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Principal Investigator: Francesca Beaudoin
Organization: BROWN UNIVERSITY
Fiscal Year: 2024
Award: $790,495
Funding agency: National Institute on Drug Abuse
PROJECT SUMMARY
Increasing numbers of opioid overdoses have been observed during the COVID-19 pandemic, likely reflecting
the pandemic’s multiple effects on this already vulnerable population. People in recovery from opioid use disorder
(OUD) have reported disproportionate psychosocial distress and isolation, as well as significant disruptions in
access to treatment including peer support, during the COVID-19 pandemic. These negative outcomes are
especially acute for rural, low-income, and minority populations in recovery from OUD. Peer support is a key
component of many evidence-based OUD recovery programs: it improves recovery capital, improves treatment
engagement, improves perceived social support, and reduces psychosocial distress, particularly when used in
conjunction with other evidence-based treatments such as medication for opioid use disorder (MOUD). This
grant, submitted in response to PA 20-237, therefore proposes a randomized controlled trial of a novel mobile
peer support app platform among a national sample of 1300 patients in recovery from opioid use disorders
(OUDs), as an adjunct to usual care, during COVID-19. Our previously piloted online-only recruitment and follow-
up strategy – in which we meld patient-reported outcomes with administrative datasets – allows strategic
recruitment of often-excluded participants from across the United States, including those facing the highest
barriers to treatment. The mobile app-based peer support intervention, provided as an individual-level
enhancement of existing treatment and recovery programs, will allow individuals in OUD recovery to access a
tailored, anonymous, peer-moderated support group 24/7. The app is augmented with natural language
processing tools capable of automatically ‘flagging’ critical or clinically relevant content, thereby creating a
scalable system to keep groups safe and constructive. Participants will be followed for 6 months through both
self-report and administrative outcomes. The study’s primary outcome is self-reported recovery capital,
complemented by objectively measured administrative data on retention in treatment programs from our
community and governmental partners in a sub-sample of 650 patients from RI and IN. Hypothesized secondary
outcomes are mitigation of psychosocial effects of COVID-19 on this vulnerable population, including depressive
symptoms, stress, and loneliness, as well as objective adverse events of emergency department visits and opioid
overdoses. Finally, we will explore whether state- and county-level variables moderate efficacy. SIGNIFICANCE:
OUD is a major public health problem, and patients in recovery from OUD are experiencing worse outcomes
during the COVID-19 pandemic. If this mobile app demonstrates efficacy among a large national sample of
patients, it has the potential to augment existing treatment programs, improve recovery capital, and reduce
disproportionate impacts of COVID-19 on this vulnerable population.
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