# The Youth Opioid Recovery Support (YORS) Intervention: An assertive community treatment model for improving medication adherence in young adults with opioid use disorder

> **NIH NIH R33** · MARYLAND TREATMENT CENTERS, INC. · 2021 · $2,465,674

## Abstract

Project Summary/Abstract:
 Young people are disproportionately affected by the current opioid crisis including worse retention and
outcomes compared to older adults. Further, young adults typically do not have access to medications for
opioid use disorder (OUD), and for those that do, struggles with adherence are a major barrier. Standard
approaches to treatment typically do not incorporate developmentally informed strategies for engagement,
retention, and medication adherence for this special population.
 The Youth Opioid Recovery Support (YORS) model is an innovative wrap-around approach that attempts
to address barriers to treatment engagement in this vulnerable young adult population, especially difficulties
with medication adherence. Its components include: (1) Home delivery of extended release naltrexone (XR-
NTX) for OUD; (2) Engagement of families in collaborative treatment planning and monitoring focusing on
medication adherence; (3) Assertive outreach from the treatment team including actively tracking and
communicating with youth and families by text messaging and social media to promote engagement and
adherence; and (4) Contingency management to provide incentives for medication adherence. YORS is
currently showing very promising results in a small pilot RCT by the investigative team.
 We propose to refine and then conduct a more definitive test of the YORS intervention for youth with OUD
using the R61/R33 mechanism. In the R61 phase we will conduct stakeholder focus groups to get input and
feedback on potential refinements, while also conducting 3 cycles of pilot testing of these potential refinements.
Based on the R61 preparation and final synthesis of the intervention refinements, in the R33 phase we will
conduct an RCT to test the efficacy of YORS, by randomizing N=120 young adults ages 18-26 seeking
treatment for OUD with XR-NTX at Mountain Manor Treatment Center (MMTC), to either the refined YORS
intervention or treatment as usual (TAU) for a 6-month course of treatment with XR-NTX.
 The primary outcome will be number of XR-NTX doses received. Secondary outcomes will include opioid
relapse, days of opioid use, time to first opioid relapse, HIV risk behaviors, criminal behaviors, psychiatric
symptoms, and family member distress and self-efficacy. It is hypothesized that participants in the YORS
condition will receive significantly more XR-NTX doses and will demonstrate less severe opioid use and
associated behaviors compared to those in the TAU group. The assertive YORS intervention has the potential
to improve the real-world effectiveness and public health impact of medication for OUD in this very high-risk,
vulnerable population. If the refined YORS intervention is found to be efficacious, it would set the stage for
future work including: an economic analysis, a larger multi-site study, longer intervention duration, study of
extended release buprenorphine, and study of step-down to less intensive interventions.

## Key facts

- **NIH application ID:** 10467167
- **Project number:** 4R33DA056230-02
- **Recipient organization:** MARYLAND TREATMENT CENTERS, INC.
- **Principal Investigator:** MARC FISHMAN
- **Activity code:** R33 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $2,465,674
- **Award type:** 4C
- **Project period:** 2019-08-28 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10467167

## Citation

> US National Institutes of Health, RePORTER application 10467167, The Youth Opioid Recovery Support (YORS) Intervention: An assertive community treatment model for improving medication adherence in young adults with opioid use disorder (4R33DA056230-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10467167. Licensed CC0.

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