HEAL JCOIN Grant

HEAL-JCOIN

FRI’s HEAL JCOIN Grant: A comparative effectiveness trial of extended-release naltrexone versus extended-release buprenorphine with individuals leaving jail.

Study OverviewPublications and PresentationsLearning Collaborative Meeting VideosLearning Collaborative Slide PresentationsLearning Collaborative ResourcesContact Information
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Study Overview

A Comparative Effectiveness Trial of Extended-Release Naltrexone versus Extended-Release Buprenorphine with Individuals Leaving Jail

Principal Investigator (Primary Contact): Michael S. Gordon, D.P.A.
Co-Principal Investigator: Thomas Blue, Ph.D.
Co-Investigator: Frank Vocci, Ph.D.
Co-Investigator: Sean Murphy, Ph.D.
Co-Investigator: Marc Fishman, M.D.
Project Manager: Isabella Cheremeteff

Funded By: National Institute on Drug Abuse (NIDA)
Grant #: UG1DA050077
Total Project Period: 7/19 – 4/24

This study is a randomized, open label, controlled trial of extended-release buprenorphine (XR-B; BRIXADI™ formulation) versus extended-release naltrexone (XR-NTX) in Maryland jails. A mulit-site, open-label, equivalence design will randomly assign 240 adults with a history of opioid use disorder (OUD) within gender and jail who are nearing release to one of two treatment arms: 1) XR-B in jail or 2) XR-NTX in jail, both followed by 6 monthly injections post-release at a community treatment program.

Aim 1. To determine the effectiveness of XR-B compared to XR-NTX in terms of: Primary Outcome. (a) pharmacotherapy adherence (number of monthly injections received). Secondary Outcomes. (b) illicit opioid urine test results; (c) self-reported illicit opioid use; (d) overdose events (non-fatal and fatal); (e) quality of life (i. physical health; ii. mental health); (f) HIV risk behaviors (i. sexual behavior; ii. needle use or sharing); and (g) criminal activity (i. crime days; ii. re-arrest; iii. re-incarceration).

Aim 2. To use a learning collaborative to understand factors related to: (a) Acceptability of providing long-acting agonists and antagonists in jail settings; and (b) Feasibility of providing medication continuity of care from jail to community treatment providers.

Aim 3. To calculate the cost to the jail/county health system of implementing XR-NTX/XR-B, and determine the relative value, including the costs associated with the interventions in the community, from a county and state-policymaker and societal perspective.

Publications

Gordon, M.S., Blue, T., Vocci, F., Mitchell, S., Wenzel, K., & Fishman, M. (2024). Buprenorphine dose induction in opioid non-tolerant individuals in jail. Drug and Alcohol Dependence Reports, 12 (September),100261.
Gordon, M. S., Mitchell, S. G., Blue, T. R., Vocci, F. J., Fishman, M. J., Murphy, S. M., Couvillion, K., Maher, K., Ryan, D., Wenzel, K., Danner, M. L., & Jarvis, D. K. (2021). A clinical protocol of a comparative effectiveness trial of extended-release naltrexone versus extended-release buprenorphine with individuals leaving jail. Journal of Substance Abuse Treatment, 128,, 108241. https://doi.org/10.1016/j.jsat.2020.108241

Presentations

MAT Utilization in Problem Solving Courts: Survey of Administrators

Presenter: Blue, T., Taxman, F. S., Witte, J., Farago, F., Smith, L., Rupp, K., Cloud, V., & Gordon, M.
Presented at: NADCP RISE21
Presentation place: National Harbor, MD
Date presented: May 2021
Poster: Poster(pdf)

Meeting Videos

Co-Occurring OUD and Psychiatric Disorders

  • Dr. Marc Fishman, Maryland Treatment Centers
  • This presentation covers:
    • The occurrence of depression and other mood disorders with a substance use disorder dual diagnosis.
      • How to assess these clients
      • How to interpret symptoms when co-occurring disorders are present and understand how they may overlap
      • How to treat these clients with medication and family engagement

Ask the Doc- Jail MAT

  • Dr. Marc Fishman, Maryland Treatment Centers
  • This presentation covers:
    • Broad considerations for treating opioid use disorder (OUD)
    • Symptom of sedation with some OUD medications and what to do about it
    • The best time of day for dosing
    • Medication cost differences
    • How to decide what dose to start patients on
    • Benefits of injectable medications
    • Options for those who have diverted their OUD medication
      • No research or evidence on what to do; there is just clinical best practice
    • Tactics for preventing and monitoring medication diversion
    • How to talk to clients about maintaining engagement with injectable MOUDs
    • Increasing treatment retention

Building MAT Capacity in Jails

  • Warden Mary Ann Thompson and Ms. Monica Thomas, St. Mary’s County Detention and Rehabilitation Center and Ms. Christy McMillan, Allegany County Detention Center
  • This presentation covers:
    • St. Mary’s Offender Reentry program and how they are implementing Maryland House Bill 116
      • Resources and community partnerships that help the inmates upon reentry
      • St. Mary’s Jail partnership with Friends Research Institute and participation in the JCOIN randomized trial
      • Benefits of running an MOUD program in a jail setting
    • The Allegany County jail methadone program development and expansion to prepare for House Bill 116
      • Reentry programming for people leaving jail

Jail MAT Economic Evaluation

    • Dr. Sean M. Murphy, Weill Cornell Medical College and CHERISH
    • This presentation covers:
      • Approaches to calculating the costs associated with starting and running an MOUD program in a jail

Jail MOUD Considerations

  • Dr. Meskerem Asresahegn and Director Corrine Labbe, Prince George’s County Correctional Center
  • This presentation covers:
    • Overview of the Prince George’s County Detention Center and how they have implemented and expanded services to prepare for House Bill 116
    • Problem solving how to release someone to the community and still maintain them on medication for OUD
    • The medication, counseling, nutritional aspects of their program
    • Implementing policies to prevent medication diversion
    • Some case examples of using MOUD for treatment in their facility

Continuity of Care for Individuals Leaving Incarceration on MOUDs

  • Tracy L. D. Schulden and Rebecca Trott, Anne Arundel County Department of Health and Tammy Black, Access Carroll Integrated Health Care
  • This presentation covers:
    • Anne Arundel County Health Department discusses their programs for substance use disorder, their partnership with Anne Arundel County Jails, and their Road to Recovery program for treatment of Opioid Use Disorder.
    • Access Carroll discusses the services they offer for substance use disorder and the continuity of care for individuals transitioning from the Carroll County jail to community treatment.

Preventing Diversion of Medications for Opioid Use Disorder in Jails

    • Presenter: Warden Mary Ann Thompson, St. Mary’s County Detention and Rehabilitation Center
      • This presentation covers:
        • How the St. Mary’s County Detention Center physically accommodated medication delivery in their facility
        • How their Medication for Opioid Use Disorder program developed and challenges they encountered when expanding the program
        • The importance of properly supervising inmates during dosing
        • Medication diversion prevention strategies and lessons learned
    • Presenter: Ms. Angel Dalverny, BSN, RN, Allegany County Sheriff’s Office, Detention Center
      • This presentation covers:
        • How the Allegany Detention Center’s medication area is set up
        • The process of medicating inmates to reduce medication diversion
        • Policies regarding inmates caught diverting medications
        • Misconceptions about providing medications for opioid use disorder in carceral settings

Increasing Inmate Acceptance of Medications for Opioid Use

  • Presenter: Major Craig Rowe, Washington County Sheriff’s Office, Detention Center
    • This presentation covers:
      • The start of their Medication for Opioid Use Disorder program and its goals
      • Messaging to inmates regarding the program
      • The importance of educating inmates on Medication Assisted Treatment and its benefits
      • The county’s Day Reporting Center Program and its successful use of extended-release naltrexone
    • Presenter: Mr. Teron Powell, MA, Silverman Treatment Solutions
      • This presentation covers:
        • The importance of therapeutic collaboration
        • How to get people on all sides of the process to say “yes”
        • The clinic’s history of treatment collaboration with the Howard County Department of Corrections

    • Adding/Expanding Peer Recovery Coaches as Staff in Carceral Settings

    • Presenter: Acting Warden Margaret M. Chippendale, Howard County Department of Corrections
      • This presentation covers:
        • How the detention center started their Peer Program
        • The role expectations and responsibilities of their peers
        • The process of hiring and training peers in their facility
        • Examples of groups and events their peers have organized
    • Presenter: Mr. Kevin Nock, i-FPRS, CPRS, RPS, Office of the Public Defender
      • This presentation covers:
        • How he began his journey to become a peer
        • The different certifications he earned and how they helped him in his work and career trajectory
        • His current role at the Maryland Office of the Public Defender

    • Expanding Buprenorphine Treatment Using Telemedicine in Rural Counties

    • Presenter: Dr. Eric Weintraub, University of Maryland School of Medicine
      • This presentation covers:
        • An overview of the opioid epidemic in rural Maryland
        • An overview of the three types of MOUDs and availability challenges
        • The benefits of offering buprenorphine via telemedicine
        • Development of their telemedicine buprenorphine program
        • A description of their buprenorphine mobile treatment unit
        • Challenges of offering a telemedicine program
        • Implementation and preliminary data from their telemedicine buprenorphine program in the Allegany County Detention Center
        • Funding issues

    Methadone Treatment for People in Jail: Different Approaches to Increase Access

      • Presenter: Ms. Rebecca Trott, Anne Arundel County Department of Health
        • This presentation covers:
          • An overview of the Anne Arundel County jail’s opioid treatment program (OTP)
          • Program standards and outcomes
          • The steps for establishing their OTP
          • Combatting methadone myths and stigma
          • The process of delivering methadone treatment from identification in the jail to release into the community
      • Presenter: Captain Steve Wallace, Kent County Department of Corrections
        • This presentation covers:
          • Staffing and logistical challenges to delivering methadone treatment to detainees in a rural county

    The Patient’s Journey: Supporting Community Reentry for People Starting MOUDs in Jail

    • Presenters: Ms. Laura Stewart Webb, Ms. Kim Sollers, & Mr. Christopher Plummer, Pyramid Healthcare
      • This presentation covers:
        • Substance use assessments and interventions offered during detention
        • Reentry planning and peer support components
        • Stories of client recovery
        • Program successes and challenges

    Slide Presentations

    Reducing Medication Diversion in Jails | PDF
    Ms. Angel Dalverny, BSN, RN, Allegany County Sheriff’s Office, Detention Center
    This presentation covers:

    • How the Allegany Detention Center’s medication area is set up
    • The process of medicating inmates to reduce medication diversion
    • Policies regarding inmates caught diverting medications
    • Misconceptions about providing medications for opioid use disorder in carceral settings

    How to Increase Inmate Acceptance of MOUDS (Especially Injectables) | PDF
    Major Craig Rowe, Washington County Sheriff’s Office, Detention Center
    This presentation covers:

    • The start of their Medication for Opioid Use Disorder program and its goals
    • Messaging to inmates regarding the program
    • The importance of educating inmates on Medication Assisted Treatment and its benefits
    • The county’s Day Reporting Center Program and its successful use of extended-release naltrexone

    House Bill 116: Peer Recovery Specialists | PDF
    Acting Warden Margaret M. Chippendale, Howard County Department of Corrections
    This presentation covers:

    • How the detention center started their Peer Program
    • The role expectations and responsibilities of their peers
    • The process of hiring and training peers in their facility
    • Examples of groups and events their peers have organized

    The Intersectionality of Peer Support and Criminal Defense | PDF
    Mr. Kevin Nock, i-FPRS, CPRS, RPS, Office of the Public Defender
    This presentation covers:

    • How he began his journey to become a peer
    • The different certifications he earned and how they helped him in his work and career trajectory
    • His current role at the Maryland Office of the Public Defender

    Expanding Buprenorphine Treatment Using Telemedicine in Rural Counties | PDF
    This presentation covers:

    • An overview of the opioid epidemic in rural Maryland
    • An overview of the three types of MOUDs and availability challenges
    • The benefits of offering buprenorphine via telemedicine
    • Development of their telemedicine buprenorphine program
    • A description of their buprenorphine mobile treatment unit
    • Challenges of offering a telemedicine program
    • Implementation and preliminary data from their telemedicine buprenorphine program in the Allegany County Detention Center
    • Funding issues

    Methadone Treatment for People in Jail: Different Approaches to Increase Access | PDF
    This presentation covers:

    • An overview of the Anne Arundel County jail’s opioid treatment program (OTP)
    • Program standards and outcomes
    • The steps for establishing their OTP
    • Combatting methadone myths and stigma
    • The process of delivering methadone treatment from identification in the jail to release into the community

    Methadone Challenges at the Kent County Detention Center | PDF
    Presenter: Captain Steve Wallace, Kent County Department of Corrections
    This presentation covers:

    • Staffing and logistical challenges to delivering methadone treatment to detainees in a rural county

    The Patient’s Journey: Supporting Community Reentry for People Starting MOUDs in Jail | PDF
    Presenters: Ms. Laura Stewart Webb, Ms. Kim Sollers, & Mr. Christopher Plummer, Pyramid Healthcare
    This presentation covers:

    • Substance use assessments and interventions offered during detention
    • Reentry planning and peer support components
    • Stories of client recovery
    • Program successes and challenges

    Resources

    Methadone Treatment Guidance

    Guidance Documents (usdoj.gov)

    Registration (usdoj.gov)

    SAMHSA Email Updates (list-manage.com)

    Training Materials and Resources | SAMHSA (usdoj.gov)

    Anti-Stigma Resources

    Free Anti-Stigma Training for Maryland’s OUD Treatment Community

    Virtual Meeting: Substance Use, Criminal Justice System Involvement, and Stigma (2-24-2021)

    Maryland’s Office of Overdose Response

    Medications for Opioid Use Disorder in Criminal Justice Settings

    JCOIN Speaker Series: Medications for Opioid Use Disorder in Criminal Justice Settings (3-5-2021)

    Issue Brief: Considerations for Initiation of OUD Medications for Patients Recently Released from Controlled Environments

    Issue Brief: Medications for Opioid and Alcohol Use Disorders: Research Insights for Criminal Justice Professionals

    JCOIN Trainings and Technical Assistance

    CTC Support: Training, TA, and Implementation Help

    Maryland OOCC Learning Community Sessions

    Contact information

    Michael S. Gordon, D.P.A
    Michael S. Gordon, D.P.A
    Principal Investigator (Primary Contact)
    Friends Research Institute
    mgordon@friendsresearch.org
    Phone: 410-837-3977 ext. 251
    Fax: 410-752-4218
    Thomas R. Blue, Ph.D.
    Thomas R. Blue, Ph.D.
    Co-Principal Investigator/Statistician
    Friends Research Institute
    tblue@friendsresearch.org
    Phone: 410-837-3977 ext. 232
    Fax: 410-752-4218
    Frank J. Vocci, Ph.D.
    Frank J. Vocci, Ph.D.
    Co-Investigator
    Friends Research Institute
    fvocci@friendsresearch.org
    Phone: 410-837-3977 ext. 255
    Fax: 410-752-4218
    Marc J. Fishman, M.D.
    Marc J. Fishman, M.D.
    Co-Investigator, Study Physician
    Maryland Treatment Centers
    mjfishman@comcast.net
    Phone: 410-233-1400 ext. 240
    Sean M. Murphy, PhD
    Co-Investigator/Economist
    Weill Cornell Medical College
    smm2010@med.cornell.edu
    Phone: 917-721-7836
    Isabella Cheremeteff, M.A.
    Isabella Cheremeteff, M.A.
    Project Manager
    Friends Research Institute
    icheremeteff@friendsresearch.org
    Phone: 410.837.3977 ext. 236
    Fax: 410.752.4218
    © Copyright - Friends Research Institute.