The Addiction Recovery Clinic (ARC): personalised behavioural intervention for opioid use disorder

INTERVENTION: Personalised Behavioural Intervention (PBI): The PBI will be delivered in 12 one hour sessions weekly. The PBI will be tailored to each client?s needs and circumstances. The PBI psychologists on the ARC team at LHH will work with clients using techniques derived and adapted from four core therapeutic approaches below recommended by the National Institute of Clinical Excellence. A menu of additional therapeutic methods will be available for use delivered according to patient preference and clinical indication e.g. 12‐step facilitation. 1. Motivational enhancement therapy 2. Cognitive behavioural coping and skills training 3. Contingency management (reinforcement therapy) 4. Community reinforcement approach (network member support for recovery) CONDITION: Opiate dependency ; Mental and Behavioural Disorders ; Opiate dependency PRIMARY OUTCOME: Self‐report of heroin use or cocaine use via structured clinical interview and individual diary record, confirmed by rapid‐result (on‐site) urine screen for morphine and cocaine metabolites. Outcome measures taken at baseline following recruitment into the study and at 14 weeks after recruitment on last day in the study SECONDARY OUTCOME: Measured at baseline and at 14 weeks after recruitment on last day in the study:; 1. Recorded treatment retention and psychological therapy adherence rates ; 2. Measures of heroin and cocaine craving; 3. Measures of the overall costs associated with PBI/TAU and TAU alone treatment configurations INCLUSION CRITERIA: 1. 18 years of age or older (no upper limit, but generally <60 years) 2. Undergoing treatment at Lorraine Hewitt House for a minimum of 6 weeks by the date of randomisation 3. Able to comprehend English to the extent required by the study protocol 4. Demonstrates verbal understanding of the study patient information material 5. Able to provide written consent and can understand and confirm willingness to comply with the protocol 6. Current diagnosis of opioid dependence 7 .Currently prescribed methadone or buprenorphine mono or combination therapy 8. Voluntarily seeking treatment and able to attend the clinic as described in the protocol 9. Lives in sufficiently stable accommodation in the community, with a personal phone 10. Can nominate at least one locator individual (e.g. a family member, friend or recovery mentor) with a verifiable address and a telephone number which we can call to assist as necessary with the arrangement of follow‐u