Each JCOIN study brings researchers together with justice and health stakeholders in five or more communities to address gaps in opioid use disorder treatment and related services. Their work engages a wide range of justice settings, including jails, prisons, community corrections, problem-solving courts, and juvenile justice agencies. The studies evaluate behavioral interventions, digital therapeutics, comprehensive patient-centered treatments, and delivery of medications for opioid use disorder (MOUD) throughout the United States.
In 2018-2020, JCOIN supported 15 accelerator supplement projects, which included short-term studies and surveys.
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Evaluation of Enhanced Primary Care and Opioid Use Disorder Treatment for Justice-involved Individuals Transitioning from Jail to Improve Opioid Treatment Cascade (038)
The study will assess whether the Transitions Clinic Network (TCN) program, which provides enhanced primary care and OUD treatment for people recently released from incarceration, improves services along the opioid treatment cascade. In TCN, formerly incarcerated community health workers are embedded within primary care teams and address social determinants of OUD, provide social support, help patients build trust in the health system, and advocate in interactions with the criminal justice system.
Implementation of an Opioid Treatment Linkage Model to Improve Cross-System Coordination in Community Supervision Settings (037)
This study is testing two different strategies to implement an Opioid Treatment Linkage Model (O-TLM). The model is designed to link individuals under community supervision with appropriate community-based treatment services. O-TLM seeks to improve interagency collaboration through staff training and cross-system data sharing.
Effectiveness of Implementing Learning Health Care System in Juvenile Justice Settings to Improve Coordination Among Justice Agencies and Community-based Services (036)
This study aims to improve treatment linkages and care coordination within the eight juvenile justice systems across Indiana. To address current gaps, the study is implementing a Learning Health System (LHS) to improve collaboration between juvenile justice agencies and community mental health centers, using interagency data-sharing to help identify gaps and opportunities to implement evidence-based interventions.
Comparison of Long-acting Buprenorphine (Sublocade) and Naltrexone Opioid Treatments Among Justice-involved Individuals Leaving Jails (035)
This study is conducting a large multisite trial to compare the effectiveness of extended-release buprenorphine (Sublocade, XR-B) to extended-release naltrexone (XR-NTX). The trial will enroll individuals prior to release from jail and randomize to either medication option. The first dose of medication will be administered prior to release, with an additional 24 weeks of treatment received in the community.
Participating jails are located in Connecticut, Delaware, New Hampshire, New Jersey and Oregon. The study will measure retention in treatment, and opioid and other substance use outcomes between the two medication conditions, as well as a sample of individuals who opt for other treatment options (“treatment as usual”).
A Comparative Effectiveness Trial of Extended-release Naltrexone and Extended-release Buprenorphine (Brixadi) with Individuals Leaving Jail (034)
This study is conducting a comparative effectiveness trial of extended-release naltrexone (XR-NTX) versus a new extended-release formulation of buprenorphine (Brixadi, XR-B) to treat opioid use disorder (OUD) among justice-involved individuals in ten Maryland county jails.
Participants will be randomly assigned to receive either XR-NTX or XR-B prior to release from jail, followed by six monthly injections while in the community. The goal of the study is to evaluate the effectiveness of the two medications, measure medication adherence, and gather data to inform broader scale-up of medications for opioid use disorder (MOUD) in jails and in the community.
Improving Retention across the Opioid Use Disorder Service Cascade upon Re-entry from Jail using Recovery Management Checkups (033)
This study is comparing the effectiveness of the Recovery Management Checkups (RMC) model, an evidence-based intervention that provides regular, fixed schedule check-ups to support treatment retention and recovery, and an adaptive model (RMC-Adapted) that tailors checkup frequency and intensity to individuals’ needs. Each condition offers justice-involved individuals referral or assertive linkage to a designated treatment provider upon release from jail.
Evaluation of Massachusetts Policy Mandating all Medication for Opioid Use Disorders in Jails (032)
A 2018 Massachusetts law (“Chapter 208”) established a 4-year pilot program to expand the use of all FDA-approved forms of medications for opioid use disorder (MOUD) at five county jails; two additional jails voluntarily joined this pilot. The law stipulates that MOUD be maintained in individuals who were already receiving it prior to detention; initiated prior to release from jail when appropriate; and continued in the community via facilitated linkages to local services after release. The Massachusetts Hub will conduct a longitudinal treatment outcome study of individuals in these jails to examine MOUD initiation, engagement and retention, as well as fatal and non-fatal overdose and recidivism. The study will also identify strategies associated with the successful implementation of MOUD and inform the development of future strategies to address opioid use disorder in jails nationwide.
Facilitating Opioid Care Connections through System Level Strategies to Improve Use of Medications and Linkages to Care Drug Courts across New York (031)
This study is evaluating strategies to implement New York’s new opioid court model (OCM) in ten counties across the state. New York’s OCM was developed by the Unified Court System and provides practice guidelines for drug courts to reduce overdose, decrease recidivism, and improve service delivery and linkages to medications for opioid use disorder (MOUD) for justice-involved individuals across the state. The goal of the study is to develop, evaluate, and refine implementation strategies to support the OCM practice guidelines to be scaled up across New York.
JCOIN Dynamic Network Collaboration Study (029)
The NORC at the University of Chicago, in partnership with the University of Texas Health Science Center at Houston, is conducting a longitudinal study to measure how collaborations and partnerships between researchers and practitioners within the JCOIN network change over time. The study will collect annual data over five years via online surveys and will be supplemented by automated web scraping to capture members’ publications, chapters, books, presentations, reports, and grants. Capturing changes in JCOIN members’ collaboration, productivity, publications, and grant activities will offer NIDA an opportunity to understand how collaborations within the JCOIN network improve when supporting a large network of substance abuse researchers and practitioners.
National Survey of Substance Use Services in US Jails (028)
Despite the effectiveness of medications for opioid use disorder (MOUD), there is a lack of information about what is currently available, accessible, and used throughout the jail and prison systems of the US. To better address this gap, the NORC at the University of Chicago will study how prisons and jails across 24 justictions are addressing opioid use disorder.
AmeriSpeak in Depth Public Opinion Survey on Opioids (027)
The NORC at the University of Chicago is conducting a comprehensive study to measure the public’s view of policies, practices, attitudes and laws related to addressing opioids in justice settings across the U.S. This study builds on the topics from the JCOIN AmeriSpeak Brief Opioid Stigma Survey (026) and will also assess how support varies based on personal experiences with opioids or knowing someone who struggled with an OUD and variations by type of opioid and respondent characteristics.
AmeriSpeak Brief Opioid Stigma Survey (026)
To assess how stigma changes overtime, the NORC at the University of Chicago is conducting a study to measure public support for opioid use disorder (OUD) treatment, assess stigma associated with OUD, and perceptions of criminality around OUD. This study will use a nationally representative survey panel and will administer short surveys twice a year for a total of five years. The data collected from this study will allow for a better understanding of the public’s opinion on issues related to OUD, stigma, and the justice system and how perceptions change over time.
Mapping Federal Opioid Investments in Justice Systems (025)
The University of Chicago is conducting a large-scale environmental scan of federally funded substance use-related initiatives and resources to understand how funds and resources are distributed across states. The study will also explore urban and rural differences, differences across areas based upon local drug-use epidemiology and availability of service resources and how federal funds are addressing opioid use disorders and other emerging drug-related challenges.
Supportive Social Networks and OUD Outcomes (024)
Social support networks have been an invaluable tool to combat addiction and other health interventions. The concept of social support networks as a powerful force in the health of substance users is well documented. Effective substance use disorder (SUD) and opioid use disorder (OUD) treatment approaches have been effectively combined with the inclusion of naturally-occurring support persons. The concept of organic social support has been under-utilized for retaining community members in SUD treatment programs.
Substance Use and Treatment Trajectories at Entry and Re-Entry: A Network Analytic Approach (023)
Diverse communities enter the justice system, exit and re-enter to create a complex circulation driven by a number of social and structural factors. Often ignored are important social interactions that drive opioid use disorder (OUD) or methamphetamine use. Social learning and differential association theories hold that risky behaviors, including rationalizations for them, diffuse through social networks of close ties. Furthermore, network members influence behavior by virtue of the behavioral example they provide, the normative pressures they exert, and perceptions of these influences. If we understand how OUD/meth or recovery/renewed use moves through networks and their local geographic contexts, we will be able to develop new interventions, and determine previously unobserved mechanisms as to why interventions may fail or have success.
Predictive-analytic Models of Opioid Overdose and Reoffending (022)
The University of Chicago is developing open-source software that can be used by researchers and practitioners to predict overdose and re-offending risk of their population. This project will use large administrative datasets and machine-learning technology to develop a framework for transparent predictive models and simulations to help identify people at highest risk and how populations will benefit from interventions, and explore the likely policy impact of observed relationships among emerging trends to improve outcomes.
MOUD Access and Place-Based Policies (021)
Across the country, various public health interventions, opioid use policies, and criminal justice policies have emerged in response to the opioid epidemic in recent years. Many of the policies help improve access to medications for opioid use disorder (MOUD) and related services. However, the impact of improving access to these resources on health outcomes can vary substantially in different local contexts under various policies.
Finding an Optimal Distance of Success: Measuring Access to Critical Resources in Opioid Use Disorder Justice Settings (020)
The University of Chicago is developing an agent-based network model (ABNM) framework to study location-specific evolution and dynamics of opioid use disorder (OUD) in justice settings. The Justice Community Circulation Model framework is designed to help researchers and practitioners explore underlying mechanisms, epidemiological processes and interactions, such as the health and mortality pathways of individuals who experience non-fatal overdose or who initiate treatment, among justice-involved individuals with OUD.
Measuring Social and Spatial Inequities in Access to Opioid Use Disorder Treatment for Reducing HIV and HCV Transmissions (019)
Access to treatment and medication for opioid use disorder (MOUD) is essential for reducing HIV and HCV transmissions. However, the spatial distribution of the resources for treatment and medication is a result of various social factors, which can include potential inequities.
To demonstrate the utility of a spatial perspective in evaluating access to MOUD resources, the University of Chicago and Argonne National Laboratory will use a simulation approach to evaluate how treatment and intervention locations affect HIV and HCV transmissions.
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