In a randomized controlled trial, with 3, 6-month and 1-year follow-up, this application aims to explore whether and how the HOPE intervention can be adapted to increase MOUD uptake among OUD patients, assess the effectiveness of using HOPE to increase MOUD requests, and analyze online community data to improve future intervention implementation and sustainability.

The proposed study is a low-risk, randomized control trial to assess the efficacy of the HOPE (Harnessing Online Peer Education) intervention, an evidenced-based peer-led social media/online community intervention (e.g., Facebook Groups), to increase self-reported requests for medications for opioid use disorder (MOUD) among patients with moderate to severe opioid use disorder (OUD). Participants will be recruited using a variety of recruitment methods including social media sites (e.g., Facebook), referral by physicians, medical records, research study websites (e.g., UCIMC Clinical Trials website), and study flyers disseminated at various venues, including clinics, group meetings, and shelters. Once enrolled, participants will be randomly assigned to an intervention or control group. Intervention group participants will be invited to join a private and hidden (unable to be viewed or searched for by others) group on Facebook, with approximately 6 peer leaders included in the group. Those in the control group will be invited into a Facebook group, but without peer leaders. The intervention will last 12 weeks. Study measures will be collected at the beginning of the study (baseline), after the completion of the intervention (3 months), with follow up surveys at 6 and 12 months after the study. Participants will be recruited in 5 waves, 2 waves of rural residents and 3 waves of urban residents.

Inclusion Criteria:

1. ≥ 18 years of age;
2. Resident of CA, NV, AZ, OR, WA;
3. English speakers only;
4. Has moderate to severe OUD;
5. Is not currently prescribed MOUD;
6. Reports using social media at least 2x per week;
7. Has, or is willing to create a Facebook/social media account and accept a friend request and group invite from our study social media page

Exclusion Criteria

1. Anyone who does not fit inclusion criteria above
2. Was a participant in phase I of the study
3. Participants with active, unstable opioid, alcohol, sedative, or other substance use and/or unstable medical or psychiatric conditions as assessed by the study questionnaires will be reviewed by the study physician consultants and will be excluded and referred for acute care including detoxification, if needed.