Medicaid Eligibility & Pre-Release MAT in Wisconsin (012)

The goal of this research is to estimate the effects of increased Medicaid availability for adults released from prison in Wisconsin on treatment access, use, and outcomes for opioid use disorder (OUD). Specifically, we will investigate the degree to which two policy changes affecting Medicaid eligibility for low-income, childless adults were associated with increased use of medication assisted treatment (MAT) by adults with opioid use disorder during the first six months after release from prison. We will create a novel longitudinal database comprised of Wisconsin Medicaid claims data, linked to administrative and correctional health systems data for a retrospectively defined cohort of adults who were incarcerated and released from a state prison between 2013-17. This will allow an in-depth analysis of the utilization of medication assisted treatment (MAT) by people diagnosed with opioid use disorder during community re-entry. This work has the potential to inform health policy nationally by documenting health gains and potential reductions in recidivism that may result from increased access to MAT through expansion of Medicaid.

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Agent Based Modeling of Effects of MAT (008)

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. Led by Miriam Hospital, this project 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 setting 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.

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Post-Release Opioid Trajectories After MOUD in Jail (006)

Individuals with opioid use disorder (OUD) who are released from correctional settings are at high risk for overdose, infectious diseases (HIV, hepatitis C), and premature death. A key strategy to address the opioid epidemic among correctional populations is to increase access to medication for addiction treatment (MAT).

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National Prison Survey (003)

Despite the widespread evidence demonstrating the effectiveness of medications for addiction treatment (MAT) and the strong recommendations for their use in criminal justice systems, information about what is currently available, accessible, and utilized throughout the criminal justice system is unknown or dated. In response, Chestnut Health Systems was provided a supplement through the parent grant TRIALS Coordinating Center to Reduce Substance Use, HIV Risk Behaviors, & Crime (5U01DA036221-05) to develop and administer a national survey to document the context, relevant laws and policies that affect the ways in which state prisons are able to address the opioid crisis.

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National Jail Survey (002)

Despite the widespread evidence demonstrating the effectiveness of medications for addiction treatment (MAT) and the strong recommendations for their use in criminal justice systems, information about what is currently available, accessible, and utilized throughout the criminal justice system is unknown or dated. Through an administration supplement provided to the parent grant TRIALS Coordinating Center to Reduce Substance Use, HIV Risk Behaviors, & Crime (5U01DA036221-05), Chestnut Health Systems develop and administer a national survey document the context, relevant laws and policies that affect the ways in which jails are able to address the opioid crisis.

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PDAPS Policy Datasets (001)

This project deployed a unique substance use-specific policy lab called the Drug Outcome Policy Evaluation (DOPE) to better understand the impact of state policies and subsequent health. DOPE expands on the Prescription Drug Abuse Policy System (PDAPS) and the Drug Abuse Policy System (DAPS), which were developed in 2017, to track state policies aimed to address the toll of opioid misuse, and will rank policies or policy features across states and measure their effects on population health.

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