Collaborative Care for Opioid Use Disorder and Mental Illness

Does a 6-month collaborative care intervention, tailored for low-resource settings, improve clinical outcomes for adults with opioid use disorder and co-occurring depression and/or posttraumatic stress disorder more so than enhanced usual care?In this randomized clinical trial of 797 participants, collaborative care showed no evidence of improved outcomes compared to enhanced usual care. Both groups improved over the 6-month follow-up.The findings suggest that for clinically complex patients, collaborative care may not be more effective than enhanced usual care; explanations include the potential for spillover, spontaneous improvement, and the fit of collaborative care for this population and setting.

Corresponding Author: Katherine E. Watkins, MD, RAND, 1776 Main St, Santa Monica, CA 90403 (kwatkins@rand.org).

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