Southwest Clinical Trials Node: Clinical Research and Practice to Address Substance Use in Diverse, Rural, and Underserved Populations - This study is part of the NIH’s Helping to End Addiction Long-term (HEAL) initiative to speed scientific solutions to the national opioid public health crisis. The NIH HEAL Initiative bolsters research across NIH to improve treatment for opioid misuse and addiction. The Southwest (SW) Node is driven to improve health equity among historically disadvantaged communities, including American Indian, Hispanic, unhoused, and rural populations. We propose to expand the reach and impact of NIDA’s mission to advance science on the wide spectrum of substance use disorders (SUDs), and translate that knowledge to individual and public health. To achieve that, this application brings together resources and expertise from committed investigators, healthcare providers, and communities from New Mexico (NM) and Arizona (AZ) in a collaborative, synergistic partnership that multiplies our potential impact in the SW region. NM and AZ are both border states with high rurality, deeply established and underrepresented Hispanic and American Indian communities, and substantial migrant Hispanic populations. Both states are facing a devastating SUD crisis, exacerbated by pervasive health disparities. Overdose mortality rates in NM and AZ substantially exceed the national average, are the highest in the Western U.S., and continue to rise. Communities in both states face challenges with effects of social determinants of health - poverty, housing insecurity, and unemployment - that contribute to high rates of SUD, including opioid use disorder (OUD) and especially high rates of methamphetamine use disorder. The need for development, rigorous evaluation, and implementation of innovative solutions has never been more urgent. The University of New Mexico Health Sciences Center (UNM HSC) and Arizona State University (ASU) and their partners share a commitment to addressing the pressing healthcare challenges facing the SW region. Growing the SW Node embodies a transformative vision for SUD science and healthcare—one where collaboration, innovation, and inclusivity converge to create a future whole that is truly greater than the sum of its parts. The SW CTN is excited to align with other Nodes facing similar challenges and with overlapping goals to advance SUD research and practice in the diverse, rural, and underserved populations of southwestern border communities. The SW Node has a breadth and depth of expertise in SUD research including clinical trials, implementation and pragmatic trials, health informatics, psychosocial interventions, and community-engaged and -based participatory research (CBPR). The SW Node provides an extensive academic infrastructure and resources to support innovative research and rapid dissemination. Both UNM and ASU are Hispanic Serving Institutions. UNM’s infrastructure includes the academic home base at UNM HSC, as well as affiliated Schools, Colleges and Hospitals; ECHO Institute; UNM Center on Alcohol, Substance use, and Addictions (CASAA); and affiliates at New Mexico State University (NMSU). ASU brings expertise from the College of Health Solutions, the Department of Psychology, the Watts College of Public Service and Community Solutions, the School of Social Work and Southwest Interdisciplinary Research Center (SIRC), as well as the Substance use and Addiction Translational Research Network (SATRN). UNM and ASU have established strong collaborations with community and clinical partners including primary and specialty care sites, community treatment (Tx) settings, and community-based organizations committed to SUD treatment, harm reduction, and prevention. The SW region thrives on the strength of community relationships, which are essential for every facet of programmatic effectiveness. The success of the SW Node lies in its ability to conduct rigorous research, disseminate findings, implement solutions, and influence practice and policy, all rooted in robust community engagement. The SW Node goals are to: (1) Generate new res
