Substance Use
Conditions
Keywords
Support groups, Recovery, Substance use disorders during incarceration
Brief summary
The goal of this study is to learn whether a virtual peer recovery coach (PRC) intervention can improve engagement in addiction treatment among incarcerated adults with substance use disorders. The main questions it aims to answer are: * Does the PRC intervention increase engagement with at least one recovery resource at 30 and 90 days? * Does it improve secondary outcomes such as substance use, recovery capital, overdose events, and recidivism? Researchers will compare Treatment-as-Usual with the PRC telehealth intervention to see if PRC support improves engagement in addiction care. Participants will: * Complete baseline and follow-up assessments * Receive either Treatment-as-Usual or a virtual PRC session focused on motivational interviewing and linkage to recovery resources
Detailed description
This study evaluates a virtual peer recovery coach (PRC) intervention designed to support adults with substance use disorders during incarceration and the transition back to the community. The trial is conducted across multiple jail facilities in Metro Atlanta, where individuals experience high rates of substance use disorders and limited access to treatment services. Peer recovery coaches-individuals with lived experience who are trained in motivational interviewing and linkage to care-have demonstrated benefit in healthcare settings, but their effectiveness within jail environments has not been rigorously tested. The intervention adapts an existing virtual PRC model for use in jail settings. PRCs meet with participants through a secure telehealth platform and provide individualized support focused on motivation, readiness for change, and connection to recovery resources. The model is designed to be scalable, flexible, and responsive to the needs of individuals with diverse substance use profiles, including those for whom no FDA-approved medications exist. The study uses a phased implementation approach in which participating jail sites transition from usual care to the PRC intervention over time. This structure allows the program to be integrated into each facility's workflow while enabling evaluation of the intervention's impact. Participants are followed for one year to assess engagement with recovery resources and other indicators of health, stability, and community reintegration. The findings will inform whether virtual PRC services can be effectively delivered in jail settings and whether they improve connection to treatment and recovery supports during a period of heightened vulnerability. Results may guide future implementation of peer-based models in correctional systems and other high-risk environments.
Interventions
BEHAVIORALVirtual Peer Recovery Coaching
A telehealth session with a peer recovery coach who provides motivational interviewing and tailored linkage to addiction treatment and recovery resources.
BEHAVIORALTreatment as Usual
Participants are provided information about community-based addiction treatment and recovery resources as part of routine jail processes.
Sponsors
Emory University
National Institute on Drug Abuse (NIDA)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Incarcerated at participating jail * Able to speak and understand English * Score of 3 or greater - "moderate level", "substantial level", or "severe level" of problems related to drug abuse - on DAST-10. * Willing to follow study procedures and complete research follow-up calls * Have at least two reliable contact numbers, e.g. participant and one or more relatives or close friends
Exclusion criteria
* Cognitive impairment (inability to comprehend the informed consent document as assessed by study staff during enrollment) * Prior participation in the study * Awaiting transfer to prison or jail outside the state of Georgia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Engagement With at Least One Recovery Resource | 30 days and 90 days after enrollment | Engagement with at least one recovery resource, defined as: * Formal addiction treatment (visit with a physician, psychologist, or licensed substance use counselor; or ≥1 night in detoxification or residential treatment), or * Recovery Community Organization (RCO) participation (contact, intake, and participation in ≥1 evidence-based recovery activity), or * Harm reduction organization engagement. Engagement may occur during incarceration or in the community after release. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Peer Recovery Coach Contacts | Baseline to 30 days, 90 days, 180 days, and 1 year | Number of PRC interactions among participants assigned to the intervention arm. |
| Self-Reported Substance Use (TLFB) | Baseline, 30, 90, 180 days, and 1 year | Days of substance use in the past 30 days using the Timeline Follow-Back method. A structured calendar-based interview used to measure self-reported substance use over the past 30 days. Participants recall days of use using memory anchors (events, routines). |
| Fatal Overdose Events | Baseline through 1 year | Overdose events identified through participant report, medical records, or community partner data. |
| Nonfatal Overdose Events | Baseline through 1 year | Overdose events identified through participant report, medical records, or community partner data. |
| Housing status | Baseline, 30, 90, 180 days, and 1 year | Current housing status (stable, unstable, homeless) |
| Employment status | Baseline, 30, 90, 180 days, and 1 year | Employment status (full-time, part-time, unemployed) |
| Social connections and Isolation: PROMIS scale | Baseline, 30, 90, 180 days, and 1 year | A validated set of items assessing perceived social support, loneliness, and connectedness. * Generates T-scores standardized to the U.S. population (mean = 50, SD = 10). * Higher scores on Social Support = more support. * Used to evaluate social determinants of recovery. |
| All-Cause Mortality | Baseline through 1 year | Death from any cause, confirmed through vital records or the National Death Index. |
| Days Receiving Medications for Substance Use Disorders | Baseline to 30 days, 90 days, 180 days, and 1 year | Number of days participants receive medications for opioid use disorder (MOUD), stimulant use disorder, or alcohol use disorder. |
| Recidivism and Justice Involvement | Baseline to 1 year | New arrests, bookings, or jail stays documented through participant report or administrative data. |
| Recovery Capital (BARC-10) | Baseline, 30, 90, 180 days, and 1 year | Brief Assessment of Recovery Capital (BARC-10) A 10-item validated scale that measures a person's internal and external resources that support recovery from substance use. Items assess domains such as social support, coping skills, housing stability, and personal motivation. * Scores range from 10 to 60. * Higher scores indicate greater recovery capital and stronger readiness to sustain recovery. |
| Healthcare Utilization | Baseline to 1 year | Emergency department visits, hospitalizations, and other acute care encounters. |
Countries
United States
Contacts
CONTACTJoseph Carpenter, MD
CONTACTYan Li
PRINCIPAL_INVESTIGATORJoseph Carpenter, MD
Emory University
Outcome results
None listed