Addressing Risk Through Community Treatment for Infectious Disease and Opioid Use Disorder Now (ACTION) Among Justice-Involved Populations (042)

Improving HIV and Opioid Use Disorder (OUD) management and implementation for criminal justice (CJ)- involved individuals requires effective approaches to screening, linkage and adherence to integrated services across community agencies and service providers. Community reentry represents a critical opportunity to link individuals to HIV prevention and treatment and OUD service providers. In response, Yale University is conducting a effectiveness-implementation random control trial study to compare two models [Patient Navigation (PN) or Mobile Health Unit (MHU) service delivery] of linking individuals recently released from prison and jail to the continuum of community-based HIV and OUD prevention and treatment service cascades of care.

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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.

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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.

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Expand NFLIS Analyses and Conduct Geospatial Analytics with Drug Arrest Data to Examine Access to Opioid Use Disorder Services (014)

The University of Maryland’s Center for Substance Abuse Research (CESAR) established the Coordinating Center for the National Drug Early Warning System (NDEWS) for NIDA in 2014. NDEWS is a public health surveillance system that generates critically needed information about drugs and their public health consequences so that rapid, informed, and effective public health responses can be developed. Over the past four years, the Coordinating Center has developed national and international collaborations to support the ability to identify, monitor, and follow-up on emerging drugs and changing drug trends. These capabilities will be used in studies to link scientists and practitioners from the justice and public health fields and to generate resources and tools to support improvements in both fields.

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Community-Based, Client-Centered Prevention Homes to Address the Rural Opioid Epidemic (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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Police-led Opioid Intervention Programs: A Qualitative Examination of Program Models and Participant Experiences (007)

In response to alarming rates of opioid use disorder (OUD) and opioid overdose related deaths across the US, police departments nationwide have partnered with The Police Assisted Addiction Recovery Initiative (PAARI) to design and implement non-arrest substance use programs and initiatives. The first PAARI program, the Gloucester ANGEL program, began in Massachusetts and other communities have adapted the model to address their local needs. The programs are designed to facilitate access to treatment services rather than taking the approach of arresting substance users.

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Reducing Opioid Mortality in Illinois (040)

This study is conducting a multi-site trial called ROMI (Reducing Opioid Mortality in Illinois) to study the effectiveness of case management approaches to link individuals with community-based treatment services upon release from jail. The ROMI intervention includes peer recovery coaches to improve linkages to medications for opioid use disorder (MOUD), supportive services, naloxone distribution, and harm reduction services for justice-involved individuals with opioid use disorder (OUD).

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Using Implementation Interventions and Peer Recovery Support to Improve Opioid Treatment Outcomes in Community Supervision (039)

This study will rigorously test a systems-change approach for increasing the use of medications for opioid use disorder (MOUD) in seven community supervision sites in Rhode Island, North Carolina, and Pennsylvania. The study uses facilitated local change teams consisting of justice and community service providers to develop and implement interorganizational linkage strategies.

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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.

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