PROJECT SUMMARY / ABSTRACT The opioid crisis has caused a national decline in average U.S. life-expectancy necessitating a declaration of a federal public health emergency. Evidence indicates that OUD is a chronic health condition best managed with long-term use of medications (MOUD). While MOUD save lives, reduce related harms, and enhance the likelihood of remission, compared to other substance use disorders, individuals suffering from OUD tend to be more in need of additional services, feel more isolated and marginalized, have fewer available recovery assets (e.g., jobs, safe housing) and report lower quality of life. These continued deficits increase biobehavioral stress and prognostic pessimism and, in turn, the odds of treatment discontinuation and subsequent relapse. There is a need for additional recovery support services (RSS) to help build positive social networks and to increase education, training, employment, and housing opportunities (collectively known as “recovery capital”) to enhance functioning and quality of life. Recovery Community Centers (RCCs) are emergent national entities designed specifically to help provide this growth in recovery capital and enhance remission and quality of life. Preliminary evidence indicates RCCs play a particularly valuable role for those with OUD, but despite their strong conceptual basis and rapid largescale investment in their growth, little is known from a systematic research standpoint about their clinical and public health utility and cost-effectiveness. To advance the development of efficacy and effectiveness research on RCCs for persons who were or who are being maintained on medications for the treatment of OUD (P-MOUD), we propose to orchestrate activities on a national level to engage multiple stakeholders and produce actionable deliverables. This proposal draws and builds upon numerous professional and academic resources and experiences, including the existence of our already established recovery dissemination platform (i.e., the Recovery Research Institute (RRI); 6,000 Bulletin readers, 37,000 Twitter followers, 24,000 website visitors per month), which due to its reputation and experience has been contracted by SAMHSA to first sum up the evidence on recovery support services and then to facilitate the first multi- stakeholder discussion on a national level to advance the science of RSS. In the spirit of the patient maxim, “nothing about us without us”, we have formulated a plan of action that engages and involves key support- receiving stakeholders in multiple aspects of our network plan. Five types of activities are proposed (i.e., monthly seminar series, pilot funding, symposium presentations at national conferences, advisory board meetings with RCC staff and attendees, hands-on support to RCC personnel to track and analyze organizational data), each of which will result in concrete deliverables. In so doing, the RRI will become a known hub for the science on recovery support via RCCs, and will attract, collect and disseminate ancillary products that support the building of a cumulative RCC science that can explicate the role of RCCs in providing support specifically for P-MOUD.

PROJECT NARRATIVE The opioid crisis has caused a national decline in average U.S. life-expectancy necessitating a declaration of a federal public health emergency. Opioid use disorder is a chronic condition best managed with long-term use of medications, but even with medication use, compared to those suffering from other substance use disorders, individuals suffering from opioid use disorder continue to suffer from additional deficits. Recovery Community Centers (RCCs) are designed to help individuals with opioid use disorder overcome such deficits, but while promising, systematic research is sorely lacking. This project engages multiple relevant stakeholders at all levels to create a national research infrastructure to facilitate the scientific investigation into the clinical and public health utility and cost-effectiveness of RCCs for individuals suffering from opioid use disorder.