About

Kirsten Langdon, PhD, is a clinical psychologist at the Brown University Health Recovery Center and an associate professor in the Department of Psychiatry and Human Behavior at The Warren Alpert Medical School of Brown University. She received her doctoral degree in clinical psychology from the University of Vermont in Burlington. Dr. Langdon completed her residency in clinical psychology at The Warren Alpert Medical School of Brown University and affiliated hospitals, and a fellowship in clinical research at the National Center for PTSD Women’s Health Sciences Division at the VA Boston Healthcare System. Her research focuses on identifying and modifying cognitive and affective mechanisms that underlie the co-occurrence of mood/anxiety and substance use disorders. She is an active member of the Society for Research on Nicotine & Tobacco and the Association for Contextual Behavioral Science.

Research topics

• Medicine
• Psychology
• Clinical psychology
• Psychiatry
• Emergency medicine

Selected publications

• Improving Social Connectedness among Justice Involved Individuals with OUD during Reentry: Protocol for a Pilot Randomized Controlled Trial of a Digital Support Intervention (Preprint)

  2026-04-06

  articleOpen access

  <sec> <title>BACKGROUND</title> Medication for Opioid Use Disorder (MOUD) is highly effective in promoting recovery and reducing overdose among justice-involved individuals. However, the challenges encountered during community reentry can undermine recovery efforts, leading to a discontinuation of MOUD, recurrent drug use, and heightened risk for overdose and death. Individuals with justice involvement may be particularly prone to experiencing loneliness and lack of social connectedness, which can further impact recovery. Peer support is a key component of many evidence-based Opioid Use Disorder (OUD) recovery programs, yet accessing this form of support has become increasingly difficult due to limited staffing resources. Technology-based solutions overcome many of the barriers to accessing support and can provide “on demand” availability. The goal of this study protocol is to assess the use of a secure, dedicated mobile application to improve access to social support among an at-risk population experiencing heightened isolation and loneliness. </sec> <sec> <title>OBJECTIVE</title> This study aims to evaluate the Marigold Health Peer Support (MPS) App for providing digital health peer support to justice-involved individuals with a history of engaging in MOUD. Specifically, this study will examine the feasibility and acceptability of the intervention, as well as its preliminary effect on perceived social support and loneliness. </sec> <sec> <title>METHODS</title> This study will include two phases. Phase 1 will consist of qualitative interviews with prospective app users (n = 15-20) and key stakeholders relevant to criminal justice settings (n = 8-10), which will be used to inform the intervention in Phase 2. A preliminary randomized controlled trial (RCT) will be conducted in Phase 2, comparing the MPS App condition to enhanced treatment-as-usual (eTAU). Individuals with a history of engaging in MOUD while in jail/prison (n = 90) will be asked to complete a baseline interview and follow-ups at 1, 3, and 6 months. Perceived social support and loneliness will be the primary outcomes, and substance use and engagement in MOUD will be secondary outcomes. </sec> <sec> <title>RESULTS</title> Phase 1 of this trial began in August, 2023 and is ongoing. Phase 2 began in March, 2025 and is ongoing. </sec> <sec> <title>CONCLUSIONS</title> This study has the potential to address the intertwined epidemics of OUD and incarceration by examining the utility of a secure and highly accessible mobile app among individuals with a history of engaging in MOUD while in jail/prison. If successful, our study will demonstrate the feasibility, acceptability, and preliminary efficacy of a novel and potentially scalable intervention designed to facilitate peer support among a population experiencing high degrees of loneliness. </sec> <sec> <title>CLINICALTRIAL</title> NCT06896656 </sec>

  PublisherDOI

• A Conceptual Model of Opioid Use Pathways: Addressing the Prescription-to-Illegal Opioid “Transition”

  Current Addiction Reports · 2025-11-25

  articleSenior author
  PublisherDOI

• Randomised clinical trial of a 16 mg vs 24 mg maintenance daily dose of buprenorphine to increase retention in treatment among people with an opioid use disorder in Rhode Island: study protocol paper

  BMJ Open · 2024-11-01 · 2 citations

  articleOpen access

  INTRODUCTION: Buprenorphine is a highly effective treatment for opioid use disorder (OUD). However, provider observations and preliminary research suggest that the current standard maintenance dose may be insufficient for suppressing withdrawal and preventing cravings among people who use or have used fentanyl. Buprenorphine dosing guidelines were based on studies among people who use heroin and have not been formally re-evaluated since fentanyl became predominant in the unregulated drug supply. We aim to compare the effectiveness of a high (24 mg) vs standard (16 mg) maintenance daily dose of buprenorphine for improving retention in treatment, decreasing the use of non-prescribed opioids, preventing cravings and reducing opioid overdose risk in patients. METHODS AND ANALYSIS: Adults who are initiating or continuing buprenorphine for moderate to severe OUD and have a recent history of fentanyl use (n=250) will be recruited at four outpatient substance use treatment clinics in Rhode Island. Patients continuing buprenorphine must be on doses of 16 mg or less and have ongoing fentanyl use to be eligible. Participants will be randomly assigned 1:1 to receive either a high (24 mg) or standard (16 mg) maintenance daily dose, each with usual care, and followed for 12 months to evaluate outcomes. Providers will determine the buprenorphine initiation strategy, with the requirement that participants reach the study maintenance dose within 7 days of randomisation. Providers may adjust the maintenance dose, if clinically needed, for participant safety. The primary study outcome is retention in buprenorphine treatment at 6 months postrandomisation, measured using clinical and statewide administrative data. Other outcomes include non-prescribed opioid use and opioid cravings (secondary), as well as non-fatal or fatal opioid overdose (exploratory). ETHICS AND DISSEMINATION: This protocol was approved by the Brown Institutional Review Board (STUDY00000075). Results will be presented at conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT06316830.

  PublisherOA PDFDOI

• Effect of a peer‐led emergency department behavioral intervention on non‐fatal opioid overdose: 18‐month outcome in the Navigator randomized controlled trial

  Addiction · 2024-07-10 · 6 citations

  articleOpen access

  BACKGROUND AND AIMS: Emergency departments (EDs) provide an opportunity to identify people at risk of overdose and reduce the risk. We evaluated the effect of an ED behavioral intervention delivered by peer recovery support specialists (PRSSs) on non-fatal opioid overdose. DESIGN: Two-arm, randomized trial. SETTING: Two EDs in Rhode Island, USA. PARTICIPANTS: ED patients presenting with an opioid overdose, complications of opioid use disorder or a recent history of opioid overdose (November 2018-May 2021). Among 648 participants, the mean age was 36.9 years, 68.2% were male and 68.5% were White. INTERVENTION AND COMPARATOR: Participants were randomized to receive a behavioral intervention from a PRSS (n = 323) or a licensed clinical social worker (LICSW) (n = 325). PRSS and LICSW used evidence-based interviewing and intervention techniques, informed by their lived experience (PRSS) or clinical theory and practice (LICSW). MEASUREMENTS: We identified non-fatal opioid overdoses in the 18 months following the ED visit through linkage to statewide emergency medical services data using a validated case definition. The primary outcome was any non-fatal opioid overdose during the 18-month follow-up period. FINDINGS: Among 323 participants randomized to the PRSS arm, 81 (25.1%) had a non-fatal opioid overdose during follow-up, compared with 95 (29.2%) of 325 participants randomized to the LICSW arm (P = 0.24). There was no statistically significant difference in the effectiveness of randomization to the PRSS arm versus the LICSW arm on the risk of non-fatal opioid overdose, adjusting for the history of previous overdose (relative risk = 0.86, 95% confidence interval = 0.67-1.11). CONCLUSIONS: In Rhode Island, USA, over one-in-four emergency department patients at high risk of overdose experience a non-fatal opioid overdose in the 18 months post-discharge. We found no evidence that the risk of non-fatal opioid overdose differs for emergency department patients receiving a behavioral intervention from a peer recovery support specialist versus a licensed clinical social worker.

  PublisherOA PDFDOI

• Interpersonal trauma, shame, and substance use: A systematic review

  Drug and Alcohol Dependence · 2024-03-06 · 9 citations

  reviewOpen access
  PublisherOA PDFDOI

• Recovery Capital and Subsequent Overdose Risk and Addiction Treatment Engagement Among Emergency Department Patients at High Risk of Opioid Overdose

  Substance Use & Misuse · 2024-12-01 · 1 citations

  articleOpen access

  BACKGROUND: Emergency department (ED) visits are an opportunity to provide prevention services to people at high risk of overdose. Considering patients' resources to initiate and sustain recovery ("recovery capital") may be useful for tailoring ED services, although its relevance in this population is unknown. METHODS: This secondary analysis used data from ED patients at high risk of opioid overdose enrolled in a randomized controlled trial in Rhode Island (2018-2021). We assessed baseline recovery capital using the Brief Assessment of Recovery Capital (BARC-10), dichotomized as a total score <47 versus ≥47. Post-discharge addiction treatment engagement within 30 days and non-fatal opioid overdose and fatal overdose within 18 months were assessed using statewide administrative data. We used modified Poisson regression and Cox proportional hazards models to estimate the association between recovery capital and (1) treatment engagement and (2) overdose risk, respectively, adjusting for potential confounders. RESULTS: Among 543 participants, 32.2% had a baseline BARC-10 total score of ≥47, 32.6% engaged in treatment within 30 days, and 25.6% had a non-fatal opioid overdose and 4.2% had a fatal overdose within 18 months. BARC-10 total score was not associated with treatment engagement within 30 days (adjusted relative risk = 0.79, 95% confidence interval [CI] = 0.60-1.05) or non-fatal opioid overdose (adjusted hazard ratio [aHR] = 0.83, 95%CI = 0.57-1.20) or fatal overdose (aHR = 0.45, 95%CI = 0.14-1.40) within 18 months. CONCLUSION: The majority of ED patients at high risk of opioid overdose had a BARC-10 total score of <47, suggesting low recovery capital. BARC-10 total score was not associated with post-discharge treatment engagement or overdose risk.

  PublisherOA PDFDOI

• Increasing Peer Support for Opioid Use Disorder Recovery During COVID-19 Through Digital Health: Protocol for a National Randomized Controlled Trial

  Iproceedings · 2023-01-31

  articleOpen access

  Background Increasing numbers of opioid overdoses have been observed during the COVID-19 pandemic, likely reflecting the pandemic’s multiple effects on this already vulnerable population. People in recovery from opioid use disorder (OUD) have reported disproportionate psychosocial distress and isolation, as well as significant disruptions in access to treatment, including peer support, during the COVID-19 pandemic. Peer support is a key component of many evidence-based OUD recovery programs; it improves recovery capital, treatment engagement, and perceived social support and reduces psychosocial distress, particularly when used in conjunction with other evidence-based treatments, such as medication for OUD. Objective This study aims to evaluate a novel mobile peer support app platform among a national sample of individuals in recovery from OUD as an adjunct to usual care during the COVID-19 pandemic. Methods Individuals residing in the United States who are aged ≥18 years; own a smartphone; and self-report being in recovery for an OUD, being in treatment for an OUD (ie, in the past 30 days received prescribed methadone, naltrexone, or buprenorphine), or currently receiving some form of assisted recovery support (n=1300) will be recruited through online, targeted social media advertisements. Eligible participants will be randomly assigned (1:1) to a mobile peer recovery support intervention utilizing a novel smartphone-based app or to a control. Participants will complete 1 baseline survey and then a follow-up survey 1, 3, and 6 months after randomization. The primary aim of recovery capital will be determined by the change in recovery capital between study groups over the 6-month study period. We will also examine treatment engagement by using administrative data from a subset of individuals (n=650) residing in Rhode Island and Indiana. Results As of June 2022, we enrolled 43 participants. Conclusions If this mobile app demonstrates efficacy among a large national sample of patients, it has the potential to augment existing treatment programs, improve recovery capital, and reduce the disproportionate impacts of COVID-19 on this vulnerable population. Conflicts of Interest None declared. Trial Registration ClinicalTrials.gov NCT05405712; https://clinicaltrials.gov/ct2/show/NCT05405712

  PublisherOA PDFDOI

• Integrating long-acting injectable treatment to improve medication adherence among persons living with HIV and opioid use disorder: study protocol

  Addiction Science & Clinical Practice · 2023-10-14 · 5 citations

  articleOpen access1st authorCorresponding

  BACKGROUND: Oral antiretroviral therapy (ART) has been effective at reducing mortality rates of people with HIV. However, despite its effectiveness, people who use drugs face barriers to maintaining ART adherence. Receipt of opioid agonist treatment, in the context of HIV care, is associated with medication adherence and decreased HIV viral loads. Recent pharmacological advancements have led to the development of novel long-acting, injectable, medications for both HIV (cabotegravir co-administered with rilpivirine) and OUD (extended-release buprenorphine). These therapies have the potential to dramatically improve adherence by eliminating the need for daily pill-taking. Despite the extensive evidence base supporting long-acting injectable medications for both HIV and OUD, and clinical guidelines supporting integrated care provision, currently little is known about how these medications may be optimally delivered to this population. This paper presents the study design for the development of a clinical protocol to guide the delivery of combined treatment for HIV and OUD using long-acting injectable medications. METHODS: The study aims are to: (1) develop a clinical protocol to guide the delivery of combined LAI for HIV and OUD by conducting in-depth interviews with prospective patients, clinical content experts, and other key stakeholders; and (2) conduct This single group, open pilot trial protocol to assess feasibility, acceptability, and safety among patients diagnosed with HIV and OUD. Throughout all phases of the study, information on patient-, provider-, and organizational-level variables will be collected to inform future implementation. DISCUSSION: Findings from this study will inform the development of a future study to conduct a fully-powered Hybrid Type 1 Effectiveness-Implementation design.

  PublisherOA PDFDOI

• Enhancing distress tolerance to uplift motivation in recovery: Results from an open development trial

  Digital Health · 2023-01-01

  articleOpen accessSenior authorCorresponding

  Objective: This open pilot study examines the feasibility, acceptability, and qualitative outcomes of an interactive web- and text message-delivered personalized feedback intervention aimed at cultivating motivation and tolerance of distress for adults initiating outpatient buprenorphine treatment. Methods: = 10) initiating buprenorphine within the past 8 weeks first completed a web-based intervention focused on enhancing motivation and providing psychoeducation on distress tolerance skills. Participants then received 8 weeks of daily personalized text messages that provided reminders of salient motivational factors and recommended distress tolerance-oriented coping skills. Participants completed self-report measures to assess intervention satisfaction, perceived usability, and preliminary efficacy. Additional perspectives were captured via qualitative exit interviews. Results: = 5.05) on the Client Satisfaction Questionnaire at the end of 8-week period indicated a high degree of satisfaction with the text-based intervention. The average rating on the System Usability Scale was 65.3 at the end of the 8-week program, suggesting that the intervention was relatively easy to use. Participants also endorsed positive experiences with the intervention during qualitative interviews. Clinical improvements were observed across the intervention period. Conclusions: Preliminary findings from this pilot suggest that the content and delivery method of this combined web- and text message-based personalized feedback intervention is perceived by patients as feasible and acceptable. Leveraging digital health platforms to augment buprenorphine has potential for high scalability and impact to reduce opioid use, increase adherence/retention to treatment, and prevent future incidence of overdose. Future work will evaluate the efficacy of the intervention in a randomized clinical trial design.

  PublisherDOI

• Perceptions of Long-Acting Injectable Antiretroviral Therapy Among People Living with HIV Who Use Drugs and Service Providers: a Qualitative Analysis in Rhode Island

  Journal of Urban Health · 2023-08-10 · 14 citations

  articleOpen access
  PublisherOA PDFDOI

Recent grants

• Integrated Digital Health Intervention to Promote Engagement in and Adherence to Medication-Assisted Treatment

  NIH · $911k · 2019–2024

• NIH Grant F31DA026634

  NIH · $121k · 2012

Frequent coauthors

• Michael J. Zvolensky

  204 shared

• Daniel J. Paulus

  University of Pittsburgh Medical Center

  76 shared

• David W. Wetter

  University of Utah

  64 shared

• Megan L. Ranney

  63 shared

• Joseph W. Ditre

  Syracuse University

  59 shared

• Jafar Bakhshaie

  Massachusetts General Hospital

  54 shared

• Susan E. Ramsey

  Providence College

  52 shared

• Josiah D. Rich

  Rhode Island Hospital

  42 shared

Education

• PhD Clinical Psychology

  University of Vermont

  2013

• B.S.

  Union College

  2004