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

项目总结/摘要 两组研究不足，但因使用阿片类药物而产生问题的风险最高 障碍是（1）涉及公共系统的新兴成年人（EA;年龄16-25）和（2）正义的个人- 参与（包括EA）。与所有其他年龄组相比，EAs报告的药物使用率最高，包括 阿片类药物的使用和公共系统参与的EA更有可能产生负面结果。对于所有年龄段的成年人， 使用类阿片导致接触司法系统的可能性增加13倍。在重返监狱的人中， 在人口中，死亡的主要原因是过量，主要是阿片类药物。此外，多种物质的使用几乎 普遍适用于使用阿片类药物的EA和涉及司法的成年人（任何年龄）。同行恢复支持服务和 康复住宅正在全国范围内激增，并可能对这两个高危群体产生巨大的好处， 但对它们的研究有限，缺乏科学严谨性。该倡议的最终目标是快速推进 通过开展可行的研究， 将不再需要资金来维持增长。要做到这一点，必须确定和装备 研究人员愿意致力于或重新定向他们的研究工作，这一主题。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 严格的研究方法和现实世界服务工作的背景不相容。这需要 适应或发展创新和全面的方法，精心联合收割机 设计、先进的测量和复杂的统计分析。调查人员还必须有能力 并训练有素，与社区利益相关者合作，使严格的研究可以进行真实的- 世界设置。不过，最理想的情况是，受恢复支持服务影响的人们以及针对以下方面进行的研究 他们必须帮助推动研究议程;而不是由研究人员发起的优先事项， 目标人群和该社区的利益攸关方（恢复支持服务提供者和付款人） 必须有效参与。因此，该倡议是高级研究人员、 从目标高风险人群、提供者和支付者那里回收。该倡议将推动关于 同行康复支持和康复住所的效率/效果，涉及公共系统的新兴 成人和涉及司法的成人阿片类药物使用障碍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，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领域，（3）提供 种子基金和指导，以产生NIH资助的初步研究，以及（4）进行传播和 延伸到更大的领域。有了这些目标，该倡议将成为促进迅速扩展的催化剂 在解决这一关键公共卫生问题的熟练调查人员和高质量研究的数量方面。

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.