Substance Use Disorder (SUD) has been recognized as a chronic, relapsing disorder. However, much of existing SUD care remains based in an acute care model that focuses on clinical stabilization and discharge, failing to address the longer-term needs of people in recovery from addiction. The high rates of client’s disengagement and attrition across the continuum of care highlight the need to identify and overcome the obstacles that people face at each stage of the treatment and recovery process. Peer recovery support services (PRSS) show promise in helping people initiate, pursue, and sustain long-term recovery from substance-related problems. Based on a comprehensive review of the literature, the goal of this article is to explore the possible roles of peers along the SUD care continuum and their potential to improve engagement in care by targeting specific barriers that prevent people from successfully transitioning from one stage to the next leading eventually to full recovery. A multidimensional framework of SUD care continuum was developed based on the adapted model of opioid use disorder cascade of care and recovery stages, within which the barriers known to be associated with each stage of the continuum were matched with the existing evidence of effectiveness of specific PRSSs. With this conceptual paper, we are hoping to show how PRSSs can become a complementary and integrated part of the system of care, which is an essential step toward improving the continuity of care and health outcomes.

La percepción de riesgo es el componente central en los modelos teóricos de comportamiento y la toma de decisiones. El presente artículo ofrece una revisión del estado actual de la investigación de la percepción social de riesgo. Especialmente, nos enfocaremos en la percepción de riesgos en salud y la tendencia de los individuos a menospreciar el riesgo personal de determinada enfermedad. Conocer la naturaleza de la percepción de riesgo personal de los individuos es clave para el desarrollo de la comunicación en salud más efectiva.

The volatile opioid epidemic is associated with higher levels of opioid use disorder (OUD) and negative health outcomes in adolescents and young adults. Medications for opioid use disorder (MOUD) demonstrate the best evidence for treating OUD. Adherence to and retention in MOUD among adolescents and young adults, however, is incompletely understood. This systematic review examines the state of the literature regarding the association of age with adherence to and retention in MOUD using methadone, buprenorphine, or naltrexone among persons aged 10 to 24 along with related facilitators and barriers. The research team searched for all studies of MOUD that examined adherence, retention, or related concepts as an outcome variable where the sample included adolescents or young adults. Search criteria generated 10,229 records, which, after removing duplicates and conducting title/abstract screening, yielded 587 studies for full-text review. Ultimately, 52 articles met inclusion criteria for abstraction and 17 were selected for qualitative coding and analysis. This review found younger age to be consistently associated with shorter retention in the published literature, although the overall quality of included studies was low. Several factors at the individual, interpersonal, and institutional levels, such as concurrent substance use, MOUD adherence, family conflict, and MOUD dosage and flexibility, were seen as playing a role in MOUD retention among adolescents and young adults. This review highlights how MOUD providers can tailor treatment to increase retention of adolescents and young adults while pointing to the need for more research explaining MOUD adherence and retention disparities in this age group.

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Person-centered recovery planning (PCRP) has been a key aspect in mental health system transformation and delivering quality health care. Despite the mandate to deliver this practice and a growing evidence base, its implementation and understanding of implementation processes in behavioral health settings remain a challenge. New England Mental Health Technology Transfer Center (MHTTC) launched the PCRP in Behavioral Health Learning Collaborative to support agencies’ implementation efforts through training and technical assistance. In an effort to explore and understand the internal implementation process changes facilitated by the learning collaborative, the authors conducted qualitative key informant interviews with the participants and the leadership of the PCRP learning collaborative. The interviews revealed the processes that are part of the PCRP implementation efforts, including staff training, changing agency policies and procedures, modifying treatment planning tools, and the structure of the electronic health records. The higher prior organizational investment and readiness for change, building staff’s competencies in PCRP, leadership investment, and frontline staff buy-in act as factors that facilitate the implementation of PCRP in behavioral health settings. Our findings inform both the implementation of PCRP in behavioral health settings and future efforts of organizing multi-agency learning collaboratives to support PCRP implementation. Supplementary Information The online version contains supplementary material available at 10.1007/s43477-023-00078-3.