Collaborative Hub for Emerging Adult Recovery Research (CHEARR)

摘要 新兴成年人（16-25岁）尤其受到阿片类药物危机的影响。虽然药物 对于降低死亡率，恢复阿片类药物使用以及与阿片类药物使用障碍（OUD）相关的其他危害至关重要， 正在服用或已经服用OUD（MOUD）药物的康复者有许多未满足的需求， 持续存在的风险因素阻碍了它们恢复充分运作和繁荣。环境机构的恢复需要 在MOUD稳定后，没有很好的记录，并且可能是该年龄组所独有的。EAs面 发展里程碑，其特点是教育、住房和 关系。同时发生的高比率使采取MOUD的EA的恢复需求进一步复杂化 心理健康障碍、多种物质使用和MOUD过早中止。恢复支持 服务，特别是治疗事件后提供的临床持续护理，可能在以下方面发挥关键作用： 为中介机构提供长期的OUD管理。尽管此类服务可以在真实的范围内找到- 世界药物使用治疗，很少有高质量的研究已经评估的功效或有效性， 康复支援服务或持续照顾，以切合幼儿园的需要。此外，持续的护理研究 主要由研究人员驱动，专注于禁欲，症状减轻和降低成本，而不是 促进恢复资本和环境机构重视的从OUD恢复的全方位成果。真正 需要伙伴关系和合作，以确保持续护理的研究反映了价值观和需求 的EA采取MOUD。我们将通过建立一个多学科， 社区参与网络：新兴成人康复研究持续护理中心（CHEARR）。我们 拟议的团队在恢复支持服务，研究与现实世界的物质使用方面具有广泛的专业知识 治疗组织，以及与采取MOUD的EA服务机构的合作伙伴关系。我们提出了三 总体目标，每个目标都提供可执行的交付成果：（1）采用基于社区的参与性办法 开发关键工具，通过创建并与两个合作伙伴在该领域进行高质量的研究， 社区委员会由采取或已经采取MOUD和恢复支持专家的EA组成， 具有EA的专业知识;（2）在多个平台上提供持续护理EA的科学中心，以教育 并让更大的科学界、受OUD影响的社区和其他关键合作伙伴社区参与进来; 和（3）通过a）博士后奖学金和学生实习， 计划和B）资助试点研究，为NIH拨款申请提供初步数据。此外该 CHEARR团队和社区委员会将合作开发一个EA特定的恢复资本措施， 这是目前科学文献中缺少的重要工具。关于这项措施的心理测量数据将是 作为试点研究计划的一部分。通过这些目标，CHEARR将促进科学的快速发展 并发展必要的基础设施，以调查继续照顾服务的EA采取MOUD。

Abstract Emerging adults (ages 16-25) have been particularly impacted by the opioid crisis. Although medications are crucial for reducing mortality, return to opioid use, and other harms associated with opioid use disorder (OUD), persons in recovery who take or who have taken medications for OUDs (MOUDs) have many unmet needs and ongoing risk factors that prevent their return to full functioning and to flourishing. The recovery needs of EAs following stabilization on MOUDs are not well documented and are likely unique to this age group. EAs face developmental milestones characterized by frequent transitions and instability in education, housing, and relationships. The recovery needs of EAs taking MOUDs are further complicated by high rates of co-occurring mental health disorders, polysubstance use, and premature discontinuation of MOUDs. Recovery support services, particularly clinical continuing care delivered after a treatment episode, are likely to play a key role in the long-term management of OUD for EAs. Although such services can be found across the spectrum of real- world substance use treatment, very little high-quality research has evaluated the efficacy or effectiveness of recovery support services or continuing care specific to the needs of EAs. Further, continuing care research has been largely researcher-driven and focused on abstinence, symptom reduction, and reducing cost, rather than fostering recovery capital and the full range of outcomes valued by EAs in recovery from OUD. Genuine partnerships and collaborations are needed to ensure research on continuing care reflects the values and needs of EAs taking MOUDs. We will advance this critical but under-researched area by building a multidisciplinary, community-engaged network: The Continuing Care Hub for Emerging Adult Recovery Research (CHEARR). Our proposed team has extensive expertise in recovery support services, research with real-world substance use treatment organizations, and partnerships with agencies that serve EAs taking MOUDs. We propose three overarching goals that each provide actionable deliverables: (1) use a community-based participatory approach to develop the critical tools to conduct high-quality research in this area by creating and partnering with two community boards comprised of EAs who take or who have taken MOUD and recovery supports specialists who have expertise with EAs; (2) provide a hub of science on continuing care for EAs on multiple platforms to educate and engage the larger scientific community, communities impacted by OUD, and other key partner communities; and (3) create a trainee-to-investigator pipeline through a) a postdoctoral fellowship and student internship program and b) funding pilot studies that will produce preliminary data for NIH grant applications. In addition, the CHEARR team and community boards will partner to develop an EA-specific measure of recovery capital, a crucial tool that is currently missing from the scientific literature. Psychometric data on this measure will be collected as part of the pilot study program. Through these aims, CHEARR will foster rapid expansion of science and develop the infrastructure necessary to investigate continuing care services for EAs taking MOUD.