This supplement expands on the scientific impact of the parent grant (1R21DA044443-01) by estimating the impact of expanded access to medications for addiction treatment (MAT) in prisons and jails on post-release rates of overdose. This study used agent-based modeling, data collected through the parent study, existing surveillance data in Rhode Island (RI), and recently-published data from similar settings to understand how different MAT interventions in prison and jail settings impact overdose death post-release. Researchers utilized an agent-based model using historical data on overdose fatality rates in RI to forecast the number of opioid overdose fatalities over an eight-year period (2017-2025) under four different MAT strategies. State surveillance data from the four years preceding implementation of the comprehensive MAT program (2012-2016) will be used to calibrate the model. In order to compare the different strategies, researchers will calculate and compare the total number of overdose fatalities statewide as well as the number of overdose fatalities among those being released from correctional facilities over the eight-year period.
These models will incorporate advanced methodological techniques that will allow for the investigation of engaged treatment, program attrition, and other complex events on a population-level. Findings from this study may be used by health agencies, policymakers, and correctional systems to inform their efforts to expand MAT access.
Study Settings: Jails/Prisons
- One guy goes to jail, two people are ready to take his spot: Perspectives on drug-induced homicide laws among incarcerated individuals (2019)
- Estimating the impact of wide scale uptake of screening and medications for opioid use disorder in US prisons and jails (2020)
- The protective effect of trusted dealers against opioid overdose in the U.S. (2020)
- Optimizing the impact of medications for opioid use disorder at release from prison and jail settings: A microsimulation modeling study (2021)
Brandon Marshall, PhD
Researchers examined the impact of the following interventions on post-release rates of overdose:
• Standard of care/no intervention;
• Providing access to depot-naltrexone alone;
• Providing access to all three MATs to only those who were prescribed it prior to incarceration; and
• Comprehensive provision of all three MATs.
Accelerator Supplement, Modeling Project