Advancing the science on recovery community centers to support persons treated with medications for opioid use disorder

项目概要/摘要 阿片类药物危机导致美国全国平均预期寿命下降，需要宣布 联邦公共卫生紧急状态。有证据表明 OUD 是一种慢性健康状况，最好的治疗方法是 长期服用药物（MOUD）。 MOUD 在拯救生命、减少相关危害并增强 与其他物质使用障碍相比，患有 OUD 的个体往往有缓解的可能性 更需要额外服务，感到更加孤立和边缘化，可用的恢复资产较少 （例如工作、安全住房）并报告生活质量较低。这些持续的缺陷增加了生物行为压力 以及预后悲观情绪，进而影响治疗中断和随后复发的可能性。有 需要额外的康复支持服务 (RSS)，以帮助建立积极的社交网络并增加 教育、培训、就业和住房机会（统称为“复苏资本”），以增强 功能和生活质量。康复社区中心 (RCC) 是新兴的国家实体，旨在 特别是帮助提供恢复资本的增长并提高缓解和生活质量。初步 有证据表明，RCC 对于那些拥有 OUD 的人来说发挥着特别有价值的作用，但尽管其概念性很强 但从系统研究的角度来看，人们对它们的增长基础和快速大规模投资知之甚少。 它们的临床和公共卫生效用以及成本效益。促进功效和作用的发展 针对曾经或正在接受药物治疗的人的 RCC 有效性研究 处理 OUD (P-MOUD)，我们建议在国家层面协调活动，让多个国家参与 利益相关者并产生可操作的交付成果。该提案借鉴并建立在众多专业人士的基础上 以及学术资源和经验，包括我们已经建立的恢复的存在 传播平台（即恢复研究所 (RRI)；6,000 名公告读者、37,000 个 Twitter 追随者，每月 24,000 名网站访问者），由于其声誉和经验已签约 由 SAMHSA 首先总结有关康复支持服务的证据，然后促进第一个多 利益相关者在国家层面进行讨论，以推进 RSS 的科学发展。本着耐心格言的精神， “没有我们，就没有我们的事”，我们制定了一项行动计划，其中涉及关键支持—— 接待利益相关者参与我们网络计划的多个方面。建议开展五种类型的活动（即每月 系列研讨会、试点资金、在国家会议上的研讨会演讲、咨询委员会会议 RCC 工作人员和与会者，为 RCC 人员跟踪和分析组织数据提供实际支持），每个 其中将产生具体的可交付成果。这样，RRI 将成为著名的科学中心 通过 RCC 提供恢复支持，并将吸引、收集和分发支持建筑的辅助产品 累积的 RCC 科学可以解释 RCC 在专门为 P-MOUD 提供支持方面的作用。

PROJECT SUMMARY / ABSTRACT The opioid crisis has caused a national decline in average U.S. life-expectancy necessitating a declaration of a federal public health emergency. Evidence indicates that OUD is a chronic health condition best managed with long-term use of medications (MOUD). While MOUD save lives, reduce related harms, and enhance the likelihood of remission, compared to other substance use disorders, individuals suffering from OUD tend to be more in need of additional services, feel more isolated and marginalized, have fewer available recovery assets (e.g., jobs, safe housing) and report lower quality of life. These continued deficits increase biobehavioral stress and prognostic pessimism and, in turn, the odds of treatment discontinuation and subsequent relapse. There is a need for additional recovery support services (RSS) to help build positive social networks and to increase education, training, employment, and housing opportunities (collectively known as “recovery capital”) to enhance functioning and quality of life. Recovery Community Centers (RCCs) are emergent national entities designed specifically to help provide this growth in recovery capital and enhance remission and quality of life. Preliminary evidence indicates RCCs play a particularly valuable role for those with OUD, but despite their strong conceptual basis and rapid largescale investment in their growth, little is known from a systematic research standpoint about their clinical and public health utility and cost-effectiveness. To advance the development of efficacy and effectiveness research on RCCs for persons who were or who are being maintained on medications for the treatment of OUD (P-MOUD), we propose to orchestrate activities on a national level to engage multiple stakeholders and produce actionable deliverables. This proposal draws and builds upon numerous professional and academic resources and experiences, including the existence of our already established recovery dissemination platform (i.e., the Recovery Research Institute (RRI); 6,000 Bulletin readers, 37,000 Twitter followers, 24,000 website visitors per month), which due to its reputation and experience has been contracted by SAMHSA to first sum up the evidence on recovery support services and then to facilitate the first multi- stakeholder discussion on a national level to advance the science of RSS. In the spirit of the patient maxim, “nothing about us without us”, we have formulated a plan of action that engages and involves key support- receiving stakeholders in multiple aspects of our network plan. Five types of activities are proposed (i.e., monthly seminar series, pilot funding, symposium presentations at national conferences, advisory board meetings with RCC staff and attendees, hands-on support to RCC personnel to track and analyze organizational data), each of which will result in concrete deliverables. In so doing, the RRI will become a known hub for the science on recovery support via RCCs, and will attract, collect and disseminate ancillary products that support the building of a cumulative RCC science that can explicate the role of RCCs in providing support specifically for P-MOUD.