UMass Chan Medical School has received CDC funding for a grant entitled “Supporting Treatment Access and Recovery through Linkage and Support” (grant # R01CE003514). This study is aligned with the CDC’s Strategic Priority Areas, including Healthy People 2030 Core Objectives, and Ending Epidemics. This study includes partners from the University of Massachusetts - Lowell Zuckerberg College of Health Sciences, Department of Public Health, and the University of Massachusetts - Amherst School of Public Health and Health Sciences, Department of Health Promotion and Policy, as well as community collaborations with the Worcester Department of Health and Human Services, the Worcester Emergency Management call center, and other community partners.

The prevalence of substance use disorders (SUD) in Massachusetts is 16% higher than the U.S. prevalence rate, and opioid-related deaths in Massachusetts are more than twice the national average. Further, in 2019, Massachusetts was ranked among the top 10 states in the country for overdose death rates per 100,000 people, with 2,215 reported deaths. In Worcester County alone, where this study will be conducted, there were 886 overdose deaths from 2018 to 2020, which accounted for nearly 14% of the total deaths in Worcester during this period. Worcester is also ranked 2nd highest in the state on a CDC social vulnerability index, indicating a need for additional resources to help address social determinants of health. Opioid use has increased since 2000, and it disproportionally affects individuals with co-occurring mental health and substance use disorders (COD). Thus, integrated multicomponent interventions to simultaneously address substance use, mental health and social determinants of health are needed. However, Multicomponent interventions for people with COD are beneficial, but more challenging to implement. Maintaining Independence and Sobriety through Systems Integration, Outreach and Networking (MISSION; www.missionmodel.org) is a multicomponent team approach, combining 3 evidence-based practices: 1) Dual Recovery Therapy (DRT), an integrated group therapy for COD; 2) Peer Support (PS), offering support by people with lived experience; and 3) Critical Time Intervention (CTI), a form of assertive community treatment. In the city of Worcester, The Department of Health and Human Services convenes over 30 local and state healthcare and social service providers (known as the “hub”) with the goal of linking people with COD and social determinants of health needs to treatment and services. 

This project innovatively embeds MISSION within the HUB and aims to increase treatment linkage, support recovery, and improve behavioral health outcomes among an acute population of individuals with COD and complex social determinants of health needs who often fall through the cracks of a fragmented and taxed healthcare system. This 2-year study will randomize 208 people with COD to evaluate the effectiveness of MISSION with peer specialists and case managers versus peer support alone, Participants will be recruited through the HUB program, and will be randomly assigned to either MISSION (with a case manager (CM) and peer support specialist (PSS) team) or peer support alone for 6 months of services Participants will also be followed for 9 months after their initial assessment, with follow-up assessments after 3, 6, and 9 months.