Substance Use Disorder (SUD)NCT07030192
Peer Support Workers Study
A study testing Emergency Department Peer Availability in people with Substance Use Disorder (SUD), run by University of British Columbia at 1 site in Canada.
Trial summary
Many people with high-risk opioid use visit emergency departments (EDs), facing a high risk of death if they leave before completing care. Peer support workers (Peers) - people with lived experience of substance use - may improve patient comfort, reduce early departures, and potentially lower mortality rates. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Substance Use Disorder (SUD)
- What is being tested?
- Emergency Department Peer Availability
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 3,781 participants
- Where
- 1 siteCanada
- Study dates
- 23 Nov 2024to Dec 2028
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Emergency Department (ED) patient at Vancouver General Hospital (VGH)
- Age 18 years or older
- Identified as using substances
- Able to receive or decline peer support services during the ED visit
Who cannot join
- Under 18 years of age
- Does not report substance use
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Canada1 site, 1 recruiting
- Recruiting
Vancouver General Hospital
Vancouver, British Columbia, V5Z 1M9
Jessica Moe, MD, jessica.moe@ubc.ca
About this study
Official title: Creating Safety in Chaos: Integrating Peer Support Workers in Emergency Departments to Support Patients Who Use Substances and Opioids
Many people with high-risk opioid use visit emergency departments (EDs), facing a high risk of death if they leave before completing care. Peer support workers (Peers) - people with lived experience of substance use - may improve patient comfort, reduce early departures, and potentially lower mortality rates. This study aims to evaluate how a hospital-implemented ED Peer program can enhance patient support, reduce barriers to care, and provide harm-reduction resources in a person-centred and trauma-informed manner. The study will assess whether Peer availability and direct Peer-patient interactions are associated with improved ED care outcomes, including reduced leaving before treatment completion, as well as subsequent healthcare utilization, overdose, mortality, and other relevant patient outcomes.
Read the detailed description
The study was initially designed as a feasibility evaluation of the ED Peer program and of the use of a randomized shift schedule to assign Peer availability. As program implementation progressed and staffing stabilized, the evaluation framework was refined to examine both the effect of Peer availability and outcomes associated with direct Peer-patient interaction.
From 23 November 2024 through 16 October 2025, Peer availability was assigned according to an a priori randomized shift schedule developed in collaboration with human resources and ED operational leadership. Following achievement of full Peer staffing, the program transitioned to routine clinical operation.
The study has two main analytic objectives: 1) during the shift-randomization period, investigators will compare outcomes between shifts with and without scheduled Peer availability among patients presenting with substance use-related concerns; 2) investigators will evaluate outcomes associated with direct Peer-patient interaction by comparing patients who interacted with a Peer with comparable patients who did not interact with a Peer.
The primary outcome is leaving before treatment completion (LBTC). Additional outcomes will include measures of ED care, subsequent healthcare utilization, substance use treatment, overdose, mortality, and other relevant clinical and health-service outcomes.
Investigators will request routinely collected records for Vancouver General Hospital ED visits during the study period. Records of eligible ED patients presenting during the study period will be linked to provincial administrative data to evaluate outcomes. Data sources will include the National Ambulatory Care Reporting System (NACRS), Discharge Abstract Database (DAD), Vital Statistics, PharmaNet, Medical Services Plan (MSP), and the Central Demographics File. Population Data BC and Health Data Platform BC will support secure data linkage, and additional relevant datasets may be explored where useful to the study objectives.
These data will support cohort definition, construction of comparison groups, development of propensity scores, sensitivity analyses, and evaluation of outcomes including receipt of ED treatments and referrals, ED revisits, hospitalizations, overdose, opioid agonist therapies and other addiction treatments, mortality, and other relevant health-service outcomes.
Investigators will also obtain records of security-related events occurring during ED visits over the study period. These data will be used to examine whether Peer availability is associated with differences in events such as need for de-escalation or other security involvement.
- Conditions
- Substance Use Disorder (SUD)
- Being tested
- Emergency Department Peer Availability
- Keywords
- Peer support workers, Substance use, Emergency department
- Medical subject headings
- Substance-Related Disorders, Emergencies
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Emergency Department Peer AvailabilityBehavioural
During intervention shifts, Peer support workers were scheduled to be available in the emergency department to provide support to patients with substance use-related concerns. Peer support workers offered services tailored to individual patients' needs, including referrals to clinical and social support services (e.g., social work, addictions specialists, Indigenous patient navigators, and community-based addiction services), provision of resources (e.g., blankets, food, naloxone kits, sterile drug use supplies, and information brochures), emotional support, and communication support between patients and healthcare providers regarding patients' conditions and ED care. The primary analysis will evaluate the effect of randomized Peer availability using an intention-to-treat approach. The secondary analysis will evaluate outcomes associated with actual Peer-patient interactions by comparing patients who received Peer support with comparable patients who did not.
| Study group | Role | What they receive |
|---|---|---|
| Peer Support Intervention | Experimental | Investigators will evaluate the Peer Support intervention using two analytical approaches:
1. Primary Analysis (Intention-to-Treat): Peer Available Shift Patients who presented to the emergency department (ED) with substance use-related complaints during shifts when a Peer support worker was scheduled to be available, according to an a priori randomized schedule. Patients may or may not have directly interacted with a Peer during their ED visit. All eligible patients will be analyzed according to their randomized shift assignment, regardless of whether a direct Peer-patient interaction occurred.
2. Secondary Analysis: Interacted With Peer Patients who presented to the ED with substance use-related concerns and directly interacted with a Peer support worker during their ED visit. Peer activities may have included harm reduction support, provision of naloxone and sterile drug use supplies, linkage to substance use treatment, and connections to follow-up care and community resources. Receives: Behavioral: Emergency Department Peer Availability |
| No Peer Support Intervention | No intervention | Investigators will define the comparison group using two approaches: 1. Primary Analysis (Intention-to-Treat): No Peer Available Shift Patients presenting to the ED with substance use-related complaints during shifts randomized to no Peer availability. 2. Secondary Analysis: Did Not Interact With Peer Patients presenting with similar substance use-related complaints who did not directly interact with a Peer. Investigators will use propensity score weighting to improve comparability with patients who received Peer support. The model will include relevant covariates (e.g., age, sex, area-level deprivation, prior substance use-related ED visits and hospitalizations, and prescriptions for substance dependence medications recorded in PharmaNet during the previous 12 months). |
What is being measured
The primary outcome is the main question the study is designed to answer.
Leaving Before Treatment Completion (LBTC)
Investigators will measure LBTC among ED patients with substance use-related complaints (e.g., substance withdrawal, misuse/intoxication, overdose, and localized swelling/redness).
Investigators will evaluate LBTC using two approaches:
- Primary Analysis (Intention-to-Treat): Peer vs. No Peer Shifts Investigators will classify eligible ED visits based on the randomized Peer schedule. For each shift, investigators will calculate the percentage of eligible visits resulting in LBTC. Linear regression will be used to compare LBTC percentages between Peer and No Peer shifts, regardless of actual Peer interaction.
- Secondary Analysis: Peer Interaction vs. No Peer Interaction Investigators will use propensity score weighting to improve comparability between patients who interacted with a Peer and those who did not. Mixed-effects logistic regression will be used to compare LBTC probabilities between groups, accounting for clustering by shift and adjusting for relevant covariates.
Measured: From enrollment through 12 months of follow-up
Secondary outcomes (8)
Distribution of randomized Peer shifts by day of week (feasibility outcome)
Assessed by examining the distribution of scheduled Peer shifts across each day of the week over the 48-week randomized schedule period. The schedule was developed in collaboration with human resources and ED operational leadership and approved as meeting hospital employee policy. The randomization approach used block-based scheduling with built-in constraints (e.g., mandatory weekends off). This outcome evaluates whether the resulting schedule achieved a balanced weekday/weekend distribution.
Unit of Measure: Number and percentage of Peer shifts scheduled per day of the week
Measured: From study initiation to achievement of full Peer staffing, approximately one year
ED-based substance use and harm reduction interventions
Secondary outcomes will include receipt of naloxone kits, opioid agonist therapy doses, and withdrawal treatments during the ED visit. Investigators will compare counts of these outcomes between intervention (Peer) and control (no Peer) groups using multivariable count regression. Investigators will assess clustering of outcomes by shift and adjust for the same covariates included in the primary analysis.
Measured: Baseline
30-day health care utilization and clinical events (e.g., drug poisoning, mortality)
Exploratory outcomes will include ED visits, hospitalizations, drug poisoning, and mortality within 30 days following the index ED visit. Investigators will analyze counts of these events using multivariable count regression, with the log-transformed length of follow-up included as an offset term where applicable, and will conduct time-to-event analyses using Cox regression. Investigators will assess clustering of outcomes by shift and adjust for the same covariates included in the primary analysis.
Measured: From enrollment through 30 days of follow-up from ED visit
Security-related events during ED visits
Investigators will obtain records of security-related events occurring during ED visits over the study period from the ED security event database. Investigators will assess whether Peer availability was associated with differences in the frequency and type of security-related events, including escalation events and incidents requiring security involvement.
Measured: Baseline
Thematic summary of Indigenous patients' experiences with the Peer program
Indigenous patient perspectives on the Peer program will be collected through surveys, culturally grounded storytelling and sharing circles. Sessions will be guided by open-ended questions to explore perceived safety, support, and emotional impact of Peer involvement in the emergency department. Transcripts will be analyzed using Indigenous-informed thematic analysis to identify key insights and priorities for culturally safe care.
Unit of Measure: Themes and narratives identified through qualitative analysis
Measured: Within 6 months after the patient's ED visit involving Peer interaction
Thematic summary of healthcare providers' perceptions of the Peer program assessed through focus groups
Acceptability of the Peer program among healthcare providers will be evaluated using semi-structured focus groups conducted periodically post-implementation. Discussions will explore perceived value, observed patient impact, integration into ED workflows, challenges, and suggestions for improvement. Audio recordings will be transcribed and analyzed using thematic content analysis to identify recurring patterns and representative quotes.
Unit of Measure: Thematic categories identified through qualitative analysis
Measured: From 12-24 months after Peer program implementation
Thematic summary of PWLLE perceptions and experiences of the Peer program assessed through focus groups
Perspectives of people with lived and living experience (PWLLE) on the Peer program will be evaluated using semi-structured focus groups. Discussions will explore participants' perceptions of the value and accessibility of Peer support, experiences of substance use-related care in the ED, perceived impacts of the Peer program, barriers and gaps in care, and suggestions for improving Peer support and program delivery. Audio recordings will be transcribed and analyzed using thematic content analysis to identify recurring themes and representative quotes. Unit of Measure: Thematic categories identified through qualitative analysis
Measured: From 12-24 months after Peer program implementation
Acceptability of the Peer program evaluated through periodic surveys
Acceptability and implementation of the Peer program will be assessed through periodic surveys administered to Peers, patients accessing Peer services, members of the ED buprenorphine/naloxone team, and multidisciplinary healthcare providers. Surveys will assess experiences with the Peer program, including perceived value, respect, ease of communication, clarity of information, comfort, confidentiality, teamwork, integration into ED workflows, and perceived facilitators and barriers to implementation.
Measured: From 12-24 months after Peer program implementation
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 Jun 2025
- Study start23 Nov 2024
- Primary completionMar 2028 (estimated)
- Study completionDec 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Substance Use Disorder (SUD)Studies of the same condition, open and under way.
- More trials run by University of British ColumbiaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 3,781 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of British Columbia
- Sponsor type
- University, hospital or other
- Collaborators
- Vancouver Coastal Health Research Institute, BC Centre for Disease Control, Health Data Platform BC, Population Data BC
- Responsible party
- Principal investigator, Jessica Moe, University of British Columbia
- Investigators
- Jessica Moe, MD, Principal investigator, University of British Columbia
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07030192
- Sponsor's protocol ID
- H24-03008
- Other IDs
- F26-03530, F25-02658
- Status last verified
- Oct 2026
- First submitted
- 3 Jun 2025
- Last updated
- 3 Nov 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: There is no plan to make individual participant data available to other researchers
Study at a glance
From the registry record, last updated by the sponsor on 3 Nov 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Creating Safety in Chaos: Integrating Peer Support Workers in Emergency Departments to Support Patients Who Use Substances and Opioids
- ClinicalTrials.gov ID
- NCT07030192
- Acronym / sponsor ID
- H24-03008
- Conditions
- Substance Use Disorder (SUD)
- Keywords
- Peer support workers, Substance use, Emergency department
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 3,781 participants (estimated)
- Lead sponsor
- University of British ColumbiaUniversity, hospital or other
- Collaborators
- Vancouver Coastal Health Research Institute, BC Centre for Disease Control, Health Data Platform BC, Population Data BC
- Study start
- 23 Nov 2024 (actual)
- Primary completion
- Mar 2028 (estimated)
- Study completion
- Dec 2028 (estimated)
- First posted
- 22 Jun 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Many people with high-risk opioid use visit emergency departments (EDs), facing a high risk of death if they leave before completing care. Peer support workers (Peers) - people with lived experience of substance use - may improve patient comfort, reduce early departures, and potentially lower mortality rates. This study aims to evaluate how a hospital-implemented ED Peer program can enhance patient support, reduce barriers to care, and provide harm-reduction resources in a person-centred and trauma-informed manner. The study will assess whether Peer availability and direct Peer-patient interactions are associated with improved ED care outcomes, including reduced leaving before treatment completion, as well as subsequent healthcare utilization, overdose, mortality, and other relevant patient outcomes.
Detailed description
The study was initially designed as a feasibility evaluation of the ED Peer program and of the use of a randomized shift schedule to assign Peer availability. As program implementation progressed and staffing stabilized, the evaluation framework was refined to examine both the effect of Peer availability and outcomes associated with direct Peer-patient interaction.
From 23 November 2024 through 16 October 2025, Peer availability was assigned according to an a priori randomized shift schedule developed in collaboration with human resources and ED operational leadership. Following achievement of full Peer staffing, the program transitioned to routine clinical operation.
The study has two main analytic objectives: 1) during the shift-randomization period, investigators will compare outcomes between shifts with and without scheduled Peer availability among patients presenting with substance use-related concerns; 2) investigators will evaluate outcomes associated with direct Peer-patient interaction by comparing patients who interacted with a Peer with comparable patients who did not interact with a Peer.
The primary outcome is leaving before treatment completion (LBTC). Additional outcomes will include measures of ED care, subsequent healthcare utilization, substance use treatment, overdose, mortality, and other relevant clinical and health-service outcomes.
Investigators will request routinely collected records for Vancouver General Hospital ED visits during the study period. Records of eligible ED patients presenting during the study period will be linked to provincial administrative data to evaluate outcomes. Data sources will include the National Ambulatory Care Reporting System (NACRS), Discharge Abstract Database (DAD), Vital Statistics, PharmaNet, Medical Services Plan (MSP), and the Central Demographics File. Population Data BC and Health Data Platform BC will support secure data linkage, and additional relevant datasets may be explored where useful to the study objectives.
These data will support cohort definition, construction of comparison groups, development of propensity scores, sensitivity analyses, and evaluation of outcomes including receipt of ED treatments and referrals, ED revisits, hospitalizations, overdose, opioid agonist therapies and other addiction treatments, mortality, and other relevant health-service outcomes.
Investigators will also obtain records of security-related events occurring during ED visits over the study period. These data will be used to examine whether Peer availability is associated with differences in events such as need for de-escalation or other security involvement.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Peer Support Intervention | Experimental | Behavioral: Emergency Department Peer AvailabilityInvestigators will evaluate the Peer Support intervention using two analytical approaches: 1. Primary Analysis (Intention-to-Treat): Peer Available Shift Patients who presented to the emergency department (ED) with substance use-related complaints during shifts when a Peer support worker was scheduled to be available, according to an a priori randomized schedule. Patients may or may not have directly interacted with a Peer during their ED visit. All eligible patients will be analyzed according to their randomized shift assignment, regardless of whether a direct Peer-patient interaction occurred. 2. Secondary Analysis: Interacted With Peer Patients who presented to the ED with substance use-related concerns and directly interacted with a Peer support worker during their ED visit. Peer activities may have included harm reduction support, provision of naloxone and sterile drug use supplies, linkage to substance use treatment, and connections to follow-up care and community resources. |
| No Peer Support Intervention | No intervention | –Investigators will define the comparison group using two approaches: 1. Primary Analysis (Intention-to-Treat): No Peer Available Shift Patients presenting to the ED with substance use-related complaints during shifts randomized to no Peer availability. 2. Secondary Analysis: Did Not Interact With Peer Patients presenting with similar substance use-related complaints who did not directly interact with a Peer. Investigators will use propensity score weighting to improve comparability with patients who received Peer support. The model will include relevant covariates (e.g., age, sex, area-level deprivation, prior substance use-related ED visits and hospitalizations, and prescriptions for substance dependence medications recorded in PharmaNet during the previous 12 months). |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Emergency Department (ED) patient at Vancouver General Hospital (VGH)
- Age 18 years or older
- Identified as using substances
- Able to receive or decline peer support services during the ED visit
Key exclusion criteria (2 listed)
- Under 18 years of age
- Does not report substance use
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Emergency Department Peer AvailabilityDuring intervention shifts, Peer support workers were scheduled to be available in the emergency department to provide support to patients with substance use-related concerns. Peer support workers offered services tailored to individual patients' needs, including referrals to clinical and social support services (e.g., social work, addictions specialists, Indigenous patient navigators, and community-based addiction services), provision of resources (e.g., blankets, food, naloxone kits, sterile drug use supplies, and information brochures), emotional support, and communication support between patients and healthcare providers regarding patients' conditions and ED care. The primary analysis will evaluate the effect of randomized Peer availability using an intention-to-treat approach. The secondary analysis will evaluate outcomes associated with actual Peer-patient interactions by comparing patients who received Peer support with comparable patients who did not. | Behavioural | Peer Support Intervention |
Primary outcome
Leaving Before Treatment Completion (LBTC)
Time frame: From enrollment through 12 months of follow-up
Investigators will measure LBTC among ED patients with substance use-related complaints (e.g., substance withdrawal, misuse/intoxication, overdose, and localized swelling/redness). Investigators will evaluate LBTC using two approaches: 1. Primary Analysis (Intention-to-Treat): Peer vs. No Peer Shifts Investigators will classify eligible ED visits based on the randomized Peer schedule. For each shift, investigators will calculate the percentage of eligible visits resulting in LBTC. Linear regression will be used to compare LBTC percentages between Peer and No Peer shifts, regardless of actual Peer interaction. 2. Secondary Analysis: Peer Interaction vs. No Peer Interaction Investigators will use propensity score weighting to improve comparability between patients who interacted with a Peer and those who did not. Mixed-effects logistic regression will be used to compare LBTC probabilities between groups, accounting for clustering by shift and adjusting for relevant covariates.
8 secondary outcomes
Distribution of randomized Peer shifts by day of week (feasibility outcome)
Time frame: From study initiation to achievement of full Peer staffing, approximately one year
ED-based substance use and harm reduction interventions
Time frame: Baseline
30-day health care utilization and clinical events (e.g., drug poisoning, mortality)
Time frame: From enrollment through 30 days of follow-up from ED visit
Security-related events during ED visits
Time frame: Baseline
Thematic summary of Indigenous patients' experiences with the Peer program
Time frame: Within 6 months after the patient's ED visit involving Peer interaction
Thematic summary of healthcare providers' perceptions of the Peer program assessed through focus groups
Time frame: From 12-24 months after Peer program implementation
Thematic summary of PWLLE perceptions and experiences of the Peer program assessed through focus groups
Time frame: From 12-24 months after Peer program implementation
Acceptability of the Peer program evaluated through periodic surveys
Time frame: From 12-24 months after Peer program implementation
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Nov 2026.
- Individual participant dataSharing planned: No. There is no plan to make individual participant data available to other researchers
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Jessica Moe, MD principal investigator
University of British Columbia
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Emergency Department Peer Availability in people with Substance Use Disorder (SUD), run by University of British Columbia at 1 site in Canada.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 3 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Cindy Liu, BSc (778-929-1281, cindy.q.liu@ubc.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Leaving Before Treatment Completion (LBTC) (time frame: From enrollment through 12 months of follow-up). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Nov 2026.