“Beyond the False Dichotomy” Bridging the MOUD-Mutual Help Group Divide

Wayne Kepner, PhD, MPH
Stanford University

ABSTRACT:
A significant barrier to addressing the opioid crisis is the "false dichotomy" between two of our most effective strategies; medications for opioid use disorder (MOUD) and 12-step mutual help groups (MHG). MOUD is the most effective pharmacological treatment to reduce mortality, while MHGs provide invaluable access to peer-based recovery capital. A fragmented system of care exists despite evidence that combining these approaches yields superior outcomes. Facilities offering recovery support services are nearly eight times more likely to exclude MOUD patients, forcing individuals to navigate seemingly incompatible systems where they may be discouraged from MOUD use, increasing risks of treatment discontinuation and overdose.

To contextualize this research, the presentation will briefly trace the history of mutual help groups and the evolution of the current MOUD-MHG divide. The talk will synthesize findings demonstrating strong preliminary, but ultimately incomplete, evidence that combining MOUD and MHG participation is associated with better treatment outcomes. It will highlight data showing MHG attendance is a strong predictor of treatment completion for MOUD patients and explore the mechanisms, such as adaptive social network changes, that may drive these synergistic effects. This presentation will also introduce a K01 research proposal designed to address this systemic failure by generating national and clinic-level evidence to inform a collaborative and community-co-designed strategy. The ultimate goal is to develop and test clinic-level strategies that improve MOUD retention and ensure patients can access the full continuum of care, thereby promoting long-term recovery and reducing opioid mortality.

Design for Digital Mental Health Interventions: Optimizing Engagement and Implementation

Andrea K. Graham, PhD
Northwestern University

ABSTRACT:
Efforts to translate evidence-based digital health interventions from research to real-world settings have struggled with sustained consumer engagement and the successful integration of these tools into their targeted systems of care. User-centered design involves collaborating with end-users throughout the process of intervention design, testing, and implementation to ensure the intervention meets consumers’ needs and preferences, to in turn increase uptake and engagement. This presentation will describe design methods that aim to increase engagement in intervention design and implementation, drawing on examples from applying these methods to mobile interventions for different mental and behavioral health problems.