Early Addiction Care Pathway After Acute Drug Intoxication in Emergency Departments | NCT07738835

NCT07738835

Overview

NCT ID: NCT07738835
Lead Sponsor: Assistance Publique - Hôpitaux de ParisOTHER
Official Title: Interventions Précoces en Addictologie Dans le Cadre Des Urgences Par Intoxications aiguës Aux Stupéfiants (IPAIS)
Brief Summary: Acute intoxication with psychoactive substances represents a major public health issue and a frequent reason for emergency department (ED) visits. Beyond the acute medical management of intoxication, one of the main challenges remains the continuity of addiction care after discharge. Many patients disengage rapidly from follow-up services, leading to recurrent intoxication episodes, repeated ED admissions, and increased morbidity.

The IPAIS study (Interventions Précoces en Addictologie dans le cadre des urgences par Intoxications aiguës aux Stupéfiants) is a multicenter, randomized, parallel-group, open-label clinical trial designed to evaluate whether an enhanced early addiction care pathway improves retention in addiction treatment among patients admitted to emergency departments for acute intoxication involving at least one illicit psychoactive substance (excluding isolated alcohol intoxication).

All participants will receive an early addiction consultation within 24 to 72 hours following the acute event. In the experimental group, this consultation will be combined with a structured and standardized feedback session on toxicological analysis results and a proactive follow-up strategy including scheduled telephone contacts over a 6-month period. The control group will receive early addiction consultation according to usual care procedures, without the structured feedback and standardized follow-up program implemented in the experimental arm.

The primary objective of the study is to determine whether the enhanced intervention improves retention in the addiction care pathway at 6 months after inclusion. Retention is defined as sustained engagement in addiction care, operationalized as at least one addiction-related consultation per month and/or regular telephone-based addiction follow-up over the 6-month period.

Status and Timeline

Status: Not yet recruiting
Last Update Posted: Jul 31, 2026Actual
Start Date: Oct 15, 2026Estimated
Primary Completion Date: Oct 15, 2029Estimated
Completion Date

Participation Criteria

Ages Eligible for Study: Adult (18-64)Older Adult (65+)
Sexes Eligible for Study: All
Accepts Healthy Volunteers?: No
Eligibility Criteria: Inclusion Criteria:

Patients admitted and/or hospitalized in the emergency department or intensive care unit following acute poisoning must:

Be over 18 years of age

Have consumed at least one identifiable non-alcoholic narcotic, including psychoactive substances detected by standard urine drug screening (dipstick)

Have a history of using at least one non-alcoholic psychoactive substance within the last 30 days

Speak and understand French

Have at least 1 cm of hair

Be covered by a social security scheme (member or dependent)

Be the patient or a relative/close contact/trusted person who has been informed about the study and has given their informed consent (or completed the emergency inclusion procedure)

Have a mobile phone number or email address to be contacted

Exclusion Criteria:

Acute suicidal crisis requiring priority psychiatric care

Acute alcohol intoxication (after confirmation by urine drug screening in the Emergency Department)

Acute episode related to exclusive opiate use, requiring opiate substitution therapy

Prolonged hospitalization in intensive care or follow-up care due to complications of alcohol intoxication beyond 8 days after the initial addiction assessment

Protected patient: under a valid legal guardianship, curatorship, or conservatorship

Patient requiring involuntary psychiatric hospitalization

Study Plan

Study Type: Interventional
Phase: Not Applicable
Enrollment: 266Estimated
Primary Purpose: Prevention
Allocation: Randomized
Interventional Model: Parallel Assignment
Masking: Single

Contacts and Locations

Central Contacts: BISSERY AnneContact
anne.bissery@aphp.fr0 1 42 16 24 32

Similar Studies

Participant Group/Arms

Structured early addiction careExperimental

Participants randomized to the experimental arm receive a structured, protocol-based early addiction care pathway initiated during hospitalization for acute intoxication. The intervention includes a standardized addiction assessment, scheduled addiction follow-up visits (1-2 contacts per month) over a 6-month period, structured harm reduction evaluation, and systematic feedback of biological toxicology results, including hair analysis, at predefined timepoints (Month 1, Month 3, Month 4, and Month 6). Follow-up contacts may include in-person consultations and protocolized telephone interviews delivered by addiction specialists or trained psychologists.

Behavioral: Structured early addiction care

Not structured early addiction careOther

Participants randomized to the control group receive addiction follow-up with randomized interviews and/or workshops, at least once a month, for a duration of 6 months or as requested by the patient, and harm reduction assessments at months 1, 3, 4, and 6, disregarding toxicology results. Follow-up contacts may include in-person consultations and structured telephone interviews conducted by trained substance abusers or psychologists.

Behavioral: Not structured early addiction care