Project Summary (Abstract) Opioid use disorder (OUD) prevalence and morbidity rates have reached unprecedented levels among adolescents and emerging adults. Recovery support services (RSS) for persons with SUDs typically focus on the individual client after acute care. But for youth with SUDs, developmental theory underscores the primacy of family-level risk and protective factors, and family-based interventions have the strongest empirical support. Yet there is an alarming paucity of research, clinical resources, and generalizable metrics focused on family- based RSS for youth with OUD. Family Recovery Research Institute (FaRRI) will be a sustainable research network designed to develop and evaluate innovative family-based RSS across the youth OUD services cascade. FaRRI will conduct research on promoting family integration in youth OUD services with the goals of increasing service engagement and engendering supportive family environments for youth recovery. It will launch with two specific foci: (1) Innovations in family RSS interventions and metrics to assist youth OUD providers with integrating families in OUD services. It will focus on training and evaluation aimed at multiple levels: behavior specialists, physicians, support staff, and organization. For the current project we will develop a modular protocol (assertive family outreach, family session management skills, OUD psychoeducation and decision-making) to train providers in enlisting family resources to fortify their efforts to deliver medication- assisted treatment, promote treatment adherence, and broker supportive services; and a companion measure of youth and family integration in OUD services. (2) Innovations in measurement of direct-to-family RSS for families of youth with OUD. The current project will enhance existing remote-access RSS for caregivers of youth with SUDs (helpline, parent coaching, mobile messaging) by developing multidimensional metrics for family service engagement and outcomes. This proposed 5-year project would leverage the expertise of a multi-stakeholder advisory board to establish FaRRI network infrastructure and sustainability pathways for advancing family-based RSS research for youth OUD (Aim 1), generating new provider resources and metrics for family integration in youth OUD care (Aim 2), and generating new metrics for remote-access family-focused OUD recovery resources (Aim 3). At project end FaRRI will maintain a sustainable network of family-based RSS research activities, provider training and measurement resources, and mentoring; resources would be available to providers and families directly from FaRRI or as white-label products replicated by other RSS providers. Feasibility of achieving study aims is bolstered by study team expertise in research on family-based clinical and digital interventions to support youth OUD recovery; and a national advisory board of scientists, organizations that train youth OUD providers, government regulators of youth OUD services, behavioral health payors and marketers, and youth and families affected by OUD. FaRRI infrastructure will be buttressed by mentoring opportunities for junior-level providers and researchers working on FaRRI research goals.

Project Narrative Opioid use disorder (OUD) prevalence rates have reached unprecedented levels among adolescents and emerging adults, and treatment engagement and retention for this population are alarmingly poor. For youth with substance use disorders, developmental theory underscores the primacy of family-level risk and protective factors, and family-based interventions have the strongest empirical support. This study will systematically build a research and technical assistance infrastructure designed to develop and evaluate innovative family- based recovery support services for youth with OUD that span the all phases of the services cascade: screening and referral, treatment initiation, treatment delivery, and continuing care.