Leveraging Parents and Peer Recovery Supports to Increase Recovery Capital in Emerging Adults with Polysubstance Use: Feasibility, Acceptability, and Scaling Up of Launch

利用父母和同伴的康复支持来增加使用多物质的新兴成年人的康复资本：可行性、可接受性和扩大启动规模

• 批准号: 10590541
• 负责人: Tess K. Drazdowski
• 金额: $ 1.16万
• 依托单位: OREGON SOCIAL LEARNING CENTER, INC.
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10590541
• 关键词: Abbreviations; Abstinence; Address; Adherence; Adolescent; Adult; Affect; Back; Capital; Caring; Cessation of life; Clinic; Communities; County; Data; Development; Dropout; Drops; Educational process of instructing; Effectiveness; Elderly; Ensure; Family; Feedback; Felis catus; Funding; Future; Goals; Health Services; Helping to End Addiction Long-term; Injury; Intervention; Interview; Investigator-Initiated Research; Knowledge; Life; Medical; Mental Health Services; Methods; Modeling; Names; Online Systems; Opiate Addiction; Opioid; Outcomes Research; Outpatients; Parents; Performance at work; Pharmaceutical Preparations; Pilot Projects; Play; Population; Procedures; Protocols documentation; Provider; Public Health; Randomized; Recovery; Recovery Support; Reporting; Research; Resources; Risk; Role; Route; Rural Community; Rural Health; Schools; Service delivery model; Services; Site; Social Network; Social support; Specific qualifier value; Speed; Stimulant; Training; Training Support; Transportation; United States National Institutes of Health; Work; acceptability and feasibility; adverse outcome; age group; aged; behavioral health; community based participatory research; community engaged research; contingency management; cost; emerging adult; evidence base; experience; feasibility testing; future implementation; health equity; help-seeking behavior; heroin use; high risk population; improved; innovation; multiple drug use; opioid epidemic; opioid misuse; overdose death; peer; peer support; personalized approach; polysubstance use; prevent; programs; recruit; residence; rural area; scale up; service gap; skills; substance use; substance use treatment; tool; uptake; virtual; virtual coach

This study is part of the NIH’s Helping to End Addiction Long-term (HEAL) initiative to speed scientific solutions to the national opioid public health crisis. The NIH HEAL Initiative bolsters research across NIH to improve treatment for opioid misuse and addiction. Emerging adults (EAs; aged 18-26) have the highest rates of poly-substance use compared to all other age groups. They have been hit particularly hard by the opioid crisis, estimated to cost the U.S. $1 trillion a year. In fact, nearly all EAs with a substance use problem report regular use of multiple drugs. Recovery capital, or the resources available to promote substance use recovery (e.g., vocational/educational skills, recovery-supportive community) is also much lower for EAs compared to older adults. This is not surprising given this developmental stage of instability and transition. Unfortunately, most EAs with poly-substance use are not receiving services, a problem that is exacerbated in rural communities, which often lack access to any behavioral health services. Further, EAs who do access substance use services are unlikely to receive evidence-based care and are more likely to drop out compared to older adults. Clearly, more developmentally appropriate and engaging services are needed for EAs with poly-substance use, regardless of residence, but particularly in rural communities. This R34, from an early stage investigator, initiates research to fill this service gap via an innovative adaptation of existing substance use services. It leverages (1) parents of EAs and (2) peer recovery supports (PRS), while ensuring services are equitable and scalable. Substance use services for EAs rarely involve parents, but their involvement could be the difference-maker for sustaining recovery. Beyond parents, the lack of recovery-focused peer social support is a major barrier to sustained recovery in EAs. Fortuitously, certified PRS are trained to help EAs find a recovery peer community and possibly build recovery capital. Thus, this R34 pilots a scalable service for EAs, named Launch, that involves both parents and PRS, thereby targeting poly-substance use from two crucial angles. After adapting and evaluating training protocols and adherence tools (Aim 1), 24 EAs with poly-substance use and their parents will be recruited. Parents will engage in web-based coaching to use Contingency Management for Emerging Adults (CM-EA), built on decades of work supporting CM as a leading intervention for poly-substance use. Concurrently, EAs will be randomized to one of two conditions to work with a PRS. In the first condition, PRS will provide typical services, including recovery social networking. In the second, PRS will provide typical services but will also further build the EAs' recovery capital via vocational/educational/ financial skills. The feasibility and acceptability of the study protocol and Launch services will be assessed (Aim 2). Notably, this project has been informed by Community-Based Participatory Research (CBPR) practices, which continue in the R34 by incorporating feedback from EAs with lived experience in recovery and the parent coach, PRS, and families. Further, to improve eventual uptake, payors/providers of substance use services will be interviewed. Sites for a future large-scale adaptive trial will also be recruited (Aim 3). If Launch is ultimately deemed effective, it would fill a major gap in the substance use services field by providing a highly specified and individualized service for reducing risk and promoting adaptive life functioning in EAs with poly-substance use.

这项研究是美国国立卫生研究院帮助结束长期成瘾（HEAL）倡议的一部分，该倡议旨在加速科学解决全国阿片类药物公共卫生危机。NIH HEAL倡议支持NIH的研究，以改善阿片类药物滥用和成瘾的治疗。与所有其他年龄组相比，新兴成人（18-26岁）使用多种物质的比例最高。他们受到阿片类药物危机的打击尤其严重，据估计，美国每年为此付出1万亿美元的代价。事实上，几乎所有有药物使用问题的ea都报告经常使用多种药物。收回资本，还是收回