Medication-assisted treatment (MAT) with buprenorphine or Suboxone for opioid use disorder (OUD) begins with a step called induction. For the medication to be effective, a person with opioid use disorder must be in (or more rarely, have gone through) active withdrawal to begin treatment. This process of withdrawal followed by the first few doses of medication is called induction. Primary care clinicians currently use different inductions methods without evidence-based guidelines to guide those decisions.
Which induction method is best? Which one should we use – and when? How can you send a patient home to do this? How can you ask a patient to come to the office to do this? There is no solid guidance for us. These are some of the questions the HOMER researchers heard during efforts to train clinicians, practice staff, and behavioral health care providers in MAT for OUD in Colorado and around the country.
HOMER is a randomized, comparative effectiveness trial of three models for induction:
HOMER is an opportunity for primary care practices to help answer these questions for themselves and their peers.
To answer these clinical questions, HOMER is working with 100 primary care practices nationwide. From these practices, 1200 patients seeking MAT for OUD will participate. The scale of this study is needed to adequately conduct a sound scientific study with meaningful results that provide information across different primary care settings.