Recent Publications from LEAP Investigators & Scholars

Locked In and Left Out: The “Prison Penalty” for Implementation of Evidence-Based Interventions
By Justin Berk, Hannah E. Frank & Mari-Lynn Drainoni

Clinical practices are often outdated, decades behind the newest evidence-based interventions (EBIs). It takes an average of 17 years between validating an EBI and incorporating it into clinical practice, with more than 80% of the best practices not becoming common clinical practice. Dr. Justin Berk, a JCOIN LEAP Investigator, with researchers from Brown University and Boston University School of Medicine explores how barriers lead to the “prison implementation penalty,” the science-to-implementation gap in the context of U.S. prisons and jail healthcare. Researchers, policymakers, administrators, and healthcare professionals can use implementation science to address the prison implementation penalty by identifying and adapting healthcare delivery strategies to fit correctional settings. The authors recommend incorporating implementation frameworks and give specific examples to inform further research and future strategic planning. Identifying and implementing new healthcare delivery strategies in carceral settings can help mitigate healthcare inequities and ensure incarcerated people have access to EBIs and receive quality healthcare treatment.

Read more


What the Drug Reform Movement Missed
By Brandon Del Pozo

In response to record levels of fatal opioid overdose, many jurisdictions have reversed War on Drugs era policies that emphasize arrests and enforcement as strategies to address the crisis. However, as the opioid crisis continues unabated and concerns about public drug use grow, jurisdictions have started reverting to police-led crackdowns, enhanced sanctions for crimes involving fentanyl, and enacted bans on harm reduction efforts such as syringe service programs and overdose prevention centers. Dr. Brandon del Pozo, a JCOIN LEAP Investigator, argues in the Boston Globe that while critics of drug policy reform point to increased overdose rates as evidence that drug policy reform has failed, these measures have not been in place long enough to be accurately assessed. Regardless, he argues, the disruptive effects of public substance use are a legitimate concern, especially among communities of color, small business owners, recent immigrants, and other historically vulnerable and underserved communities. The failure to acknowledge it, he argues, has led to a frustration in many communities that is the principal threat to lasting drug policy reform. To address the growing overdose crisis, communities should invest in harm reduction and treatment and enact compassionate, effective drug policies, while also ensuring safe and fair access to public spaces. This will require reducing public substance use and its disruptive consequences in dense urban spaces, and establishing programs where the police and outreach workers work in tandem to secure both public health and public safety.

Read more


Death by Withdrawal
By Taleed El-Sabawi

Detoxing or going through opioid withdrawal can be extremely painful and dangerous. Jails and prisons in the U.S. often do not have practices or policies to screen for or medically manage withdrawal for incarcerated people, which can lead to the incarcerated person experiencing pain and suffering. However, the U.S. Supreme Court in Estelle v. Gamble established that incarcerated people have a constitutional right to adequate medical care and institutions denying incarcerated people care results in “the unnecessary and wanton infliction of pain.” Dr. Taleed El-Sabawi, a JCOIN LEAP Investigator, in the UCLA Law Review, demonstrates that institutions failing to medically manage incarcerated people’s withdrawal violates their Fourteenth and Eighth Amendment rights because it qualifies as deliberate indifference to a serious medical need. Dr. El-Sabawi uses medical literature on evidence-based medical treatment for withdrawal syndrome to highlight how jails and prisons have not met the bare minimum of evidence-based medical care standards.

Read more