Linking Individuals Needing Care for Substance Use Disorders to Peer Coaches & Across INcarceration Settings

Linking Individuals Needing Care for Substance Use Disorders to Peer Coaches & Across INcarceration Settings

The goal of this study is to learn whether a virtual peer recovery coach (PRC) intervention can improve engagement in addiction treatment among incarcerated adults with substance use disorders.

The main questions it aims to answer are:

• Does the PRC intervention increase engagement with at least one recovery resource at 30 and 90 days?
• Does it improve secondary outcomes such as substance use, recovery capital, overdose events, and recidivism?

Researchers will compare Treatment-as-Usual with the PRC telehealth intervention to see if PRC support improves engagement in addiction care.

Participants will:

• Complete baseline and follow-up assessments
• Receive either Treatment-as-Usual or a virtual PRC session focused on motivational interviewing and linkage to recovery resources

This study evaluates a virtual peer recovery coach (PRC) intervention designed to support adults with substance use disorders during incarceration and the transition back to the community. The trial is conducted across multiple jail facilities in Metro Atlanta, where individuals experience high rates of substance use disorders and limited access to treatment services. Peer recovery coaches-individuals with lived experience who are trained in motivational interviewing and linkage to care-have demonstrated benefit in healthcare settings, but their effectiveness within jail environments has not been rigorously tested.

The intervention adapts an existing virtual PRC model for use in jail settings. PRCs meet with participants through a secure telehealth platform and provide individualized support focused on motivation, readiness for change, and connection to recovery resources. The model is designed to be scalable, flexible, and responsive to the needs of individuals with diverse substance use profiles, including those for whom no FDA-approved medications exist.

The study uses a phased implementation approach in which participating jail sites transition from usual care to the PRC intervention over time. This structure allows the program to be integrated into each facility's workflow while enabling evaluation of the intervention's impact. Participants are followed for one year to assess engagement with recovery resources and other indicators of health, stability, and community reintegration.

The findings will inform whether virtual PRC services can be effectively delivered in jail settings and whether they improve connection to treatment and recovery supports during a period of heightened vulnerability. Results may guide future implementation of peer-based models in correctional systems and other high-risk environments.

Inclusion Criteria:

• Incarcerated at participating jail
• Able to speak and understand English
• Score of 3 or greater - "moderate level", "substantial level", or "severe level" of problems related to drug abuse - on DAST-10.
• Willing to follow study procedures and complete research follow-up calls
• Have at least two reliable contact numbers, e.g. participant and one or more relatives or close friends

Exclusion Criteria:

• Cognitive impairment (inability to comprehend the informed consent document as assessed by study staff during enrollment)
• Prior participation in the study
• Awaiting transfer to prison or jail outside the state of Georgia