PROJECT SUMMARY/ABSTRACT Safe and stable housing is widely recognized as critical to recovery from alcohol and drug use disorders generally, but it may be even more critical to recovery from opioid use disorders (OUD). Addiction to opioids is associated with changes in the structure and function of the brain. These changes may take months or years to resolve, all the while leaving individuals vulnerable to relapse, which is all too often deadly. It may also lead to unemployment, criminal justice involvement, and social isolation, which present additional impediments to recovery. Recovery housing can offer invaluable support in the early phases of recovery by providing structure and minimizing exposure to conditioned cues and other triggers for relapse. It can also set the stage for long- term gains by integrating residents into new peer communities that are supportive of recovery and can help as they face challenges in daily life. Unfortunately, research on the outcomes of residents in recovery from OUD, particularly those being treated with medications is limited. Further, there is literature that suggests that individuals being treated with medications for OUD (MOUD) may experience barriers to recovery housing due to negative attitudes towards MOUD and lack of recovery housing that is equipped to support persons on medication. This application seeks to enhance infrastructure to conduct effectiveness research on recovery housing for persons treated with MOUD. Specifically, it aims to: (1) Develop a network of diverse stakeholders dedicated to expanding access to recovery housing for persons prescribed MOUD and conducting research on it; (2) Increase capacity of recovery housing that is equipped to support residents who are prescribed MOUD and to participate in effectiveness research as well as researchers who are trained to conduct it; (3) Provide resources and opportunities to junior investigators and those who may be new to recovery housing research to collaborate with recovery housing researchers to expand the evidence base on recovery housing for persons treated with MOUD. To achieve these aims, the proposed team will establish an Advisory Board comprised of leading researchers and members of national treatment, recovery, and recovery housing organizations to establish a large multi-stakeholder network of providers and researchers. The team will also host a webinar series with intensive year-long tracks for recovery housing providers and researchers new to the field and foster opportunities for these researchers to network with providers and other researchers at conferences. Finally, members of the team will mentor pilot studies with junior and new recovery housing researchers to develop new tools and establish the feasibility of innovative research methods and research in novel settings to fill key gaps in the literature. Findings from these pilot studies will be disseminated to the larger multi-stakeholder network to improve practice and launch wider scale effectiveness research.

PROJECT NARRATIVE/PUBLIC HEALTH RELEVANCE Recovery housing may be a critical component in a comprehensive response to the current opioid crisis, but evidence-based practices in recovery housing for those being treated with medications for opioid use disorders are lacking. By developing a national multi-stakeholder network, hosting webinars for researchers and recovery housing providers, and supporting mentored pilot studies for new recovery housing researchers, this application proposes to develop the infrastructure necessary to begin developing this evidence base.