The Friends Research Institute (FRI) Social Research Center (SRC) was established in Baltimore in the mid-1960s to create a supportive environment for the interdisciplinary research of behavioral scientists who were seeking to understand and address the emerging heroin addiction epidemic. This body of research over the course of the next 30 years, led by the late Dr. David Nurco, examined the etiology, course, correlates, and consequences of heroin addiction. It further examined the application of specialized self-help support groups for patients treated with methadone maintenance, urine drug testing, and the use of opioid antagonist medications in the provision of probation and parole supervision of individuals with what is now termed opioid use disorder. Three particularly notable achievements of the SRC at that time were the:
- demonstration of the link between heroin addiction and crime. By examining self-reported criminal activity over the lifetime of heroin-addicted individuals, researchers determined that higher crime rates were associated with periods of active addiction and markedly lower crime rates were associated with periods of non-addiction;
- clarification of the drug-crime connection through the development of a typology of addiction that distinguished individual from situational determinants of addiction-related behavior; and
- determination of the impact of early developmental risk factors underlying vulnerability to addiction including associations with deviant peers, early onset of substance use and addiction, and high rates of poverty and unemployment in low-resource communities.
Recent Research Achievements
Building upon the work of Dr. Nurco and his colleagues, the SRC research agenda turned to services research and clinical trials to study the prevention, identification, and treatment of substance misuse and addiction and their correlates including HIV infection, criminal behavior, and decreased quality of life. These studies have been conducted in healthcare settings, schools, community substance abuse treatment programs, parole and probation offices, jails, and prisons.
Three particularly notable and more recent achievements of the SRC have resulted from clinical trials which found that:
- methadone treatment without counseling (termed interim treatment) compared to usual waiting list placement was associated with greater reduction in heroin use, HIV risk behavior, and arrest;
- methadone treatment prior to release from prison compared to referral to treatment was associated with greater reduction in heroin use in the community; and
- extended-release naltrexone treatment for opioid dependent adults with criminal justice involvement, compared to referral to treatment without medication, was associated with greater reduction in heroin use in a multi-site study led by the University of Pennsylvania.
Other recently completed FRI studies conducted by SRC researchers have included:
Medication Studies. The following implementation studies and clinical trials have examined the:
- implementation of pharmacotherapy in criminal justice settings;
- effectiveness of patient-centered methadone treatment;
- use of buprenorphine treatment as a reentry strategy for pre-release prisoners;
- efficacy of buprenorphine implants for opioid use disorder; and
- potential efficacy of multiple medications to treat cocaine use disorder.
Prevention Studies. The following prevention studies have evaluated:
- an after-school prevention program designed to reduce the initiation and escalation of substance use, risky sexual behaviors, and violence among high-risk urban African American youth; and
- the relationship between specific risk and protective factors and perceptions of HIV risk and involvement in risky sexual behaviors among high-risk African American youth.
Screening and Brief Intervention in Health Care Settings. The following studies of screening and brief intervention in general health care settings include:
- evaluation of a screening instrument (BSTAD; Brief Screener for Tobacco, Alcohol, and other Drugs) for adolescent primary care patients;
- development of a computerized alcohol screening and intervention tool for adolescent primary care patients based on the NIAAA practitioner’s guide;
- evaluation of a screen and brief assessment instrument for substance misuse [Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) Tool] among adult primary care patients through the NIDA Clinical Trials Network;
- the effectiveness of a computer- vs. clinician-delivered brief intervention for substance misuse in primary care in New Mexico; and
- implementation of a specialist vs. generalist model for brief intervention for substance misuse among adolescent primary care patients.
Substance Use Disorder Treatment Studies. Listed below are some of the recently completed studies of approaches to substance use disorder treatment:
- the effectiveness of intensive outpatient vs. outpatient counseling for opioid-dependent African Americans receiving buprenorphine treatment; and
- the effectiveness of initiating methadone treatment with vs. without counseling.
Current Research Studies
The SRC investigators have sought to improve the quality of life of Maryland residents through collaborations with the Baltimore City Health Department, the Maryland Department of Public Safety and Correctional Services, and numerous health care and substance use disorder treatment agencies. For a list of current FRI SRC research studies, please see SRC Research Projects.