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

与所有其他年龄段相比，新兴成年人(18-26岁)使用多种物质的比率最高。 组。他们受到阿片类药物危机的打击尤其严重，据估计，阿片类药物危机每年造成美国1万亿美元的损失。在……里面 事实上，几乎所有有物质使用问题的EA都报告经常使用多种药物。恢复资本，或 可用于促进药物使用恢复的资源(例如，支持恢复的职业/教育技能 与老年人相比，老年人的生活质量(社区生活质量)也要低得多。考虑到这种发展，这并不令人惊讶 不稳定和过渡阶段。不幸的是，大多数使用多物质的EA没有得到服务， 这一问题在农村社区加剧，农村社区往往无法获得任何行为健康服务。 此外，获得物质使用服务的EA不太可能接受以证据为基础的护理，而且 与年长的人相比，他们可能会辍学。显然，更适合发展和更具吸引力的服务 对于使用多物质的环境影响评估机构，无论其居住地如何，尤其是在农村社区，都需要。这 来自早期研究人员的R34发起了研究，通过创新的调整来填补这一服务空白 现有的物质使用服务。它利用(1)EA的父母和(2)对等恢复支持(PR)，而 确保服务是公平和可扩展的。为EA提供的物质使用服务很少有父母参与，但他们的 参与可能是可持续复苏的关键因素。除了父母，缺乏以康复为重点的 同伴社会支持是东亚地区持续复苏的主要障碍。幸运的是，经过认证的PR经过培训可以提供帮助 EAS找到一个复苏同行社区，并可能建立复苏资本。因此，这款R34是一种可扩展的服务 对于EA，名为Launch，包括父母和PR，从而从两个方面瞄准多物质使用 关键角度。在调整和评估培训方案和遵守工具(目标1)后，48名具有多学科能力的EA 吸毒者和他们的父母将被招募。家庭将被随机分为三种情况之一。在 第一个条件，父母将参与基于网络的指导，以使用应急管理来应对新兴成年人 (CM-EA)，建立在数十年的工作基础上，支持CM作为多物质使用的领先干预措施。在第二个 在这种情况下，PRS将提供典型的服务，包括恢复社交网络，并将进一步建设 EAS的恢复资本通过职业/教育/金融技能。在第三种情况下，家庭将同时获得CM- 一名教练和一名护士。将评估研究方案和发射服务的可行性和可接受性 (目标2)。值得注意的是，该项目得到了基于社区的参与性研究(CBPR)实践的启发， 通过将来自EA的反馈与在恢复方面的亲身经历和家长结合在一起，继续在R34中进行 教练员、护士和家属。此外，为了改善最终的吸纳量，物质使用服务的付款人/提供者将 接受采访。还将招募今后进行大规模适应性试验的地点(目标3)。如果发射最终是 它被认为是有效的，它将通过提供高度具体和 为减少风险和促进多种物质使用的东亚地区的适应性生活功能提供的个性化服务。

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), 48 EAs with poly- substance use and their parents will be recruited. Families will be randomized to one of three conditions. In the first condition, 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. In the second condition, PRS will provide typical services, including recovery social networking and will also further build the EAs’ recovery capital via vocational/educational/ financial skills. In the third condition, families will get both a CM- EA coach and a PRS. 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.