# Peer Engagement in Methamphetamine Harm-Reduction with Contingency Management (PEER-CM)

> **NIH NIH R01** · OREGON HEALTH & SCIENCE UNIVERSITY · 2022 · $1,936,443

## Abstract

Project Summary/Abstract
Use of fentanyl and methamphetamine (MA) made 2021 the deadliest year ever for people using drugs in the
United States (US). Intentional co-use as well as rising adulteration of MA with fentanyl elevate the risks and
harms associated with MA use – the age-adjusted rate of drug overdose deaths involving psychostimulants
(primarily MA) increased 10-fold between 2009 and 2019. Little is known about preventing overdoses involving
MA or engaging people using MA in harm reduction and treatment. Strategies to engage people who use MA
in harm reduction activities are essential. Contingency management (CM) uses rewards to incentivize
behaviors and is the most efficacious strategy for improved retention in treatment and reduced stimulant use.
Peer recovery support specialists reach people not seeking treatment to help them identify harm reduction
goals and engage in treatment. The PEER-CM study combines both evidence-based interventions—CM and
peer engagement--to decrease overdose and improve engagement in harm reduction services for people who
use MA. Our network of peer harm reduction organizations is eager to identify optimal strategies for
implementing Oregon’s recent approval of sustainable CM funding to reduce overdose. The PEER-CM study
tests the effect of incentivizing achievement of self-identified, personal harm reduction goals compared with
standard of care (peer harm reduction service with incentives for peer visits) to increase the reach and
effectiveness of MA harm reduction services. A hybrid type 1 effectiveness-implementation framework and
stepped-wedge design randomizes eighteen community-based peer harm reduction sites to provide standard
of care (incentives for peer encounters) versus client achievement of self-identified, personal harm reduction
goals. Peers assist clients in setting personal harm reduction goals using a client-driven harm reduction goal-
setting process focused on completing harm reduction supply training, possessing harm reduction supplies,
daily life goals, treatment and care goals, and relationship and social support goals. The CM intervention is
rolled out at three-month intervals in the stepped-wedge design (2 peer sites at a time). Peers manage
incentives and facilitate progress towards meeting self-identified goals. Aim 1 tests the impact of incentives for
achieving self-identified, personal harm reduction goals on the likelihood of overdose among people using MA.
Aim 2 determines whether incentives for achieving self-identified, personal harm reduction goals increase
engagement with harm reduction and treatment services. Aim 3 completes qualitative interviews to understand
the optimal context and implementation strategies for peer-facilitated contingency management. The PEER-
CM study advances a patient-centered, sustainable, scalable, and innovative contingency management model
to increase the impact of harm reduction delivered outside of traditional treatment networks and stem the ti...

## Key facts

- **NIH application ID:** 10590236
- **Project number:** 1R01DA057670-01
- **Recipient organization:** OREGON HEALTH & SCIENCE UNIVERSITY
- **Principal Investigator:** Philip Todd Korthuis
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $1,936,443
- **Award type:** 1
- **Project period:** 2022-09-30 → 2025-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10590236

## Citation

> US National Institutes of Health, RePORTER application 10590236, Peer Engagement in Methamphetamine Harm-Reduction with Contingency Management (PEER-CM) (1R01DA057670-01). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10590236. Licensed CC0.

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