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

项目摘要/摘要 阿片类药物危机导致美国全国平均预期寿命下降，有必要宣布 联邦突发公共卫生事件。证据表明，OUD是一种慢性健康状况，最好的治疗方法是 长期服药(Moud)。同时穆德拯救生命，减少相关伤害，并加强 缓解的可能性，与其他物质使用障碍相比，患有OUD的人往往 需要更多服务的人更多，感觉更孤立和被边缘化，可用的恢复资产更少 (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的压力 和预后悲观，反过来，停止治疗和随后复发的几率。的确有 需要额外的恢复支持服务(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”) 功能和生活质量。恢复社区中心(RCC)是专门设计的新兴国家实体 特别是帮助提供这种复苏资金的增长，并提高缓解和生活质量。初步 有证据表明，RCC对于那些患有OUD的人来说特别有价值，但尽管他们有很强的概念性 基础和快速的大规模投资在其增长中，从系统研究的角度来看，对 它们的临床和公共卫生效用和成本效益。推进药效与药效发展 RCCS对正在或正在接受药物治疗的人的有效性研究 对于OUD(P-Moud)的处理，我们建议在国家层面上协调活动，使多个 利益相关者，并产生可操作的交付成果。这项建议借鉴并建立了许多专业人士 以及学术资源和经验，包括我们已经确立的复苏的存在 传播平台(即，恢复研究所；6,000名公告读者，37,000名推特 追随者，每月2.4万网站访问量)，由于其声誉和经验，已签约 由SAMHSA首先总结关于恢复支持服务的证据，然后促进第一次多 国家层面的利益相关者讨论，以推动RSS的科学研究。本着病人格言的精神， 我们已经制定了一项行动计划，涉及到关键的支持- 在我们的网络计划的多个方面接待利益相关者。提出了五种类型的活动(即每月 研讨会系列，试点资金，在国家会议上的专题演讲，咨询委员会会议 RCC工作人员和参与者，为RCC人员提供实际支持以跟踪和分析组织数据)，每个 其中将产生具体的可交付成果。通过这样做，RRI将成为众所周知的科学研究中心 通过农村信用社提供恢复支持，并将吸引、收集和传播支持建筑的辅助产品 一个累积的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.