Implement opioid mitigation practices effectively
Join a network of researchers and practitioners
CEA’s resource for training on new research, new initiatives, and best practices to manage the opioid health crisis in your community is available now.
The County Executives of America has partnered with the national JCOIN project, a groundbreaking initiative designed to advance scientific knowledge and disseminate information on effective policies, practices, and interventions, and to expand their use in daily practice to ensure quality care is provided to individuals with opioid use disorder (OUD). JCOIN is managed by the National Institute on Drug Abuse (NIDA) at the National Institutes of Health (NIH). JCOIN is funded through the Helping to End Addiction Long-termâ„ Initiative, or NIH HEAL Initiativeâ„ . https://heal.nih.gov.
Complete the two courses on the website, plus another 10 hours of training by mixing and matching webinars, podcasts, and quick lessons to receive a County Executives of America's Opioid Abatement Certificate. Once completed, email Belinda Blades for your Certificate at Belinda Blades at bblades@countyexecutives.org.
STIGMA Course
Substance use disorders (SUD) are some of the most stigmatized health conditions worldwide. Stigma creates barriers to healthcare and leads to lower engagement and retention in addiction treatment.
This course provides an introduction to the latest research around SUD and criminal justice stigma. Participants will also learn from leading experts on stigma within the SUD and criminal justice fields about the manifestation of stigma at the structural and individual level and innovations to reduce stigma.
Developed by Addiction Policy Forum and County Executives of America (CEA)
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Course goals: Improve knowledge about the experiences of stigma among individuals with a substance use disorder and that are justice-involved.
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Lessons learned: Different types of stigma, the social construct of stigma, and strategies to address stigma.
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Lessons learned: Different types of stigma, the social construct of stigma, and strategies to address stigma.
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Length: 30 minutes
Webinar
JCOIN Speaker Series: Deflection – Leveraging Police and First Responders to Create New Pathways to Treatment and Recovery
Deflection is an emerging field that aligns public safety and health at the intersection of police, treatment, and community. Deflection programs are helping create opportunities for people who use drugs and/or have mental health issues instead of using the justice system by linking individuals to treatment and services. Deflection programs can build police-community relations by keeping individuals out of the justice system by avoiding arrest and fostering real-time linkages to community-based treatment/services for addiction and/or mental health issues.
In this webinar, presenters discussed the latest research and innovations in this emerging field. Topics covered include the scope and services covered by deflection partnerships, legislative and policy developments that are advancing the field, and new approaches to linkages to mental health services, police training, and police response.
Webinar
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The risk of overdose death significantly increases during the first two weeks during entry into the community. In this webinar, presenters will discuss the latest research, science, and innovation around mitigating risk during reentry for people with opioid use disorders. Topics covered will include medications for opioid use disorder (MOUD), behavioral interventions, and establishing linkages to community-based support services.
JCOIN Speaker Series: Deflection – Leveraging Police and First Responders to Create New Pathways to Treatment and Recovery
Quick Lession
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Tracking Policy on Access to MOUD for Justice Involved Communities during COVID-19 – Heidi Grunwald, PhD, and Elizabeth Platt, JD/MA, Center for Public Health Law Research at the Temple University Beasley School of Law
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Enhanced Metrics, Mapping & Data for the Opioid Environment Policy Scan (OEPS) Warehouse – MaryniaKolak, PhD, and Susan Paykin, MPP, Healthy Regions & Policies Lab, Center for Spatial Data Science, University of Chicago
Quick Lession
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COVID-19 Mitigation During and After Incarceration: Innovative Models of Surveillance and Testing – Matthew Akiyama, MD, Associate Professor of Medicine and Clinician Investigator, Albert Einstein College of Medicine and Montefiore Medical Center
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Prosecutors, Public Health, & Drug-Induced Homicide – Taleed El-Sabawi, JD, PhD, Assistant Professor of Law (’22), Florida International University, College of Law; affiliated Research Scholar, Addiction and Public Policy Initiative, the O’Neill Institute for National & Global Health Law, Georgetown Law Center
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Human-Centered Design of an Opioid Misuse Prevention Program for Justice-Involved Adolescents & their Caregivers – Sarah Helseth, PhD, Assistant Professor, Department of Behavioral and Social Sciences, Brown University School of Public Health
Quick Lession
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Examining Disparities along the SUD Care Cascade for Youth in Juvenile Justice – Tennisha Riley, PhD, Indiana University
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Understanding the Perspectives of Jail and Treatment Staff on MOUD Uptake – TaLisa Carter, PhD, American University
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Identifying MOUD Decision-Making Factors in Criminal Problem-Solving Courts – BasiaAndraka-Christou, JD, PhD, University of Central Florida
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Improving Low-Threshold Naloxone on Release from Incarceration – Peter Davidson, PhD, University of California at San Diego
Podcasts
Ever wonder how opioids affect the body and the brain? This episode breaks down the neuroscience of opioids by showcasing innovative research from several leading scholars. Will you be an expert after listening? Nope. But you’ll definitely know more and it may inspire you to keep learning.
Adoption of Evidence-Based Clinical Innovations: The Case of Buprenorphine Use by Opioid Treatment Programs
At a more macro level, this podcast considers how states implemented buprenorophine programs for individuals with OUD. What worked? What did not? How and Why?
The Benefits and Implementation Challenges of the First State-Wide Comprehensive Medication for Addictions Program in a Unified Jail and Prison Setting
This episode takes a different look at OUD by examining the implementation of an MAT program to consider some of the challenges facing programs, organizations, and communities who want to help individuals with OUD but find there are often roadblocks or hurdles to doing so effectively.
Effectiveness of Medication Assisted Treatment for Opioid Use in Prison and Jail Settings: A Meta-Analysis and Systematic Review
This episode takes a deep dive into medically assisted treatment (MAT) for substance use disorders by discussing a study that compares carceral resident outcomes when using methadone, buprenorphine, and naltrexone to see which group had lower recidivism and fewer risky behaviors. Want to know which MAT works best? Listen and find out.
A Community Outreach Intervention to Link Individuals with Opioid Use Disorders to Medication-Assisted Treatment
​Helping individuals with OUD is a big undertaking. Whole communities are required. This episode discusses a peer outreach and MAT treatment linkage program and considers the various factors that increase the likelihood that participants pursue treatment.
Adoption of Evidence-Based Clinical Innovations: The Case of Buprenorphine Use by Opioid Treatment Programs
At a more macro level, this podcast considers how states implemented buprenorophine programs for individuals with OUD. What worked? What did not? How and Why?
Conceptualizing Social Recovery: Recovery Routes of Methamphetamine Users
Ever heard of “social” recovery? No? Oh, you’re missing out. In this episode, we talk you through one study that examines various pathways methamphetamine users may take to achieve recovery. It’s not all about abstinence, but it can still yield positive results.
This episode examines the role of communities in helping individuals with substance use disorder. Study findings suggest a distinct and pronounced need for better education and training around treatment and recovery and a need for everyone to get involved. Download the One-Pager for this episode (PDF).
This bonus episode is an update to our very first Aced It episode titled "Language Matters." The words we use to describe certain individuals or groups matter greatly. Words possess indirect connotation or tone beyond their direct meanings. This episode considers language around individuals and groups involved with the criminal legal system and offers suggestions for how to make sure language is specific, stigma-free, and humanizing. This episode fits nicely with the JCOIN goal of capacity building and enhances the entire LEAP curriculum. For more information, download the one-pager for this episode (PDF) and visit the The Language Project by The Marshall Project. Cox, A. (2020). The language of incarceration. Incarceration, 1(1), 2632666320940859.
We often talk about or study communities’ responses to substance use disorders but not all communities are the same. This episode considers what scholars found when they compared various community resources and services and what those differences mean for individuals in need of services. Download the One-Pager for this episode (PDF).
While some argue that incarceration is not the answer for solving our substance use disorder challenges, will police-assisted referrals for SUDs help? This episode takes a deep dive into a study of one such program and reports on what the authors found and what it might mean for us as we continue working toward better outcomes. Download the One-Pager for this episode (PDF)
In this super-interesting episode, we report on a study of U.S. veterans with opioid use disorder who discuss what they think would help them in their treatment. The veterans describe barriers to treatment and what they think they need to be successful during recovery. Download the One-Pager for this episode (PDF).
Studies
Improving HIV and opioid use disorder (OUD) management and implementation for justice-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, treatment, and OUD service providers.
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The Yale University JCOIN Research Center is conducting an effectiveness-implementation random control trial study to compare two models, Patient Navigation (PN) and 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.
The study will recruit justice-involved individuals who are being released to communities in Connecticut and Texas with pre-arrest histories of opioid/injection drug use and are living with or at-risk of HIV. At post-release, participants will be randomized to receive either: (a) PN system for care, wherein patient navigators will link study participants to community-based service providers during the six-month post-release intervention period (those without HIV will be provided access to PrEP services, and those living with HIV will receive access to ART services); or (b) MHU service delivery, wherein study participants will be linked to a MHU within their community where they will receive integrated PrEP/ART, MOUD, and harm reduction services during the six-month post-release intervention period.
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Study Settings: Community Corrections, Treatment/Healthcare Settings
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Study Locations: Connecticut, Texas
The Brown University JCOIN Research Center is rigorously testing 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.
In a second stage, individuals under community supervision will be randomly assigned to receive assistance from peer support specialists vs. no peer support. The aims of the study are to test the independent and combined effects of organizational and client-level linkage strategies on outcomes including linkage to opioid use disorder (OUD) treatment, retention, satisfaction, opioid use, opioid overdoses, recidivism, and utilization of recovery services.
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Study Settings: Community Corrections, Treatment/Healthcare Settings
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Study Locations: North Carolina, Pennsylvania, Rhode Island
The University of Chicago JCOIN Research Center 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).
The study will utilize a hub-and-spoke model anchored at the University of Illinois at Chicago to help unify the delivery of OUD treatment and harm reduction services across four jails and two prisons throughout Illinois. The goal of the study is to examine the effectiveness of these case management approaches combined with peer recovery coaches to improve MOUD retention and outcomes.
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Study Settings: Jails/Prisons, Treatment/Healthcare Settings
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Study Locations: Illinois
The Brown University JCOIN Research Center is rigorously testing 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.
In a second stage, individuals under community supervision will be randomly assigned to receive assistance from peer support specialists vs. no peer support. The aims of the study are to test the independent and combined effects of organizational and client-level linkage strategies on outcomes including linkage to opioid use disorder (OUD) treatment, retention, satisfaction, opioid use, opioid overdoses, recidivism, and utilization of recovery services.
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Study Settings: Community Corrections, Treatment/Healthcare Settings
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Study Locations: North Carolina, Pennsylvania, Rhode Island
The New York University (NYU) School of Medicine JCOIN Research Center 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”).
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Study Settings: Jails/Prisons, Treatment/Healthcare Settings
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Study Locations: Connecticut, Delaware, New Hampshire, New Jersey, Oregon
The Friends Research Institute JCOIN Research Center 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.
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Study Settings: Jails/Prisons, Treatment/Healthcare Settings
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Study Locations: Maryland
The Chestnut Health Systems JCOIN Research Center 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 check-up 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.
The study will be conducted in six county jails across Illinois, with the goal of increasing linkage to, and retention in, evidence-based treatment in the community, while reducing relapse and recidivism.
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Study Settings: Jails/Prisons, Treatment/Healthcare Settings
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Study Locations: Illinois