Researchers at the University of Massachusetts Amherst and the University of Massachusetts Medical School are among the scientists at a dozen institutions nationwide that will form the Justice Community Opioid Innovation Network (JCOIN), an ambitious, $155 million effort to improve opioid addiction treatment in criminal justice settings, the National Institutes of Health (NIH) announced.
Over the next five years, researchers will study the impact of evidence-based medications for opioid use disorder, behavioral interventions, digital therapeutics and patient-centered treatments in 15 states and Puerto Rico. They will focus on a range of justice settings, including jails, drug and problem-solving courts, policing and diversion, and probation and parole.
In Massachusetts, co-principal investigators Elizabeth Evans, assistant professor in the UMass Amherst School of Public Health and Health Sciences, and Dr. Peter Friedmann, associate dean of research at UMass Medical School-Baystate and chief research officer at Baystate Health, will receive a $10 million grant from the NIH's National Institute on Drug Abuse (NIDA) to examine a pilot opioid treatment program for jail detainees in seven Massachusetts counties. The treatment program, including community-based follow-up care after detainees' release from jail, was mandated by the Massachusetts Legislature.
Evans says Massachusetts is at the forefront of improving treatment for opioid use disorder in vulnerable populations and understanding the high risk of fatal overdose that detainees with this condition face following their release from jail.
"We are at a historical turning point, and this is an exciting opportunity to partner with the jails, see where they have needs and help address them," says Evans, who already has been working with the sheriffs in Franklin and Hampshire counties to design and implement the jail-based treatment program. "Jails are shifting from the traditional focus on public safety to a public health model, where they see their role as helping people avoid overdose, death and also reincarceration. They care about saving lives of people in their community."
The creation of JCOIN will enable researchers to tackle various aspects of the opioid crisis and share their discoveries. "This multistate research collaborative has many strengths," Evans says. "It will speak to policy-making at the state level and how that impacts public health."
Aided by Massachusetts' extensive collection of data sets known as the Public Health Data Warehouse, UMass researchers will perform a treatment outcome study among detainees with opioid use disorder who receive methadone, extended-release naltrexone, buprenorphine/naloxone or no medication.
They will also perform an implementation study to pinpoint and understand factors that assist or impede the delivery of treatment in jails and community settings. "We want to understand how the way we implement the program could lead to different outcomes," Evans says. "Are there best practices that will lead to better outcomes?"
The research will include an economic evaluation of the Massachusetts jail treatment program - both the costs to provide the medications and what savings, if any, result from the treatment.
JCOIN is part of the NIH HEAL (Helping to End Addiction Long-term) Initiative to accelerate science-based solutions to the national opioid public health crisis.
"Within the broader opioid epidemic, justice-involved populations are disproportionately affected by opioid use disorder," says Dr. Nora Volkow, director of NIDA. "JCOIN will help develop effective intervention and treatment strategies for this crucial setting. It is vitally important to provide evidence-based approaches for people leaving criminal justice facilities in order to prevent relapse and opioid overdose, which often occurs as they transition back into their communities."