Optimizing parental involvement in the recovery of young adults with opioid use disorder: A qualitative exploration of a contingency management support app

Opioid use disorder (OUD) is associated with numerous negative outcomes among young adults (YAs), including Hepatitis and HIV transmission, criminal behavior, and overdoses, which rose across the United States by nearly 30 percent during 2020. Our previous research indicates a need for supplemental support options for YAs in early stages of recovery, and recent smartphone recovery apps offer potential new tools that can also help the family system mitigate issues related to trust and accountability.

This pilot study recruited YAs with OUD (n=10), aged 18-26, who were engaged in, or just recently discharged from a residential and outpatient treatment setting, as well as a primary caregiver for the YA (n=5) to form a dyad. YAs and caregivers each completed independent interviews that explored perceived issues and barriers related to treatment engagement, issues and barriers facing caregivers during the YAs early recovery, conflicts within the family system, and the perceived utility of a novel smartphone recovery app. A subsample consisting of 3-dyads (n=6) was also selected to complete product demonstrations to further explore their perceived utility of the app in greater detail. Interviews were approximately 40-60 minutes in duration, transcribed for accuracy, and analyzed using Atlas.ti.

Youth perceptions related to the likelihood that they would use the app if offered were mixed, but most reported the greatest promise of the recovery coaching and financial incentives for negative substance screens. Youth and their caregivers both agreed that this type of app would promote trust, provide accountability, and ultimately reduce conflict among family members. However, youth did not believe this type of app would prevent their relapse if they had already decided to use.

As smartphone apps related to treatment and recovery gain popularity, consideration should be given to those features that demonstrate the most promise in achieving patient-centered goals.