New study could speed up methadone restart for opioid users

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. Age 19 years or older 2. Opioid use disorder (OUD) of any severity by DSM-5 TR Clinical Diagnostic criteria \[American Psychiatric Association, 2022\] 3. Previously 'stable' on methadone as per the below definitions: 1. Previous maintenance treatment with methadone for opioid use disorder at a stable dose for at least 5 consecutive days prior to discontinuing, with allowance for a maximum of 1 missed dose within that 5-day period. 2. Participants who were being titrated on methadone for opioid use disorder prior to discontinuation. If participants were on the most recent dose for less than 5 days, they can be restarted on the prior dose providing they cumulatively received 5 consecutive doses (with a maximum of 1 missed dose in that period) between the two most recent dosages. 4. Missed 4-8 doses of methadone in a row leading up to intake assessment. 5. Participant able to provide baseline opiate use history as per opiate use screening questions in Appendix A. This must provide an estimate of opiate use prior to stopping methadone and change in use since stopping. 6. Self-reported increased use of fentanyl since stopping methadone. 7. No significant change in opiate withdrawal symptoms as compared to when on methadone, based on self-report and examination. 8. Urine drug test (UDT) positive for fentanyl at screening or within 24 hours prior to re-initiating methadone. 9. Participant wishes to continue methadone maintenance treatment. 10. If applicable the participant must be willing to complete a urine pregnancy test to ensure they are not currently pregnant. 11. Participants will require a baseline ECG that demonstrates a QTc \< 500ms. 12. For participants from VGH study site specifically: 1. must be admitted to either psychiatry or CTU, ideally with planned admission of at least 3 days. 2. must agree if discharged prior to the completion of the 7 day follow up period, to either return to VGH Diamond Centre for follow up assessments on Days 1/3/7 (+/-2 days). 3. must have access to a functioning cell phone to allow for the study team to contact them in case of discharge prior to completion of study follow up period. 13. The participants must be willing and able to provide written informed consent for study participation. Exclusion Criteria: 1. COWS score of 8 or more at the time of clinician assessment 2. Self-reported Opioid overdose or naloxone administration since methadone discontinuation or during the 5 days prior to methadone discontinuation 3. Self-reported New cardiac disease diagnosis since methadone discontinuation 4. Self-reported Intolerable side effects reported when taking methadone 5. Individuals who are pregnant (urine pregnancy test) or breast-feeding (self-reported) 6. Use of buprenorphine-naloxone (Suboxone®, Sublocade®, Butrans ®) within the previous 3 days (self-reported) 7. Participants with a QTc interval \>500 msec on the screening ECG