The University of Kentucky recently received an $8.8 million grant from the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, to establish a Clinical Research Center as part of the Justice Community Opioid Innovation Network (JCOIN) to support research on quality addiction treatment for opioid use disorder (OUD) in criminal justice settings nationwide. The awards, totaling an estimated $155 million, will support the multi-year innovation network, including 10 research institutions and two centers that will provide supportive infrastructure.
At UK, the grant will be used to create the Kentucky Women's Justice Community Opioid Innovation Network (WJCOIN) to enhance access to opioid use disorder treatment for women as they transition from jail back to the community. In Kentucky, women represent the fastest-growing demographic in the criminal justice system and are also susceptible to unique vulnerabilities that can lead to opioid overdose.
Michele Staton, associate professor in the UK College of Medicine Department of Behavioral Science, will serve as principal investigator on the project. Staton will lead a team of experts from across UK's campus including the colleges of Medicine, Nursing, Public Health and Arts & Sciences; the Center on Drug and Alcohol Research; and UK HealthCare's Kentucky Telecare. This partnership also includes collaborators at Research Triangle Institute and the University of Miami, as well as the Kentucky Department of Corrections (DOC) and the Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities (BHDID).
This grant is only possible because of our longstanding partnerships with the Kentucky Department of Corrections and the Department for Behavioral Health, Developmental and Intellectual Disabilities. We value and share their commitment to increasing access to treatment. Their involvement in the JCOIN network is going to be critical - not just at the local level for implementation, but nationally, considering their expertise and their success in delivering treatment for high-risk individuals in the criminal justice system."
Michele Staton, associate professor, UK College of Medicine Department of Behavioral Science
The overall plan for WJCOIN involves implementing telehealth services in six Kentucky jails in both rural and urban areas to deliver pre-treatment for medications used to treat OUD. Community providers will connect with women in jail prior to their release to conduct screenings, assessments, medical evaluations and education about the benefits and risks of medications for OUD. Additionally, when women are released from jail, they will be able to enter treatment with those community providers.
"We are so excited to be able to include rural jails and communities in this project, because the service delivery system for women is limited in these areas," Staton said. "A huge part of this grant is to build capacity in those communities, as well as strengthening treatment opportunities as women transition from jail to the community."
By default and not by design, the DOC has become the largest provider of substance abuse treatment in Kentucky, with nearly 6,000 treatment slots available. Giving inmates an opportunity to enter recovery is a responsibility the Department of Corrections takes very seriously, says Sarah Johnson, director of addiction services at the DOC.
"The majority of individuals who are incarcerated will be released at some point," Johnson said. "They will be your neighbor; your coworker. We want to offer them the best evidence-based treatment so they have opportunities to have a different trajectory in life. OUD is a debilitating illness, and we want to give them the tools they need to be successful."
Katherine Marks, a UK College of Medicine research assistant professor who serves as project director for the Kentucky Opioid Response Effort within the Cabinet for Health and Family Services, emphasizes that by focusing on women with this project, the team has an opportunity to spread a broader positive impact.
"When we provide evidence-based services to support women in entering remission and sustaining long-term recovery, we also positively impact our families and communities in Kentucky," Marks said. "Related to the opioid crisis is a rapidly growing, overburdened foster care system. By creating a pathway to treatment for women, a pathway to healing can also be created for her family. These changes can have generational impacts on our community."
Nationally, JCOIN will establish a network of investigators collaborating with justice and behavioral health stakeholders to research promising interventions and other approaches to improve the capacity of the justice system to respond to the opioid crisis. JCOIN is part of the NIH HEAL (Helping to End Addiction Long-term) Initiative, an aggressive, trans-agency effort to speed scientific solutions to stem the national opioid public health crisis.
Launched in April 2018, the NIH HEAL Initiative is focused on improving prevention and treatment strategies for opioid misuse and addiction and enhancing pain management. This $8.8 million HEAL award is new funding that is separate from UK's recently awarded $87 million HEALing Communities grant.
"Within the broader opioid epidemic, justice-involved populations are disproportionately affected by opioid use disorder. JCOIN will help develop effective intervention and treatment strategies for this crucial setting," said NIDA Director Dr. Nora D. Volkow. "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."
Awarded research centers will study evidence-based medications, behavioral interventions, digital therapeutics and comprehensive patient-centered treatments in 15 states and Puerto Rico.
Each grantee will work with five or more communities, where they will engage with organizations in justice settings and service providers in the community. JCOIN will address gaps in OUD treatment and related services in a wide range of criminal justice settings, including jails, drug courts, problem-solving courts, policing and diversion, re-entry, and probation and parole.
The funded institutions and respective site locations include:
- University of Kentucky - Kentucky
- New York State Psychiatric Institute - New York
- Baystate Medical Center - Massachusetts
- Friends Research Institute, Inc. - Maryland
- Texas Christian University - Illinois, New Mexico, Texas
- New York University School of Medicine - Connecticut, Delaware, New Hampshire, New York, Oregon
- Brown University - North Carolina, Pennsylvania, Rhode Island
- University of Chicago - Illinois
- Chestnut Health Systems, Inc. - Illinois
- Yale University - Connecticut, Minnesota, New York, North Carolina, Puerto Rico
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