Overdose Prevention for Substance Use Disorder and Homelessness

(HOPE Trial)

This trial tests a program designed to prevent overdoses among homeless Veterans with substance use disorders. It emphasizes education on overdose prevention and the distribution of naloxone, a medication that can reverse an overdose. The trial compares two approaches: a low-intensity version, offering resources and guidance, and a high-intensity version, providing more hands-on support and training. Veterans in a supportive housing program who are at risk for opioid overdose may be suitable candidates for this trial. As an unphased trial, it offers Veterans the opportunity to contribute to innovative solutions for overdose prevention.

A previous study showed that overdose education and naloxone distribution (OEND) are safe. Naloxone, a medication that can reverse opioid overdoses, has been used safely for years. Research shows that OEND programs are generally well-tolerated by participants, with few reported side effects. These programs aim to teach people about overdose risks and provide naloxone.

The Homeless Overdose Prevention-Expansion (HOPE) treatment includes both High Intensity and Low Intensity approaches, focusing on education and naloxone distribution. This builds on existing evidence that these strategies are safe and effective for helping those at risk of overdose.

Researchers are excited about the HOPE program because it aims to address overdose prevention in a unique way for people experiencing homelessness. Unlike traditional approaches that often focus solely on medication-assisted treatment or naloxone distribution, HOPE combines structured training and resources with different intensity levels of support. The high-intensity approach stands out by integrating a dedicated clinical team and providing regular feedback and technical assistance, which could enhance the effectiveness of overdose education and prevention strategies. This adaptability and focus on comprehensive support could lead to more successful outcomes in preventing overdoses among this vulnerable population.

Research has shown that programs teaching overdose prevention and providing naloxone can reduce overdose deaths. These programs equip people with crucial knowledge and tools to save lives. Naloxone, a medication that can reverse opioid overdoses if administered quickly, plays a key role. This trial will compare two approaches within the Homeless Overdose Prevention-Expansion (HOPE) program, specifically designed for homeless veterans. Participants will be assigned to either the high-intensity or low-intensity HOPE program. Although direct data on these specific programs is limited, their core methods, such as overdose education and naloxone distribution, have a strong track record of success.