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Counseling for Harm Reduction and Retention in Medication-assisted treatment - Cherokee Nation (CHaRRM-CN)

Award Number: R33DA049376
ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/01/2019
PERIOD OF PERFORMANCE END DATE: 07/31/2025

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Counseling for Harm Reduction and Retention in Medication-assisted treatment - Cherokee Nation (CHaRRM-CN) - ABSTRACT American Indians (AIs) are disproportionately impacted by the current opioid epidemic. AIs experience an 88% higher prevalence of OUDs (1.5%) than the US general population (0.8%), and AIs are second only to non-Latinx whites in their experience of opioid overdose deaths (13.9 and 17.5 per 100,000, respectively). Fortunately, medication-assisted treatment (MAT; e.g., buprenorphine + naloxone) is highly effective for reducing opioid- related harm, including overdose, making it the gold-standard OUD treatment approach. A recent systematic review, however, showed a median retention of 56% at the NIDA-recommended 12-month treatment length. Further, most AIs with OUD do not attend traditional substance-use treatment (62%). This is concerning because treatment retention is strongly associated with mortality rate reduction. Although no studies have documented OUD treatment outcomes specific to AIs, research in Native communities has generally highlighted concerns about the cultural acceptability of the highly directive, Western medical substance-use treatment approaches (e.g., cognitive-behavioral therapy, 12-step programming) that are widely available. Further, previous research has indicated that AIs with substance use disorders want greater representation of Native staff and better integration of culturally adapted approaches in the services they receive. Culturally adapted approaches to treatment are associated with reductions in use and associated problems. However, there are currently no evidence-based, culturally adapted counseling approaches for AIs addressing MAT retention and opioid-related harm. Accordingly, we propose a 2-phase R61/R33 development and evaluation project in response to RFA-DA- 19-013 - “Responding to Opioid Use Disorders (OUD) in Tribal Communities in the Context of SAMHSA and CDC Funding.” This project will leverage recent federal OUD treatment initiative funding (SAMHSA TI-18-016, CDC-RFA-OT18-18030101supp) as a platform for culturally adapting substance-use counseling focused on improving MAT retention and reducing opioid-related harm within the Cherokee Nation Health System (CNHS). The 2-year R61 Phase will entail 2 parts. First, we will conduct a mixed methods inquiry to inform research methods and the community-specific, cultural adaptation of an existing, efficacious, harm-reduction counseling approach. Second, we will manualize and pilot the resulting Counseling for Harm Reduction and Retention in MAT at Cherokee Nation (CHaRRM-CN) together with a community advisory board comprising CNHS providers, staff, and patients as well as researchers from Cherokee Nation, Washington State University, and the University of Washington. The subsequent, 3-year R33 Phase will entail a 2-arm RCT (N=160) conducted within CNHS testing the efficacy of CHaRRM-CN in improving 6-month MAT retention, reducing substance-related harm and illicit opioid use, and increasing Native enculturation compared to a services-as-usual control condition (i.e., cognitive behavioral treatment).


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $643,161 )
2024	2024	WASHINGTON STATE UNIVERSITY	240 FRENCH ADMINISTRATION BLDG	PULLMAN	WA	99164	WHITMAN	USA	Drug Use and Addiction Research Programs	001	5	7/19/2024	NON-COMPETING CONTINUATION	$606,933
2024	2024	WASHINGTON STATE UNIVERSITY	240 FRENCH ADMINISTRATION BLDG	PULLMAN	WA	99164	WHITMAN	USA	Drug Use and Addiction Research Programs	002	5	7/25/2024	SUPPLEMENT FOR EXPANSION	$36,228
2024	2023	WASHINGTON STATE UNIVERSITY	240 FRENCH ADMINISTRATION BLDG	PULLMAN	WA	99164	WHITMAN	USA	Drug Use and Addiction Research Programs	000	4	10/23/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $643,161

Issue Date FY: 2023 ( Subtotal = $981,083 )
2023	2023	WASHINGTON STATE UNIVERSITY	240 FRENCH ADMINISTRATION BLDG	PULLMAN	WA	99164	WHITMAN	USA	Drug Use and Addiction Research Programs	001	4	7/3/2023	NON-COMPETING CONTINUATION	$623,716
2023	2023	WASHINGTON STATE UNIVERSITY	240 FRENCH ADMINISTRATION BLDG	PULLMAN	WA	99164	WHITMAN	USA	Drug Use and Addiction Research Programs	002	4	7/12/2023	SUPPLEMENT FOR EXPANSION	$36,228
2023	2022	WASHINGTON STATE UNIVERSITY	240 FRENCH ADMINISTRATION BLDG	PULLMAN	WA	99164	WHITMAN	USA	Drug Use and Addiction Research Programs	003	3	7/26/2023	EXTENSION WITH OR WITHOUT FUNDS	$321,139
2023	2022	WASHINGTON STATE UNIVERSITY	240 FRENCH ADMINISTRATION BLDG	PULLMAN	WA	99164	WHITMAN	USA	Drug Use and Addiction Research Programs	000	3	10/24/2022	EXTENSION WITH OR WITHOUT FUNDS	$0
														Subtotal = $981,083

Issue Date FY: 2022 ( Subtotal = $648,324 )
2022	2022	WASHINGTON STATE UNIVERSITY	240 FRENCH ADMINISTRATION BLDG	PULLMAN	WA	99164	WHITMAN	USA	Drug Use and Addiction Research Programs	000	3	7/31/2022	EXTENSION WITH OR WITHOUT FUNDS	$648,324
														Subtotal = $648,324

Grand Total All Awards = $2,272,568

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Counseling for Harm Reduction and Retention in Medication-assisted treatment - Cherokee Nation (CHaRRM-CN)

Award Number: R33DA049376

ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/01/2019

PERIOD OF PERFORMANCE END DATE: 07/31/2025

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