Funded Projects

Medications used to treat opioid use disorder (OUD) such as methadone and buprenorphine can cause central sleep apnea—a condition in which an individual momentarily stops breathing during sleep. This project will evaluate whether central sleep apnea, by worsening sleep quality and causing low blood oxygen levels, leads to nighttime arousal and emotional distress, which in turn increases the risk of relapse in individuals receiving treatment for OUD.

Social safety net programs and Medicaid that provide basic necessities such as shelter, health care, and food to people with low incomes are particularly important for women parents who use drugs. This project will examine the separate and combined impact of state social safety net program eligibility and administration on opioid-related behavioral outcomes for women parents experiencing poverty. Findings from this research will provide actionable recommendations for changes to these programs that may promote health and well-being for these women.

Multiple social determinants affect the health of youth experiencing homelessness. These include a lack of stable safe housing, income, education, food security, restricted access to services, as well as discrimination, victimization, and social isolation. This project will test the use of prevention efforts to address the factors that may be embedded within systems that serve this population, such as drop-in centers. The research will gather generalizable information about helping these youth along with cost estimates to inform future implementation efforts.

People who use opioids, as well as those who take medications approved by the U.S. Food and Drug Administration for opioid use disorder (OUD), report significant problems with sleep and biological rhythms. This project will explore the activity of a novel group of photosensitive neurons in the retinas, a potential source for sleep disturbances in these individuals. The research could lead to new treatment strategies and responses, but also may identify a non-invasive, circadian biomarker to predict recovery and relapse in people with OUD.

Chronic opioid use has well-known effects on sleep quality and circadian rhythms, but few predictive metrics core to mental and physical health and well-being are available to guide treatment with medications for opioid use disorder (OUD). This project will identify observable characteristics related to sleep and circadian rhythms that predict OUD treatment outcomes, toward refining treatment strategies and developing new ones. This data coordinating center will ensure that (1) high quality and standardized data are collected across all research sites, (2) all milestones and regulatory requirements are met, (3) study results are reported in a timely manner, and (4) that data and results are disseminated broadly.

Drug checking services provide individuals who use drugs with information about the true contents of their purchases, and thus may help prevent overdoses. However, current technologies are either costly, technically complex, and non-portable or subject to false signals and restricted in their detection capabilities. This project will continue development of a new, simple-to-use, point-of-care analytical technology (DoseCheck) that can rapidly detect established drug threats in a sample and recognize newly emerging drugs. The project will also attempt to adapt DoseCheck to provide rapid results in emergency overdose situations and improve the analytical capabilities of medical examiners in under-resourced jurisdictions.

Providing housing and prevention services (often referred to as “housing first”) has great potential to prevent opioid use disorder, continued homelessness, and other problem behaviors among youth experiencing homelessness. However, implementation of these services is challenging because criminal justice system involvement (which is common in this population) often prevents or delays access to housing. This project will explore interactions between criminal justice system involvement and the housing first intervention, toward reducing risks for opioid use and death among justice-involved youth experiencing homelessness

Most opioid misuse begins during adolescence and young adulthood. Adolescence is the best time for prevention interventions in settings like school-based health centers (HCs), yet few programs focus on preventing initiation of opioid misuse. This study harnesses the power of video game interventions and incorporates components of effective substance use prevention programs to develop an evidence-informed intervention to prevent the initiation of opioid misuse in adolescents. In partnership with the national School-Based Health Alliance (SBHA), researchers will develop and test a new video game intervention, PlaySmart. It will build on our previous video game intervention that has demonstrated efficacy in improving attitudes and knowledge related to risk behaviors. The study will evaluate the game in a randomized controlled trial in 10 school-based HCs and examine strategies for implementing PlaySmart in school-based HCs nationally. This research has considerable potential for wide implementation, reach, and impact on high-risk adolescents through school-based HCs.

The parent project’s Housing First initiative can be divided into two interconnected goals: (1) to reduce the likelihood of substance misuse and the development of an opioid use disorder and (2) to provide youth with housing stability and opioid and related risk prevention services that will assist them in exiting homelessness. The proposed supplement project complements the goals of the parent grant project by exploring two additional components that are related to exiting homelessness and reducing substance misuse or the development of opioid use disorder: (1) to further investigate youth’s interactions with social service providers, via qualitative methods, with the goal of cultivating a detail understanding actionable practices as it relates to fostering successful interactions between substance using homeless youth and service providers and (2) to evaluate, via quantitative methods, the extent to which ethnic identity protects youth from the negative effects of discrimination, substance misuse, and the development of a opioid use disorder.

The emergency department (ED) is an ideal venue to reach and intervene with adolescents and young adults at risk for opioid misuse, particularly as young adults may disconnect from primary care when transitioning out of pediatric medicine. This study will evaluate the efficacy of interventions of varying type/intensity to prevent/reduce opioid misuse or opioid use disorder (OUD). The research leverages technology that is appealing to youth to facilitate intervention delivery by health coaches. In this study, adolescents and young adults in the ED screening positive for opioid use or misuse will be randomly assigned to one of four intervention conditions with outcomes measured at 4, 8, and 12 months. Technology-driven, scalable interventions delivered via health coach allow for real-time tailoring to the rapidly changing opioid epidemic, with the potential for a sustainable impact on preventing escalation of opioid misuse among adolescents and young adults. While we know that Black/African American youth are at increased risk for opioid and other substance use, they often do not participate in research studies. As a result, we do not know how well prevention interventions work with Black/African American individuals. This supplement will focus on increasing participant diversity and inclusion by recruiting additional Black/African American participants for this ongoing randomized controlled trial to study technology-driven prevention interventions.