Linking Individuals Needing Care for Substance Use Disorders to Peer Coaches & Across INcarceration Settings (LINCS UP & IN)

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

Study Overview

• Status: Not yet recruiting
• Conditions: Substance Use
• Intervention / Treatment: Behavioral: Virtual Peer Recovery Coaching; Behavioral: Treatment as Usual

Detailed Description

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.

• Study Type: Interventional
• Enrollment (Estimated): 550
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Joseph Carpenter, MD; Phone Number: 404-778-5975; Email: jecarpe@emory.edu
• Study Contact Backup: Name: Yan Li; Email: yan.li@emory.edu

Study Locations

• United States
  • Georgia
    • Atlanta, Georgia, United States, 30318
      • Fulton County Jail
    • Atlanta, Georgia, United States, 30303
      • Atlanta City Detention Center
    • Decatur, Georgia, United States, 30032
      • Dekalb County Jail

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: PRC group; Participants meet virtually with a trained peer recovery coach using a secure telehealth platform. PRCs use motivational interviewing, assess readiness to change, and provide individualized linkage to recovery resources. Support may include connection to medications for opioid use disorder, residential treatment, detoxification centers, harm reduction services, mutual support groups, sober living, or recovery community organizations. PRCs may also conduct post-release check-ins to support ongoing engagement.	Behavioral: Virtual Peer Recovery Coaching; A telehealth session with a peer recovery coach who provides motivational interviewing and tailored linkage to addiction treatment and recovery resources.
Active Comparator: Standard of Care; Participants receive the jail's standard approach to substance use support. This includes a review of available community treatment and recovery resources consistent with existing facility practices. No peer recovery coach is involved, and no additional study-driven services are provided.	Behavioral: Treatment as Usual; Participants are provided information about community-based addiction treatment and recovery resources as part of routine jail processes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Engagement With at Least One Recovery Resource	Engagement with at least one recovery resource, defined as: Formal addiction treatment (visit with a physician, psychologist, or licensed substance use counselor; or ≥1 night in detoxification or residential treatment), or; Recovery Community Organization (RCO) participation (contact, intake, and participation in ≥1 evidence-based recovery activity), or; Harm reduction organization engagement. Engagement may occur during incarceration or in the community after release.	30 days and 90 days after enrollment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Days Receiving Medications for Substance Use Disorders	Number of days participants receive medications for opioid use disorder (MOUD), stimulant use disorder, or alcohol use disorder.	Baseline to 30 days, 90 days, 180 days, and 1 year
Recidivism and Justice Involvement	New arrests, bookings, or jail stays documented through participant report or administrative data.	Baseline to 1 year
Healthcare Utilization	Emergency department visits, hospitalizations, and other acute care encounters.	Baseline to 1 year
Recovery Capital (BARC-10)	Brief Assessment of Recovery Capital (BARC-10) A 10-item validated scale that measures a person's internal and external resources that support recovery from substance use. Items assess domains such as social support, coping skills, housing stability, and personal motivation.; Scores range from 10 to 60.; Higher scores indicate greater recovery capital and stronger readiness to sustain recovery.	Baseline, 30, 90, 180 days, and 1 year
Number of Peer Recovery Coach Contacts	Number of PRC interactions among participants assigned to the intervention arm.	Baseline to 30 days, 90 days, 180 days, and 1 year
Self-Reported Substance Use (TLFB)	Days of substance use in the past 30 days using the Timeline Follow-Back method. A structured calendar-based interview used to measure self-reported substance use over the past 30 days. Participants recall days of use using memory anchors (events, routines).	Baseline, 30, 90, 180 days, and 1 year
Fatal Overdose Events	Overdose events identified through participant report, medical records, or community partner data.	Baseline through 1 year
Nonfatal Overdose Events	Overdose events identified through participant report, medical records, or community partner data.	Baseline through 1 year
Housing status	Current housing status (stable, unstable, homeless)	Baseline, 30, 90, 180 days, and 1 year
Employment status	Employment status (full-time, part-time, unemployed)	Baseline, 30, 90, 180 days, and 1 year
Social connections and Isolation: PROMIS scale	A validated set of items assessing perceived social support, loneliness, and connectedness.; Generates T-scores standardized to the U.S. population (mean = 50, SD = 10).; Higher scores on Social Support = more support.; Used to evaluate social determinants of recovery.	Baseline, 30, 90, 180 days, and 1 year
All-Cause Mortality	Death from any cause, confirmed through vital records or the National Death Index.	Baseline through 1 year

Collaborators and Investigators

• Sponsor: Emory University
• Collaborators: National Institute on Drug Abuse (NIDA)
• Investigators: Principal Investigator: Joseph Carpenter, MD, Emory University

Study record dates

Study Major Dates

• Study Start (Estimated): June 1, 2026
• Primary Completion (Estimated): March 1, 2030
• Study Completion (Estimated): March 1, 2030

Study Registration Dates

• First Submitted: April 22, 2026
• First Submitted That Met QC Criteria: April 29, 2026
• First Posted (Actual): May 4, 2026

Study Record Updates

• Last Update Posted (Actual): May 4, 2026
• Last Update Submitted That Met QC Criteria: April 29, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Recovery; Support groups; Substance use disorders during incarceration
• Additional Relevant MeSH Terms: Mental Disorders; Chemically-Induced Disorders; Substance-Related Disorders; Therapeutics
• Other Study ID Numbers: 2025P012936; 1R01DA064519-01 (U.S. NIH Grant/Contract)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No