Medications for Opioid Use Disorder (MOUD) / Medications for Alcohol Use Disorder (MAUD) at least once

  18 months post-implementation

• Adoption of CBT-SUD (Cognitive Behavioral Therapy-Substance Use Disorders)

  % (percent of) Department of Housing and Urban Development - VA Supportive Housing (HUD-VASH) case managers who delivered ≥1 CBT-SUD (Cognitive Behavioral Therapy-Substance Use Disorders) session

  18 months post-implementation

• Sustainment of MAT (Medications for Addiction Treatment)

  * (percent of) Veterans who used Medications for Opioid Use Disorder (MOUD) for OUD, ≥1 prescription * (percent of) Veterans who used MOUD for OUD for 180 days since initial prescription (without a break ≥14 days in supply) * (percent of) Veterans who used Medications for Alcohol Use Disorder (MAUD) for AUD, ≥1 prescription * (percent of) Veterans who used MAUD for AUD for 180 days since initial prescription (without a break ≥14 days in supply) * (percent of) Department of Housing and Urban Development - VA Supportive Housing (HUD-VASH) and mental health prescribers engaged with Veterans who ordered Medications for Opioid Use Disorder (MOUD) / Medications for Alcohol Use Disorder (MAUD) at least once

  18-27 months post-implementation

• Sustainment of CBT-SUD (Cognitive Behavioral Therapy-Substance Use Disorders)

  * (percent of) Veterans with stimulant use disorder who had ≥1 visit for Cognitive Behavioral Therapy-Substance Use Disorders (CBT-SUD) or contingency management * (percent of) Veterans with substance use disorder with ≥1 CBT-SUD visit * (percent of) Veterans with substance use disorder with ≥9 CBT-SUD visits * (percent of) Department of Housing and Urban Development - VA Supportive Housing (HUD-VASH) case managers who delivered ≥1 CBT-SUD (Cognitive Behavioral Therapy-Substance Use Disorders) session

  18-27 months post-implementation

Secondary Outcomes (4)

• Housing retention

  1 year after implementation by cohort

• Provider experience

  Baseline and 18 months post-implementation

• Cost impact of Medications for Addiction Treatment (MAT) and Cognitive Behavioral Therapy-Substance Use Disorders (CBT-SUD)

  18 months (during the course of implementation)

• Acute care utilization

  1 year after implementation by cohort

Study Arms (3)

Replicating Effective Programs (REP)

EXPERIMENTAL

A stakeholder-informed training and technical assistance implementation strategy

Drug: Medication for Addiction Treatment (MAT); Behavioral: Cognitive Behavioral Therapy for Substance Use Disorders (CBT-SUD)

REP + Consumer Engagement (CE)

ACTIVE COMPARATOR

REP plus CE package (educational materials, peer coaching, toolkit) to support MAT and CBT-SUD implementation.

Drug: Medication for Addiction Treatment (MAT); Behavioral: Cognitive Behavioral Therapy for Substance Use Disorders (CBT-SUD)

Control Group

NO INTERVENTION

No MAT or CBT-SUD implementation

Interventions

Medication for Addiction Treatment (MAT) DRUG

MAT includes medications for alcohol use disorder (MAUD) and medications for opioid use disorder (MAUD). It reduces substance use, increases SUD treatment engagement, enhances quality of life, and reduces overdoses.

Also known as: MAT

REP + Consumer Engagement (CE); Replicating Effective Programs (REP)

Cognitive Behavioral Therapy for Substance Use Disorders (CBT-SUD) BEHAVIORAL

An evidence-based psychotherapy that uses cognitive behavioral therapy to further recovery goals across SUD diagnoses.

Also known as: CBT-SUD

REP + Consumer Engagement (CE); Replicating Effective Programs (REP)

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Homeless-experienced Veterans (HEVs) enrolled in the Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH) Program.

You may not qualify if:

• None

Sponsors & Collaborators

• VA Office of Research and Development: lead
• University of California, Los Angeles: collaborator

Study Sites (1)

VA Greater Los Angeles Healthcare System, West Los Angeles, CA

West Los Angeles, California, 90073-1003, United States

Location

MeSH Terms

Conditions

Substance-Related Disorders

Interventions

Dosage Forms; Cognitive Behavioral Therapy

Condition Hierarchy (Ancestors)

Chemically-Induced Disorders; Mental Disorders

Intervention Hierarchy (Ancestors)

Pharmaceutical Preparations; Technology, Pharmaceutical; Investigative Techniques; Behavior Therapy; Psychotherapy; Behavioral Disciplines and Activities

Study Officials

• Sonya Emi Gabrielian, MD MPH

  VA Greater Los Angeles Healthcare System, West Los Angeles, CA

  PRINCIPAL INVESTIGATOR

• Evelyn T Chang, MD MSHS

  VA Greater Los Angeles Healthcare System, Sepulveda, CA

  PRINCIPAL INVESTIGATOR

• Erin P Finley, PhD MPH

  VA Greater Los Angeles Healthcare System, West Los Angeles, CA

  PRINCIPAL INVESTIGATOR

• Emily Treichler, PhD

  VA San Diego Healthcare System, San Diego, CA

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Sonya E Gabrielian, MD MPH

CONTACT

(310) 478-3711; Sonya.Gabrielian@va.gov

Jenny M Barnard, BA

CONTACT

(626) 367-1077; Jenny.Barnard@va.gov

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: FED
• Responsible Party: SPONSOR

Model Details: Investigators are implementing two evidence-based Substance Use Disorder (SUD) services - Medications for addiction treatment (MAT) and cognitive behavioral therapy for SUDs (CBT-SUD) - among Veterans in the Department of Housing and Urban Development-VA Supportive Housing Program (HUD-VASH).

Study Record Dates

• First Submitted: August 6, 2025
• First Posted: August 26, 2025
• Study Start (Estimated): October 1, 2026
• Primary Completion (Estimated): September 30, 2030
• Study Completion (Estimated): September 30, 2030
• Last Updated: October 10, 2025

Record last verified: 2025-10

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL

Locations

US (1)