Building a Lasting Foundation to Advance Actionable Research on Recovery Support Services for High Risk Individuals with Opioid Use Disorder: The Initiative for Justice and Emerging Adult Populations

项目摘要/摘要 研究不足但阿片类药物使用问题风险最高的两组人 障碍是(1)涉及公共系统的新兴成年人(EA；16-25岁)和(2)正义的个人-- 涉及的(包括东亚银行)。与所有其他年龄段相比，环境保护局报告的吸毒率最高，包括 使用鸦片类药物和涉及公共系统的环境影响评估更有可能产生负面结果。对于所有年龄段的成年人来说， 阿片类药物的使用导致司法系统接触的可能性增加了13倍。而且，在重新进入监狱的过程中 在人口方面，主要死因是服药过量，主要是阿片类药物。此外，多物质的使用几乎 对使用阿片类药物的成年人(任何年龄段)普遍适用于环境评估和司法。同行恢复支持服务和 康复住宅在全国范围内激增，可能会给这两个高危群体带来巨大的好处， 但对它们的研究有限，缺乏科学严谨性。这一倡议的最终目标是快速推进 通过开展可采取行动的研究，使持续的网络 资金将不再是维持增长所必需的。要做到这一点，识别和装备是至关重要的 愿意致力于或将他们的研究努力转向这一主题的研究人员。然而，一个根本性的挑战 评估恢复支持服务(和任何其他基于社区的计划)是固有的 严谨的研究方法与现实世界服务工作的背景不相容。这需要 经过深思熟虑地结合适应性的创新和综合方法的适应或发展 设计、先进的测量和复杂的统计分析。调查人员也必须有能力 并接受过良好的培训，能够与社区利益相关者协作，以便能够真正进行严格的研究- 世界设置。不过，最好的情况是，受恢复支持服务影响的人和在 他们必须帮助推动研究议程；优先事项不是由研究人员发起的，而是处于恢复中的人 来自该社区的目标人群和利益相关者(恢复支持服务提供者和付款人) 必须有效地参与其中。因此，这一倡议是高级研究人员、 从目标高危人群、提供者和付款人恢复。该倡议将推动对 新出现的公共系统的同伴康复支持和康复住所的效力/有效性 成人和涉及司法的阿片类药物使用障碍成年人和药物辅助治疗经验 通过雄心勃勃但可实现的目标：(1)通过让个人参与恢复工作，确定优先研究领域 和提供者/付款人，(2)发展专注于这项研究的熟练的早期职业调查人员领域，(3)提供 种子基金和指导，以产生NIH资金的初步研究，以及(4)进行传播和 拓展到更大的领域。有了这些目标，该倡议将成为推动快速扩张的催化剂 在处理这一关键公共卫生问题的熟练调查人员和高质量研究人员的数量方面。

PROJECT SUMMARY/ABSTRACT Two groups that are under-researched but at the highest risk for problems stemming from opioid use disorder are (1) public system-involved emerging adults (EAs; ages 16-25) and (2) individuals who are justice- involved (including EAs). Compared to all other age groups, EAs report the highest rates of drug use, including use of opiates, and public system-involved EAs are more likely to have negative outcomes. For adults of all ages, opioid use results in a 13-fold increased probability of justice system contact. And, among the prison re-entry population, the leading cause of death is overdose, mostly from opioids. Further, polysubstance use is nearly universal for EAs and justice-involved adults (of any age) using opioids. Peer recovery support services and recovery residences are proliferating nationally and may have tremendous benefit for these two high-risk groups, but research on them is limited and lacks scientific rigor. The ultimate goal of this Initiative is rapid advancement of the recovery support services field through developing actionable research such that continued network funding will no longer be necessary to sustain growth. To accomplish this, it is essential to identify and equip investigators willing to dedicate or redirect their research efforts to this topic. However, a fundamental challenge for evaluating recovery support services (and any other community-based program) is the inherent incompatibility of rigorous research methods and the context of real-world services efforts. This requires adaptation or development of innovative and comprehensive methods that thoughtfully combine adaptable designs, advanced measurement, and sophisticated statistical analyses. Investigators also must be competent and well-trained to collaborate with community stakeholders so that rigorous research can be conducted in real- world settings. Optimally, though, people impacted by recovery support services and the research conducted on them must help drive the research agenda; rather than priorities being researcher-initiated, persons in recovery from the target populations and stakeholders in that community (recovery support service providers and payors) must be effectively engaged. Thus, this Initiative is a partnership between advanced researchers, persons in recovery from the target high-risk populations, providers, and payors. The Initiative will advance research on the efficacy/effectiveness of peer recovery supports and recovery residences for public-system involved emerging adults and justice-involved adults with opioid use disorders and medication assisted treatment experience through ambitious but achievable goals: (1) identify priority areas of research via engaging individuals in recovery and providers/payors, (2) grow the field of skilled early career investigators focused on this research, (3) provide seed funds and guidance to produce preliminary studies for NIH funding, and (4) conduct dissemination and outreach to the larger field. With these aims, the Initiative is poised to be a catalyst that provokes rapid expansion in the number of skilled investigators and high-quality research tackling this critical public health issue.