This project is a hybrid type I clinical trial to assess the effectiveness and implementation determinants of a peer-led court navigation program for people who use drugs and are passing through county courthouses. Courthouses are a common point of contact for people with behavioral health needs, but outside of specialty court models, they remain underexplored as a setting for connecting people to substance use disorder treatment and related services. This study will test whether court navigation led by peer recovery specialists can increase receipt of substance use disorder treatment and reduce overdose and incarceration. Peer court navigators will meet with participants in courthouse settings, assess their needs, provide information and referrals, and offer follow-up support for up to 3 months. Peer recovery specialists, who have lived experience with substance use recovery, are increasingly being integrated into criminal legal and community-based settings; however, peer-led court navigation remains an innovative and understudied approach.

Inclusion Criteria:

• Aged 18 years or older
• Current resident of Indiana
• Able to complete study procedures in English
• Meets at least one of the following criteria: used heroin, fentanyl, methamphetamine, or cocaine in the past 12 months; is interested in resources or treatment for a substance use disorder; or experienced an opioid-related overdose in the past 12 months

Exclusion Criteria:

• Has been sentenced to incarceration in jail or prison for the next 12 months

The investigators will enroll 600 subjects over 24 months with 12 months of follow-up data by linking administrative records (e.g., prescription fills, emergency department/emergency medical services encounters, mortality, arrests/jail bookings) to survey contents that will include demographics, substance use disorder and treatment history, criminal legal system involvement, social constructs (self-efficacy, motivation, stigma), and harmonized measures. The National Institutes of Health requires that the study team release study data. The investigators will preserve and share de-identified survey datasets (with codebooks), and project documentation (protocols, instruments); derived variables from linked administrative data will be shared, while raw state administrative source files obtained under data use agreements will not be shared. The publicly released scientific data will include only fully de-identified data.

IPD and additional supporting information will be archived in the National Addiction & HIV Data Archive Program (NAHDAP), assigned persistent identifiers, and made available as soon as possible and no later than the earlier of the primary publication or the end of the performance period, whichever comes first.

After project completion, only de-identified datasets will be made available as public-use files and deposited in repositories for broader research, teaching, replication. Shared data will be provided in open, non-proprietary formats, along with parallel Stata/R scripts and a README so that no specialized software is required to access or manipulate the data. Publicly shared datasets will receive a DOI to facilitate sharing, citation, and version control. Access will be controlled when there is any non-trivial re-identification risk or when required by data use agreements. In those cases, repositories will gate access under standard data use agreements that prohibit re-identification and onward sharing, require secure storage and destruction at project end, and log requestor credentials and approved uses. Raw state administrative source files received under data use agreements will not be shared; only de-identified, derived variables constructed from those sources will be deposited.