Abstract
Emerging adults (ages 16-25) have been particularly impacted by the opioid crisis. Although medications are
crucial for reducing mortality, return to opioid use, and other harms associated with opioid use disorder (OUD),
persons in recovery who take or who have taken medications for OUDs (MOUDs) have many unmet needs and
ongoing risk factors that prevent their return to full functioning and to flourishing. The recovery needs of EAs
following stabilization on MOUDs are not well documented and are likely unique to this age group. EAs face
developmental milestones characterized by frequent transitions and instability in education, housing, and
relationships. The recovery needs of EAs taking MOUDs are further complicated by high rates of co-occurring
mental health disorders, polysubstance use, and premature discontinuation of MOUDs. Recovery support
services, particularly clinical continuing care delivered after a treatment episode, are likely to play a key role in
the long-term management of OUD for EAs. Although such services can be found across the spectrum of real-
world substance use treatment, very little high-quality research has evaluated the efficacy or effectiveness of
recovery support services or continuing care specific to the needs of EAs. Further, continuing care research has
been largely researcher-driven and focused on abstinence, symptom reduction, and reducing cost, rather than
fostering recovery capital and the full range of outcomes valued by EAs in recovery from OUD. Genuine
partnerships and collaborations are needed to ensure research on continuing care reflects the values and needs
of EAs taking MOUDs. We will advance this critical but under-researched area by building a multidisciplinary,
community-engaged network: The Continuing Care Hub for Emerging Adult Recovery Research (CHEARR). Our
proposed team has extensive expertise in recovery support services, research with real-world substance use
treatment organizations, and partnerships with agencies that serve EAs taking MOUDs. We propose three
overarching goals that each provide actionable deliverables: (1) use a community-based participatory approach
to develop the critical tools to conduct high-quality research in this area by creating and partnering with two
community boards comprised of EAs who take or who have taken MOUD and recovery supports specialists who
have expertise with EAs; (2) provide a hub of science on continuing care for EAs on multiple platforms to educate
and engage the larger scientific community, communities impacted by OUD, and other key partner communities;
and (3) create a trainee-to-investigator pipeline through a) a postdoctoral fellowship and student internship
program and b) funding pilot studies that will produce preliminary data for NIH grant applications. In addition, the
CHEARR team and community boards will partner to develop an EA-specific measure of recovery capital, a
crucial tool that is currently missing from the scientific literature. Psychometric data on this measure will be
collected as part of the pilot study program. Through these aims, CHEARR will foster rapid expansion of science
and develop the infrastructure necessary to investigate continuing care services for EAs taking MOUD.