Funded Projects

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Project # Project Title Research Focus Area Research Program Administering IC Institution(s) Investigator(s) Location(s) Year Awarded
3U19AR076734-01S5
University of Michigan BACPAC Mechanistic Research Center Cross-Cutting Research Training the Next Generation of Researchers in HEAL NIAMS UNIVERSITY OF MICHIGAN CLAUW, DANIEL J; HASSETT, AFTON L Ann Arbor, MI 2022
NOFO Title: Notice of Special Interest to Encourage Eligible NIH HEAL Initiative Awardees to Apply for Administrative Supplements to Support Career Enhancement Related to Clinical Research on Pain (Admin Supp – Clinical Trial Not Allowed)
NOFO Number: NOT-NS-22-087
Summary:

Many medication-based and complementary/integrative interventions are available to treat chronic low back pain, yet no treatment works for all patients. This clinical research strives to understand patient characteristics that predict differential responses to chronic low back pain interventions such as acupressure. This knowledge will enable early career researchers and clinicians to develop tailored treatments for individual patients.
1R21HD112210-01
Neurobiology of Pain Experiences in Youth in the ABCD Study Cross-Cutting Research Leveraging Existing and Real-Time Opioid and Pain Management Data NICHD OREGON HEALTH & SCIENCE UNIVERSITY WILSON, ANNA CAMILLE Portland, OR 2022
NOFO Title: HEAL Initiative: Secondary Analysis and Integration of Existing Data Related to Acute and Chronic Pain Development or Management in Humans (R21 Clinical Trials Not Allowed)
NOFO Number: RFA-DE-22-011
Summary:

Many millions of Americans experience chronic pain, including about 25 million who report pain that substantially interferes with daily activities and reduces quality of life. Many chronic pain syndromes are more prevalent in females, and the incidence of chronic pain increases dramatically during adolescence. This research will use neuroimaging and other biological, social, and psychological data from a large study of young adolescents with or without pain to identify risk and protective factors for chronic pain.
1R01DA057673-01
The Short and Long-Term Dynamics of Opioid/Stimulant Use: Mixed Methods to Inform Overdose Prevention and Treatment Related to Polysubstance Use Translation of Research to Practice for the Treatment of Opioid Addiction Improving Delivery of Healthcare Services for Polysubstance Use NIDA JOHNS HOPKINS UNIVERSITY GENBERG, BECKY LYNN (contact); GERMAN, DANIELLE Baltimore, MD 2022
NOFO Title: HEAL Initiative: Understanding Polysubstance Use and Improving Service Delivery to Address Polysubstance Use (R01 Clinical Trial Optional)
NOFO Number: DA22-047
Summary:

Use of both opioids and stimulants is increasing, but little is known about how polysubstance use evolves over time and how it influences overdose risk. This project will use data from two groups at high risk for overdose: i) participants in the AIDS Linked to the IntraVenous Experience (ALIVE) study who inject drugs and ii)  participants in the new Stimulant Opioid Non-Injection Cohort (SONIC) study. This research will identify drug use patterns and their association with treatment and overdose over time – toward informing overdose prevention efforts and interventions to improve the U.S. opioid crisis.
1R61DA057683-01
Leveraging Regulatory Flexibility for Methadone Take-Home Dosing to Improve Retention in Treatment for Opioid Use Disorder: A Stepped-wedge Randomized Trial to Facilitate Clinic Level Changes Cross-Cutting Research Translating Data 2 Action to Prevent Overdose NIDA NEW YORK UNIVERSITY SCHOOL OF MEDICINE NEIGHBORS, CHARLES J (contact); BAO, YUHUA ; RAMSEY, KELLY S New York, NY 2022
NOFO Title: HEAL Initiative: HEAL Data2Action Innovation Projects (R61/R33 Clinical Trial Optional)
NOFO Number: RFA-DA-22-051
Summary:

During the COVID-19 public health emergency, the Substance Use and Mental Health Services Administration relaxed regulations for take-home dosing of methadone, offering an opportunity to improve methadone treatment access and address racial and ethnic disparities. This project aims to address regulatory, legal liability, and financial concerns related to clinical practice changes in opioid treatment programs. The project will first review state administrative data and conduct qualitative interviews to inform the intervention approach. The project will then evaluate an opioid treatment program intervention involving take-home methadone and its effect on take-home dosing, retention in care, and health outcomes for Black/African American and Hispanic/Latino individuals who take methadone for opioid use disorder.
1R01DA057654-01
Expansion of Mail-Delivered Harm Reduction Services in the U.S. Translation of Research to Practice for the Treatment of Opioid Addiction Harm Reduction Approaches to Reduce Overdose Deaths NIDA WEILL MEDICAL COLL OF CORNELL UNIV BEHRENDS, CZARINA NAVOS New York, NY 2022
NOFO Title: HEAL Initiative: Harm Reduction Policies, Practices, and Modes of Delivery for Persons with Substance Use Disorders (R01 Clinical Trial Optional)
NOFO Number: RFA-DA-22-046
Summary:

Harm reduction supplies include fentanyl test strips that allow people who use drugs to identify whether the substance(s) they plan to take contain fentanyl and sterile syringes that help to prevent the spread of infectious diseases among people who inject drugs. One potential way to increase access to harm reduction supplies is mail delivery. This project will describe state-level policies that deter the use of mail-based delivery of harm reduction services, examine characteristics of people who use mail-based harm reduction services, and assess individual preferences related to mail-based harm reduction services.
1R41AR080620-01A1
Injectable Ice Slurry Cooling Technology for Treatment of Postoperative Pain Cross-Cutting Research Small Business Programs NIAMS BRIXTON BIOSCIENCES, INC. SIDOTI, CHARLES Cambridge, MA 2022
NOFO Title: HEAL Initiative: Development of Therapies and Technologies Directed at Enhanced Pain Management (R41/R42 Clinical Trial Not Allowed)
NOFO Number: RFA-NS-20-009
Summary:

More than 700,000 total knee replacement surgeries are performed each year in the United States to relieve joint pain in patients with end-stage osteoarthritis or rheumatic arthritis. However, many patients still experience significant pain after this procedure, calling for additional long-lasting, drug-free pain management strategies. This project will develop and test a commercial prototype device for persistent knee pain after total knee replacement. The injection-based method freezes peripheral nerves to reduce pain sensation.
3UH3CA261067-03S1
Optimizing the use of ketamine to reduce chronic postsurgical pain Cross-Cutting Research Training the Next Generation of Researchers in HEAL NCI NEW YORK UNIVERSITY SCHOOL OF MEDICINE WANG, JING (contact); DOAN, LISA New York, NY 2022
NOFO Title: HEAL Initiative: Pain Management Effectiveness Research Network: Clinical Trial Planning and Implementation Cooperative Agreement (UG3/UH3 Clinical Trial Required)
NOFO Number: RFA-NS-20-028
Summary:

Approximately 20% of patients who undergo surgery develop chronic Postsurgical Pain, which is linked with slow recovery, persistent opioid use and dependence. This project supports a scientist from a group underrepresented in biomedicine to expand ongoing research testing ketamine during and/or after surgery to prevent post-mastectomy pain syndrome. Ketamine is a low-risk treatment option that is easy to implement in a wide range of clinical settings.
1R61DK135406-01
PAINED: Project Addressing Inequities in the Emergency Department Clinical Research in Pain Management Advancing Health Equity in Pain Management NIDDK Children's Research Institute GOYAL, MONIKA KUMARI Washington, DC 2022
NOFO Title: HEAL Initiative: Advancing Health Equity in Pain Management (R61/R33 Clinical Trial Required)
NOFO Number: NS22-002
Summary:

Clinician bias causes inequities in healthcare, and interventions are needed to mitigate and eradicate this bias. This project aims to develop and test the impact of two interventions on overcoming clinician implicit bias in the management of pain for children from ethnic minorities treated in the emergency department. The study will include pediatric patients from under-represented minority groups with pain from long-bone fractures or acute appendicitis who are cared for by racially and ethnically diverse caregivers. Researchers will use stakeholder-informed approaches to establish quality of care metrics and then use clinician audit and feedback as well as data from electronic health records to quantify evidence of bias.      
R41DA056239-01
Leptin Receptor Agonist as a Novel Prevention of Opioid Induced Respiratory Depression Cross-Cutting Research Small Business Programs NIDA Arrevus, Inc. KRAUS, CARL NEIL (contact); POLOTSKY, VSEVOLOD Y Raleigh, NC 2022
NOFO Title: HEAL Initiative: America’s Startups and Small Businesses Build Technologies to Stop the Opioid Crisis (R43/R44 - Clinical Trial Optional)
NOFO Number: RFA-DA-19-020
Summary:

The primary cause of death associated with opioids is opioid-induced respiratory depression, and there is currently no way to prevent this condition. The goal of this research is to develop a therapy to prevent opioid-induced respiratory depression without disrupting opioids’ analgesic effects. Previous research has shown that the hormone leptin, which suppresses appetite and increases metabolic rate, also stimulates breathing. This research project in a mouse model will test if the novel, brain-penetrant leptin receptor-binding protein E1/Aca can prevent fentanyl-induced breathing failure without diminishing fentanyl’s analgesic effects.
1UC2AR082196-01
Innervation of the Knee and TMJ  Preclinical and Translational Research in Pain Management Restoring Joint Health and Function to Reduce Pain (RE-JOIN) NIAMS UNIVERSITY OF FLORIDA ALLEN, KYLE D (contact); ALMARZA, ALEJANDRO JOSE; CAUDLE, ROBERT M Gainesville, FL 2022
NOFO Title: HEAL Initiative: Restoring Joint Health and Function to Reduce Pain Consortium (RE-JOIN) (UC2 Clinical Trial Not Allowed)
NOFO Number: RFA-AR-22-009
Summary:

A complex network of different nerve cell subtypes connects to joints in different ways throughout body regions, such as the knee and the temporomandibular joint (TMJ) that connects the lower jaw and skull. This project aims to identify disease-specific pain symptoms using clinically relevant rat models of TMJ and knee osteoarthritis – and compare findings with disease-specific pain symptoms in human patients with the same conditions. This research may lead to a better understanding of how different nerve cell subtypes contribute to joint pain as well as how these nerve cell subtypes change with age and disease.
1R21DA057500-01
G Alpha Z Subunit as a Potential Therapeutic Target to Modulate Mu Opioid Receptor Pharmacology Preclinical and Translational Research in Pain Management Discovery and Validation of Novel Targets for Safe and Effective Treatment of Pain NIDA UNIVERSITY OF ROCHESTER BIDLACK, JEAN M Rochester, NY 2022
NOFO Title: Emergency Awards: HEAL Initiative-Early-Stage Discovery of New Pain and Opioid Use Disorder Targets Within the Understudied Druggable Proteome (R21 Clinical Trial Not Allowed)
NOFO Number: TR22-011
Summary:

Opioids affect the body by attaching to certain types of receptors that attach to G-proteins (particularly, a subtype called G-alpha). Opioids vary in their ability to provide pain relief as well as in their ability to require more drug to provide a response, known as tolerance. This project will explore the potential of various G-alpha subunits to increase or decrease opioid receptor signaling. The research findings will lay the groundwork for tailoring G-alpha related opioid effects to provide more pain relief while being less addictive.
3UH3AR076573-04S1
Randomized-Controlled Trial of Virtual Reality for Chronic Low-Back Pain to Improve Patient-Reported Outcomes and Physical Activity (HEAL Supplement) Cross-Cutting Research Training the Next Generation of Researchers in HEAL NIAMS CEDARS-SINAI MEDICAL CENTER SPIEGEL, BRENNAN Los Angeles, CA 2022
NOFO Title: Notice of Special Interest to Encourage Eligible NIH HEAL Initiative Awardees to Apply for Administrative Supplements to Support Career Enhancement Related to Clinical Research on Pain (Admin Supp – Clinical Trial Not Allowed)
NOFO Number: NOT-NS-22-087
Summary:

This research is measuring patient-reported outcomes, unique physical and behavioral characteristics, and opioid use in individuals with chronic low back pain who are using virtual reality (VR) therapy. This project expands the clinical pain workforce by enhancing the ability of an early career clinician to conduct mixed-methods research involving patients using VR technology. This research will contribute new information about barriers to implementing VR technologies across diverse populations, patient preferences for using VR for relief of chronic low back pain.
1R21DE032531-01
Long-term Opioid Therapy, Depression, and Suicide Mortality Risk in Patients with Head and Neck Cancer Cross-Cutting Research Leveraging Existing and Real-Time Opioid and Pain Management Data NIDCR DUKE UNIVERSITY OSAZUWA-PETERS, NOSAYABA Durham, NC 2022
NOFO Title: HEAL Initiative: Secondary Analysis and Integration of Existing Data Related to Acute and Chronic Pain Development or Management in Humans (R21 Clinical Trials Not Allowed)
NOFO Number: RFA-DE-22-011
Summary:

It is unclear if long-term use of opioids by head and neck cancer patients affects risk for depression, which is higher in this population compared to people without cancer. This knowledge could inform interventions such as increased opioid prescription safety or alternative pain management approaches and could thus help reduce the risk for depression-related outcomes. This project will use data from a national cancer database linked to Medicare claims and a Veterans Administration database to determine whether people with head and neck cancer that take opioid medications for more than 90 days have increased risk for new-onset or worsening depression or suicide death.
1R01DA057608-01
Treating Polysubstance Use in Methadone Maintenance: Application of Novel Digital Technology Translation of Research to Practice for the Treatment of Opioid Addiction Improving Delivery of Healthcare Services for Polysubstance Use NIDA FRIENDS RESEARCH INSTITUTE, INC. MITCHELL, SHANNON GWIN Baltimore, MD 2022
NOFO Title: HEAL Initiative: Understanding Polysubstance Use and Improving Service Delivery to Address Polysubstance Use (R01 Clinical Trial Optional)
NOFO Number: DA22-047
Summary:

Although methadone is an effective treatment for opioid use disorder, many individuals drop out of treatment, putting them at risk of relapse and overdose. One of the factors associated with poor retention in methadone treatment is concurrent cocaine use. There is currently no effective medical treatment for cocaine use disorder. However, contingency management, in which individuals receive tangible rewards for desired behaviors such as abstinence, has been shown to be effective for cocaine use. This project will test the value of a digital therapy app, DynamiCare Health Contingency Management, in methadone treatment programs to promote treatment for polysubstance use.
1R61DA057675-01
Using System Dynamics Modeling to Foster Real-Time Connections to Care Cross-Cutting Research Translating Data 2 Action to Prevent Overdose NIDA YALE UNIVERSITY HECKMANN, REBEKAH (contact); S SABOUNCHI, NASIM New Haven, CT 2022
NOFO Title: HEAL Initiative: HEAL Data2Action Innovation Projects (R61/R33 Clinical Trial Optional)
NOFO Number: RFA-DA-22-051
Summary:

First responders prevent many overdose deaths by providing life-saving resuscitation and giving naloxone to reverse an opioid overdose. This project will use a modeling approach to assess the impact of Good Samaritan Laws that protect people from certain criminal penalties if they call 911 to save an overdose victim by giving naloxone on overdose mortality. This research will develop and test a novel, scalable, telehealth platform that can be used at the time of an opioid overdose to link patients with access to medication for opioid use disorder, harm reduction services, and recovery support. The research will be informed by patient-outcome data.
1R01DA057651-01
Culturally Response Integrated Harm Reduction Services for Black and Latinx People Who use Drugs Translation of Research to Practice for the Treatment of Opioid Addiction Harm Reduction Approaches to Reduce Overdose Deaths NIDA NEW YORK UNIVERSITY SCHOOL OF MEDICINE JORDAN, AYANA New York, NY 2022
NOFO Title: HEAL Initiative: Harm Reduction Policies, Practices, and Modes of Delivery for Persons with Substance Use Disorders (R01 Clinical Trial Optional)
NOFO Number: RFA-DA-22-046
Summary:

There has been a substantial increase in overdose deaths among Black and Hispanic/Latino people who use drugs. This project will test and evaluate delivery of harm reduction services from a mobile van. A community-based care coordinator will assess the specific needs of each participant (such as housing, food assistance, and mental health treatment) toward the goal of linking each person to appropriate services.
1R44NS125745-01A1
Development and Evaluation of Computerized Chemosensory-Based Orbitofrontal Networks Training for Treatment of Pain (CBOT-P) Cross-Cutting Research Small Business Programs NINDS EVON MEDICS, LLC NWAOKOBIA, CHARLES CHIEDU (contact); NWULIA, EVARISTUS A Elkridge, MD 2022
NOFO Title: HEAL INITIATIVE: Development of Therapies and Technologies Directed at Enhanced Pain Management (R43/R44 - Clinical Trial Required)
NOFO Number: RFA-NS-20-010
Summary:

Research shows that individuals with chronic pain may experience brain changes that contribute to anxiety, depression, and cognitive impairment. This project will test a user-friendly, home-based device to treat chronic pain. The device stimulates the brain through olfactory training: repetitive daily stimulation with specific smells. The research will optimize a treatment approach and test the device in a clinical study.
3UM1DA049412-04S1
MassHEAL - Reducing overdose deaths by 40% (2019-2023) Cross-Cutting Research Training the Next Generation of Researchers in HEAL NIDA BOSTON MEDICAL CENTER SAMET, JEFFREY Boston, MA 2022
NOFO Title: Research Supplements to Promote Diversity in Health-Related Research (Admin Supp - Clinical Trial Not Allowed)
NOFO Number: PA-21-071
Summary:

Although there are effective prevention and treatment programs and services to address opioid misuse, opioid use disorder, and overdose, gaps remain between those needing and those receiving prevention and treatment. There is a need to better understand how to make these programs and services most effective at a local level, a problem being addressed by the HEALing Communities Study. This project supports a scientist from a group underrepresented in biomedicine to continue ongoing work to test the impact of an integrated set of evidence-based practices across health care, behavioral health, justice, and other community-based settings.
1R61MH132249-01
Latinx Children and Surgery Clinical Research in Pain Management Advancing Health Equity in Pain Management NIMH University of California, Irvine KAIN, ZEEV Irvine, CA 2022
NOFO Title: HEAL Initiative: Advancing Health Equity in Pain Management (R61/R33 Clinical Trial Required)
NOFO Number: NS22-002
Summary:

Both pain experience and treatment response are determined by a variety of factors, including race and ethnicity. Inequities in access to healthcare and pain treatment affect patients from minority populations, such as Hispanic/Latino populations of all age groups. This study will develop and test an online intervention—Web-based Tailored Intervention for Preparation of Parents and Children for Outpatient Surgery (L-WebTIPS)—tailored for Latino families of children having outpatient surgeries. The intervention aims to lower child and family anxiety before surgery as well as to reduce post-surgical pain by enhancing parent self-efficacy and behavioral pain coping strategies. After an exploratory phase to assess usability and acceptability of the intervention, the study will evaluate the impact of L-WebTIPS on child pre-surgery anxiety and post-surgery pain as well assess other child and parent outcomes.
R44DA056280-01
Reducing Opioid Use and Adverse Effects through Proactive Precision Pain Management Following Spine Surgery Cross-Cutting Research Small Business Programs NIDA Opalgenix, Inc. PLUMP, STEVEN R (contact); SADHASIVAM, SENTHILKUMAR Carmel, IN 2022
NOFO Title: HEAL Initiative: America’s Startups and Small Businesses Build Technologies to Stop the Opioid Crisis (R43/R44 - Clinical Trial Optional)
NOFO Number: RFA-DA-19-019
Summary:

Lumbar spinal surgery, an increasingly common surgery in adults with severe chronic back pain, is associated with acute post-surgical pain, costly postoperative opioid-related adverse effects, long hospital stays, high-risk for chronic post-surgical back pain, and persistent opioid use and dependence. Each individual responds differently to opioids based on their unique genetic and clinical factors, and the current trial-and-error approach to opioid use and prescribing promotes excessive opioid use, costly adverse outcomes, and poor surgical pain management. To address this issue, this research project will develop a preoperative diagnostic test that will use genetic and clinical information to proactively assess each person’s risk for opioid-related adverse events and chronic post-operative pain. The results will help clinicians provide personalized pain management to maximize pain relief while minimizing opioid-related safety risks, including opioid dependence.
1UC2AR082197-01
Neural Architecture of the Murine and Human Temporomandibular Joint Preclinical and Translational Research in Pain Management Restoring Joint Health and Function to Reduce Pain (RE-JOIN) NIAMS DUKE UNIVERSITY DONNELLY, CHRISTOPHER RYAN; CAI, DAWEN; EMRICK, JOSHUA JAMES Durham, NC 2022
NOFO Title: HEAL Initiative: Restoring Joint Health and Function to Reduce Pain Consortium (RE-JOIN) (UC2 Clinical Trial Not Allowed)
NOFO Number: RFA-AR-22-009
Summary:

Temporomandibular joint (TMJ) disorders are the most common form of chronic pain in the face and mouth area (orofacial pain), but relatively little is known about the biological causes of these conditions. This project will define the properties of sensory neurons that connect to tissues that make up the TMJ which connects the lower jaw and skull. This research aims to lay groundwork for development of new therapeutic approaches to treat these painful conditions.
1R21TR004333-01
Discovery of Novel Openers of the Understudied Human Drug Target Kir6.1 Preclinical and Translational Research in Pain Management Discovery and Validation of Novel Targets for Safe and Effective Treatment of Pain NCATS NEW YORK UNIVERSITY SCHOOL OF MEDICINE CARDOZO, TIMOTHY J New York, NY 2022
NOFO Title: Emergency Awards: HEAL Initiative-Early-Stage Discovery of New Pain and Opioid Use Disorder Targets Within the Understudied Druggable Proteome (R21 Clinical Trial Not Allowed)
NOFO Number: TR22-011
Summary:

Routine treatment of pain with prescription opioid medications may evolve into opioid use disorder, addiction, and potentially overdose. New, non-opioid molecular targets for pain are needed as a key element of responding to the opioid and overdose crisis. Ion channels are molecular gateways that convert electrical signals into physiological responses, and many have been implicated in transmitting pain signals. The ion channel Kir6.1/KCNJ8 has been linked to the control of postoperative and cancer pain. Studies in animal models show that low levels of this ion channel are evident after an injury. This research will identify compounds that can open the Kir6.1/KCNJ8 channel as potential treatment strategy for pain.
1K12NS130673-01
University of Michigan (UM) HEAL Initiative National K12 Clinical Pain Career Development Program (UM-HCPDP) Cross-Cutting Research Training the Next Generation of Researchers in HEAL NINDS UNIVERSITY OF MICHIGAN WILLIAMS, DAVID A (contact); CLAUW, DANIEL J; HARTE, STEVEN EDWARD Ann Arbor, MI 2022
NOFO Title: HEAL Initiative: National K12 Clinical Pain Career Development Program (K12 Clinical Trial Not Allowed)
NOFO Number: RFA-NS-22-045
Summary:

The Interagency Pain Research Coordinating Committee has reported that early-stage investigators are leaving the clinical pain research workforce for other fields. In addition, pain clinician researchers at the senior/mentor level are also exiting the field. This project will create a national training center for early-career clinicians and scientists interested in pursuing and sustaining independent careers in clinical pain research. Research will focus on rigorous scientific methods and procedures in pain research as well as the importance of stakeholder engagement.
1R21AT012430-01
Pain Management Strategies, Associated Psychological Variables, and Outcomes in Critical Limb Ischemia Cross-Cutting Research Leveraging Existing and Real-Time Opioid and Pain Management Data NIDCR YALE UNIVERSITY SMOLDEREN, KIM GERMAINE (contact); MENA-HURTADO, CARLOS New Haven, CT 2022
NOFO Title: HEAL Initiative: Secondary Analysis and Integration of Existing Data Related to Acute and Chronic Pain Development or Management in Humans (R21 Clinical Trials Not Allowed)
NOFO Number: RFA-DE-22-011
Summary:

Critical limb ischemia is the most severe form of peripheral artery disease, is very painful, and can lead to amputation and even death. Most patients with this condition live with chronic pain, but comprehensive and effective treatment is lacking. This project will use existing data from three databases to study medical pain management approaches used over time by individuals with critical limb ischemia – toward creating an integrated, patient-centered, and multimodal pain management approach for this condition.
1R01DA057443-01
Peer-Delivered, Behavioral Activation Intervention to Improve Polysubstance Use and Retention in Mobile Telemedicine OUD Treatment in an Underserved, Rural Area Translation of Research to Practice for the Treatment of Opioid Addiction Improving Delivery of Healthcare Services for Polysubstance Use NIDA UNIVERSITY OF MARYLAND, COLLEGE PARK MAGIDSON, JESSICA F (contact); KATTAKUZHY, SARAH M College Park, MD 2022
NOFO Title: HEAL Initiative: Understanding Polysubstance Use and Improving Service Delivery to Address Polysubstance Use (R01 Clinical Trial Optional)
NOFO Number: DA22-047
Summary:

Polysubstance use, especially use of both opioids and stimulants, is compounding the already devastating effects of the opioid crisis in underserved rural areas. This project builds on a previously established treatment model for opioid use disorder that uses telehealth and mobile treatment units, which seeks to engage people in activities they enjoy, to help them avoid negative behaviors such as drug use. This research will evaluate the effectiveness of a behavioral treatment approach delivered by peer recovery support specialists in rural areas and using mobile treatment units. The project will measure the intervention’s effect on treatment retention and polysubstance use – as well as evaluate the intervention’s feasibility, acceptability, adoption, and economic value.