Skip to main content
OpenTrials
Not Yet Recruiting

NCT Number: NCT07141394

Coordinated Access for Addiction Recovery and Equity in VA Supportive Housing

The Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH) Program provides subsidized permanent housing with case management to homeless-experienced Veterans (HEVs). Up to 40% of Veterans exit HUD-VASH within two years of attaining housing; substance use disorders (SUDs) are one of the largest causes of returns to homelessness for HEVs. CARE-VASH QUERI proposes to implement and evaluate two evidence-based SUD services - Medications for addiction treatment (MAT) and cognitive behavioral therapy for SUDs (CBT-SUD) - among Veterans in HUD-VASH.

Not Yet Recruiting

Trial opening soon.

Get Notified

Key information

Conditions

Homelessness Chemically-Induced Disorders Mental Disorders Substance Use Disorder (SUD) Substance-Related Disorders

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

VA Greater Los Angeles Healthcare System, West Los Angeles, CA

West Los Angeles, California, 90073-1003, United States

About this study

The Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH) program provides subsidized, permanent housing and supports to Veterans experiencing homelessness. Substance use disorders (SUDs) are a common primary or contributing factor to negative exits from HUD-VASH. The Coordinated Access for Addiction Recovery and Equity in VA Supportive Housing (CARE-VASH) QUERI will implement two evidence-based practices (EBPs) for SUDs-Medications for Addiction Treatment (MAT) and cognitive behavioral therapy for SUDs (CBT-SUD)-in 12 HUD-VASH sites. We will use the Replicating Effective Programs (REP) implementation bundle to support EBP implementation at all 12 sites. Half the sites (n=6) will also receive 9 months of consumer engagement (REP+CE). In a type 3 hybrid trial, we will use mixed methods to examine the impacts of REP vs. REP+CE. Using our trial data, we will develop a budget impact analysis and implementation playbook for our program partners to spread and sustain MAT and CBT-SUD in HUD-VASH.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Homeless-experienced Veterans (HEVs) enrolled in the Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH) Program.

Exclusion criteria

  • None

Treatment and study plan

Medication for Addiction Treatment (MAT)

Drug

MAT includes medications for alcohol use disorder (MAUD) and medications for opioid use disorder (MAUD). It reduces substance use, increases SUD treatment engagement, enhances quality of life, and reduces overdoses.

Other names: MAT

Cognitive Behavioral Therapy for Substance Use Disorders (CBT-SUD)

Behavioral

An evidence-based psychotherapy that uses cognitive behavioral therapy to further recovery goals across SUD diagnoses.

Other names: CBT-SUD

Primary outcomes

  1. Reach of MAT (Medications for Addiction Treatment)

    Time frame: 18 months post-implementation

    • (percent of) Veterans who used Medications for Opioid Use Disorder (MOUD) for OUD, ≥1 prescription
    • (percent of) Veterans who used MOUD for OUD for 180 days since initial prescription (without a break ≥14 days in supply)
    • (percent of) Veterans who used Medications for Alcohol Use Disorder (MAUD) for AUD, ≥1 prescription
    • (percent of) Veterans who used MAUD for AUD for 180 days since initial prescription (without a break ≥14 days in supply)

  2. Reach of CBT-SUD (Cognitive Behavioral Therapy-Substance Use Disorders)

    Time frame: 18 months post-implementation

    • (percent of) Veterans with stimulant use disorder who had ≥1 visit for Cognitive Behavioral Therapy-Substance Use Disorders (CBT-SUD) or contingency management
    • (percent of) Veterans with substance use disorder with ≥1 CBT-SUD visit
    • (percent of) Veterans with substance use disorder with ≥9 CBT-SUD visits

  3. Adoption of MAT (Medications for Addiction Treatment)

    Time frame: 18 months post-implementation

    % (percent of) Department of Housing and Urban Development - VA Supportive Housing (HUD-VASH) and mental health prescribers engaged with Veterans who ordered Medications for Opioid Use Disorder (MOUD) / Medications for Alcohol Use Disorder (MAUD) at least once

  4. Adoption of CBT-SUD (Cognitive Behavioral Therapy-Substance Use Disorders)

    Time frame: 18 months post-implementation

    % (percent of) Department of Housing and Urban Development - VA Supportive Housing (HUD-VASH) case managers who delivered ≥1 CBT-SUD (Cognitive Behavioral Therapy-Substance Use Disorders) session

  5. Sustainment of MAT (Medications for Addiction Treatment)

    Time frame: 18-27 months post-implementation

    • (percent of) Veterans who used Medications for Opioid Use Disorder (MOUD) for OUD, ≥1 prescription
    • (percent of) Veterans who used MOUD for OUD for 180 days since initial prescription (without a break ≥14 days in supply)
    • (percent of) Veterans who used Medications for Alcohol Use Disorder (MAUD) for AUD, ≥1 prescription
    • (percent of) Veterans who used MAUD for AUD for 180 days since initial prescription (without a break ≥14 days in supply)
    • (percent of) Department of Housing and Urban Development - VA Supportive Housing (HUD-VASH) and mental health prescribers engaged with Veterans who ordered Medications for Opioid Use Disorder (MOUD) / Medications for Alcohol Use Disorder (MAUD) at least once

  6. Sustainment of CBT-SUD (Cognitive Behavioral Therapy-Substance Use Disorders)

    Time frame: 18-27 months post-implementation

    • (percent of) Veterans with stimulant use disorder who had ≥1 visit for Cognitive Behavioral Therapy-Substance Use Disorders (CBT-SUD) or contingency management
    • (percent of) Veterans with substance use disorder with ≥1 CBT-SUD visit
    • (percent of) Veterans with substance use disorder with ≥9 CBT-SUD visits
    • (percent of) Department of Housing and Urban Development - VA Supportive Housing (HUD-VASH) case managers who delivered ≥1 CBT-SUD (Cognitive Behavioral Therapy-Substance Use Disorders) session

Secondary outcomes

  1. Housing retention

    Time frame: 1 year after implementation by cohort

    Difference in the mean days homeless over 1 year of follow-up for Veterans enrolled in trial sites that received the base versus enhanced implementation strategy, versus the expected number of days homeless had they enrolled in a comparison group of all sites not engaged in the trial

  2. Provider experience

    Time frame: Baseline and 18 months post-implementation

    Experiences of and satisfaction with providing HUD-VASH services to HEVs with SUDs pre- and post- implementation, which will be assessed using semi-structured qualitative interviews (data will be coded from key findings in the narratives provided during the interviews).

  3. Cost impact of Medications for Addiction Treatment (MAT) and Cognitive Behavioral Therapy-Substance Use Disorders (CBT-SUD)

    Time frame: 18 months (during the course of implementation)

    The predominant cost of delivering MAT in the Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH) programs is prescriber time; for CBT-SUD, the predominant cost is case manager time. We will use VA administrative data to identify visits in which MAT was prescribed or CBT-SUD was delivered. Interviews with HUD-VASH prescribers will be used to estimate minutes/visit spent on MAT, including visits in which MAT was discussed but not prescribed; at implementation sites, we will add a mandated field to templated CBT-SUD notes that indicates time spent outside the encounter (e.g., preparing for the visit).

  4. Acute care utilization

    Time frame: 1 year after implementation by cohort

    Emergency department visits and hospitalizations associated with primary SUD diagnoses

Study contacts

Contact information is provided by the study sponsor or research team.

Jenny M Barnard, BA

CONTACT

[email protected]

(626) 367-1077

Sonya E Gabrielian, MD MPH

CONTACT

[email protected]

(310) 478-3711 ext. 49853

Sponsors and collaborators

Lead sponsor

VA Office of Research and Development

Fed

Collaborators

  • University of California, Los Angeles

Registry information

Official study title

Coordinated Access for Addiction Recovery and Equity in VA Supportive Housing (CARE-VASH) (QUE 25-013)

Acronym: CARE-VASH

Important dates

Study start
2026
Primary completion
2030
Study completion
2030
First posted
Aug 26, 2025
Registry last updated
Oct 10, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Related clinical trials

Published trials that share one or more normalized conditions with this study.