# Coordinated medical treatment of opioid use disorder and infectious disease

> **NIH NIH U01** · YALE UNIVERSITY · 2021 · $1,347,367

## Abstract

Project Abstract
 The current opioid use disorder (OUD) epidemic has resulted a rise in infections including not only HCV
and HIV, but also invasive bacterial infections including Staphylococcus Aureus bacteremia, endocarditis, skin
and soft tissue infections, and bone and joint infections. Persons admitted to hospitals with co-occurring OUD
and related infections presents a critical time to intervene, both to improve infectious disease and opioid
addiction outcomes. Most hospitals, particularly in under-resourced and rural areas, lack physicians trained in
treatment of OUD, and standard care for patients even in busy academic urban hospitals typically consists of
detoxification and referral to outpatient resources for follow-up treatment. This asks patients with severe OUD
to tolerate withdrawal symptoms, risking premature exit from hospital, and relapse to opioid use after failure to
connect with OUD treatment referrals. Results include long lengths of stay due to concern about relapse and
non-adherence if patients leave the hospital, and readmissions after OUD relapse, lack of antibiotic adherence
and reinfection, leading to both poor clinical outcome and high healthcare costs. Hospital settings that manage
these infections are treating increasing numbers of people with untreated OUD. This provides an opportunity
to engage patients in treatment of their OUD while managing their infections. Infectious Disease (ID)
specialists and hospitalists are a critical and logical resource to build capacity and increase access to
medication-assisted treatment (MAT). An injectable long-acting monthly formulation of buprenorphine (LAB)
has a potential advantage for initiating OUD treatment within hospital settings and bridging to treatment after
discharge to the community. We propose to test a new model of care (ID/LAB) in which opioid use disorder
(OUD) is managed by ID specialists and hospitalists concurrent with management of the OUD-related
infections, using long-acting injectable buprenorphine (LAB), followed by referral as soon as possible after
hospital discharge to community resources for long term treatment of OUD. Adults admitted to a hospital for
infections related to OUD (N = 200) will be identified at hospital admission and randomly assigned 1:1 to
ID/LAB or treatment as usual (TAU), consisting of detoxification and referral to community-based treatment for
OUD in parallel with treatment of the infectious disease. The primary outcome measure will be the proportion
of patients enrolled in effective medication treatment for OUD (buprenorphine, methadone, or injection
naltrexone) at 3 months (12 weeks) after randomization. Study sites will be three hospitals serving
geographically diverse, mixed urban and rural communities across the Eastern U.S. With successful co-
treatment of addiction and infectious diseases, OUD could be stabilized, while repeat infections are avoided,
and risk of morbidity and mortality due to infection or overdose reduced.

## Key facts

- **NIH application ID:** 10210317
- **Project number:** 5U01TR002763-03
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** KATHLEEN T. BRADY
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $1,347,367
- **Award type:** 5
- **Project period:** 2019-07-18 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10210317

## Citation

> US National Institutes of Health, RePORTER application 10210317, Coordinated medical treatment of opioid use disorder and infectious disease (5U01TR002763-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10210317. Licensed CC0.

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