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Recovery Research at CleanSlate

Pioneering Better Outcomes in Addiction Treatment

At CleanSlate, our mission is to provide proven addiction treatment services. We are committed to advancing medical research to improve our treatments for opioid use disorder (OUD) and alcohol use disorder (AUD).

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Empowering Recovery with Groundbreaking Research

Our research initiatives focus on developing and refining treatment modalities that not only address the symptoms of addiction but also the underlying causes and co-occurring conditions. By integrating cutting-edge technology and advanced analytical techniques, such as machine learning and statistical modeling, CleanSlate is at the forefront of innovation in addiction treatment research.

This page highlights some of the key research conducted by CleanSlate’s team, led by Dr. Phyllis Losikoff and colleagues, showcasing our commitment to evidence-based practice and patient-centered care. Our studies span a range of topics crucial to advancing treatment strategies, from integrated care models to predictive analytics for patient outcomes.

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Why Our Research Matters

Each piece of research we conduct is designed to enhance understanding, refine practices, and ultimately improve the lives of individuals battling addiction. By sharing our findings, we contribute to the broader knowledge base in the medical community, influencing treatment standards and public health policies worldwide.

We invite you to explore the summaries of our recent studies below to see how CleanSlate is making a tangible difference in the lives of those we serve. Our commitment to research and innovation reflects our dedication to your recovery journey.

Recovery Research at CleanSlate: On the Cutting Edge of Treatment

Under One Roof: Identification, Evaluation, and Treatment of Chronic Hepatitis C in Addiction Care

Overview

This study highlights the significant role addiction treatment centers can play in diagnosing, evaluating, and treating chronic hepatitis C (HCV) among people who inject drugs (PWID). Integrating HCV care within addiction treatment programs can greatly improve access to effective treatment and reduce the prevalence of HCV.

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Key Findings

High Prevalence of HCV Among PWID

The majority of new HCV infections occur in young people who inject drugs, yet fewer than 5% of this population receives HCV treatment.

Benefits of Integrated HCV and Addiction Treatment

Co-locating HCV treatment within addiction clinics has been shown to reduce attrition in the care cascade. In the study, 43% of patients with chronic HCV entered treatment when offered on-site at addiction clinics, with an 85% cure rate using intention-to-treat analysis.

Effective Strategies for Integration

Successful integration involves leveraging in-house expertise, repurposing staff skills for HCV care, and participating in capacity-building initiatives like Project ECHO. These strategies help scale and sustain HCV treatment in addiction care settings.

In-House Counseling is Associated with Improved Retention in MOUD Treatment and Recovery

Overview

Integrating in-house counseling with medical treatment significantly improves retention rates for patients with substance use disorder (SUD). CleanSlate’s model demonstrates that providing both types of care under one roof leads to better patient outcomes.

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Key Findings

Higher Retention Rates

Patients who attended counseling sessions had significantly higher retention rates across all time points compared to those who did not receive counseling, with improvements ranging from 16% to 34%.

Improved Outcomes

Preliminary results indicate that patients receiving in-house counseling showed better treatment outcomes, supporting the importance of psychosocial therapy in SUD treatment.

Overcoming Barriers

The integrated model of care at CleanSlate, combining counseling and pharmacotherapy in one location, helps overcome barriers to accessing vital treatment services.

The Optimum Mix of Virtual and In-Person in the Treatment of Patients with Opioid Use Disorder: Leveraging AI Modeling Can Help Pinpoint the Right Mix of In-Person vs. On-Screen [Data Brief]

Overview

Finding the right balance between virtual and in-person care is essential for treating opioid use disorder (OUD). CleanSlate’s study shows that patients who attended more in-person visits had significantly better outcomes.

Key Findings

Higher Success Rates

Patients who attended more than 50% of their visits in person were 150% more likely to achieve stable maintenance, defined as a year in treatment and six months free of non-prescribed substances.

Impact of Visit Types

None of the patients with less than 30% in-person visits (over 70% virtual visits) achieved stable maintenance, emphasizing the importance of in-person interactions for successful recovery.

Personalized Care

AI modeling helps determine the best mix of virtual and in-person visits to meet individual patient needs, improving long-term recovery outcomes.

Ongoing Evaluation

To combat the opioid epidemic, it is crucial to adopt innovative care methods while continuously assessing their impact on patient outcomes to ensure high quality, personalized treatment.

Integrated Hepatitis C Treatment is Associated with Improved Retention and Success in Outpatient Treatment for Opioid Use Disorder at a Private Clinic

Overview

This study assessed the impact of combining hepatitis C (HCV) treatment with opioid use disorder (OUD) care on patient recovery.

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Key Findings

Reduced Relapse Rates

OUD patients treated for HCV at our clinic experienced significantly fewer relapses to illicit opioids or cocaine compared to those treated only for OUD.

Improved Retention

Patients receiving HCV treatment were 13.4 times more likely to stay in addiction care compared to those who did not receive HCV treatment.

Effective Integration

Co-locating HCV treatment with OUD care is feasible, effective, and leads to positive outcomes for both conditions.

Keeping Patients in Care: Factors Associated with Patients Returning to Care

Overview

Longer treatment retention improves outcomes for substance use disorder (SUD) patients, but disruptions and early termination are major challenges. This study explores why patients with opioid use disorder (OUD) return to treatment after leaving care for over 90 days.

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Key Findings

Positive Return Factors

Patients with more counseling sessions and frequent visits with their primary provider were more likely to return to care after a departure.

Negative Return Factors

Factors like having the initial visit remotely, higher-than-average opioid-positive urine tests, and self-paying for services decreased the likelihood of returning to care.

Enhancing Return Rates

Strengthening patient-provider relationships, providing counseling, ensuring in-person initial visits, closely monitoring substance use, and addressing financial barriers can significantly improve the chances of patients returning to treatment after a gap.

Transition from Sublingual to LA Injectable Buprenorphine Best Practices

Overview

With new buprenorphine formulations available, it is essential to examine real-world experiences to determine best practices for patient selection and transition to long-acting buprenorphine.

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Key Findings

Ongoing Assessment Needed

The expanding range of OUD treatment options requires continuous evaluation and sharing of real-world experiences to establish and refine best practices.

Predictors of Success

Persistent opioid use, rather than the length of time in treatment, predicts which patients are less likely to succeed, showing poor retention and continued opioid use when transitioned to long-acting buprenorphine.

Enhancing Return Rates

Strengthening patient-provider relationships, providing counseling, ensuring in-person initial visits, closely monitoring substance use, and addressing financial barriers can significantly improve the chances of patients returning to treatment after a gap.

Predicting Fentanyl Use for Patients in Treatment for Opioid Use Disorder

Overview

Fentanyl and its analogs have caused a 282% increase in overdose deaths from 2016 to 2021. This study used machine learning and AI with over 30 predictors to identify which patients in OUD treatment are at risk of fentanyl relapse.

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Key Findings

Higher Risk Groups

Younger individuals and those using multiple substances are more likely to relapse to fentanyl, consistent with previous research.

Risk Factors

Non-adherence to treatment (evidenced by negative urine drug screens for buprenorphine) and late visit cancellations (less than 24 hours before scheduled) are significant programmatic and treatment-related risk factors.

Targeted Support Needed

The study underscores the importance of targeted support for high-risk patients, emphasizing adherence to medication and appointment scheduling. Policy adjustments, such as monitoring late cancellations and ensuring follow-up appointments, are crucial to prevent relapse.

Using Machine Learning to Predict Outpatient Treatment Success and Identify Risk Factors

Overview

This study used machine learning to predict treatment success for patients in substance use disorder (SUD) outpatient care, analyzing over 30,000 patient records and 400 predictors with XGBoost.

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Key Findings

Model Performance

The model achieved a balanced accuracy of 88%, an AUC of 94%, and an F1 score of 90%.

Success Factors

Total days in treatment and full-time employment were strongly associated with achieving long-term success.

Barriers to Success

Factors like marijuana use, telemedicine visits, missing appointments, lack of a state ID, and past legal issues were linked to not achieving success.

Personalized Treatment

The study highlights the potential of explainable AI in developing personalized treatment plans, making SUD treatment more effective and transparent, and advancing AI’s role in healthcare.

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Our Commitment to Innovation & Patient-Centered Care

At CleanSlate, we’re proud to share our successes in helping people recover from addiction and our research that helps us find new ways to improve. Our work shows that focusing on each person’s unique needs leads to better health and happier lives. We’re excited to keep leading the way in making recovery possible for more people, using our discoveries to help everyone we can. Thank you for joining us on this important journey.

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