# 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. · 2022 · $492,562

## Abstract

PROJECT SUMMARY. Young adults with opioid use disorders (OUD) are disproportionately affected by the
current opioid crisis and have poorer treatment engagement and adherence compared to their older
counterparts with catastrophic consequences. As such, the identification of neural networks and behavioral
predictors of treatment adherence and abstinence outcomes related to relapse prevention medication
treatment for OUD (termed MOUD) in young adults is of great importance and may enhance treatment
refinement efforts and improve precision and efficacy of treatment matching. The purpose of this
administrative supplement to NIDA R33DA056230 is to identify neurobehavioral features (brain activity,
functional connectivity (FC), and cognition and social/emotional processes) at baseline that are related to
medication adherence and opioid relapse (Aim 1) in young adults with OUD receiving extended-release
injectable naltrexone (XR-NTX) or buprenorphine (XR-BUP) medication treatment, and investigate how these
neurobehavioral features change during treatment (Aim 2). The supplement will use a mechanism-focused
prospective ‘add-on’ pre-to-post-treatment study design linked to the parent grant’s randomized controlled trial
(RCT) testing the efficacy of enhanced recovery support through the Youth Opioid Recovery Support (YORS)
program, a developmentally-informed intervention that incorporates home delivery of MOUD, family
engagement, assertive outreach, and contingency management to promote medication adherence. The parent
RCT will randomize N=120 young adults ages 18-28 seeking treatment for OUD with XR-NTX or XR-BUP to
either the YORS intervention or treatment as usual (TAU) for a 6-month course of MOUD treatment. In the
supplement project, N=65 young adults from the parent treatment grant (estimated N=32 each choosing XR-
NTX and XR-BUP) who meet MRI eligibility criteria and are randomized to receive the YORS intervention will
complete pretreatment and week-12 fMRI scan visits and a pre-treatment ‘deep’ behavioral phenotyping
assessment visit. During scan visits, participants will complete fMRI scans during rest, opioid cue exposure,
emotional faces presentation, and reward. Data on opioid addiction severity, withdrawal, cravings, impulsivity,
mood/anxiety, cognitive regulation skills, decision making, and psychiatric diagnoses will be collected during
the behavioral assessment visit. Integrated aspects of the fMRI/phenotyping supplement project and main
YORS study will allow for investigation of how resting-state and task-related brain activity and connectivity, and
cognitive and social/emotional processes relate to opioid relapse and medication adherence and change
during treatment in young adults receiving MOUD treatment. It will also allow for exploratory, albeit
underpowered, analyses examining mediating effects of medication choice (XR-BUP versus XR-NTX) on
relationships identified in the primary analyses between brain connectivity, opioid relapse, and...

## Key facts

- **NIH application ID:** 10594594
- **Project number:** 3R33DA056230-02S1
- **Recipient organization:** MARYLAND TREATMENT CENTERS, INC.
- **Principal Investigator:** MARC FISHMAN
- **Activity code:** R33 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $492,562
- **Award type:** 3
- **Project period:** 2019-08-28 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10594594

## Citation

> US National Institutes of Health, RePORTER application 10594594, The Youth Opioid Recovery Support (YORS) Intervention: An assertive community treatment model for improving medication adherence in young adults with opioid use disorder (3R33DA056230-02S1). Retrieved via AI Analytics 2026-05-29 from https://api.ai-analytics.org/grant/nih/10594594. Licensed CC0.

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