FRI’s HEAL JCOIN Grant: A comparative effectiveness trial of extended-release naltrexone versus extended-release buprenorphine with individuals leaving jail.
HEAL JCOIN Grant
Study OverviewPublications and PresentationsLearning Collaborative Meeting VideosLearning Collaborative Slide PresentationsLearning Collaborative ResourcesContact Information
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
- The occurrence of depression and other mood disorders with a substance use disorder dual diagnosis.
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
- St. Mary’s Offender Reentry program and how they are implementing Maryland House Bill 116
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
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- 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
- This presentation covers:
- Presenter: Warden Mary Ann Thompson, St. Mary’s County Detention and Rehabilitation Center
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- 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
- This presentation covers:
- Presenter: Ms. Angel Dalverny, BSN, RN, Allegany County Sheriff’s Office, Detention Center
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
- This presentation covers:
- 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
- This presentation covers:
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
- This presentation covers:
- 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
- This presentation covers:
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
- This presentation covers:
Methadone Treatment for People in Jail: Different Approaches to Increase Access
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- 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
- This presentation covers:
- Presenter: Ms. Rebecca Trott, Anne Arundel County Department of Health
-
- 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
- This presentation covers:
- Presenter: Captain Steve Wallace, Kent County Department of Corrections
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
- This presentation covers:
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)
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)
JCOIN Trainings and Technical Assistance
Contact information
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
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.
Co-Principal Investigator/Statistician
Friends Research Institute
tblue@friendsresearch.org
Phone: 410-837-3977 ext. 232
Fax: 410-752-4218
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.
Co-Investigator
Friends Research Institute
fvocci@friendsresearch.org
Phone: 410-837-3977 ext. 255
Fax: 410-752-4218
Co-Investigator
Friends Research Institute
fvocci@friendsresearch.org
Phone: 410-837-3977 ext. 255
Fax: 410-752-4218
Marc J. Fishman, M.D.
Co-Investigator, Study Physician
Maryland Treatment Centers
mjfishman@comcast.net
Phone: 410-233-1400 ext. 240
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
Co-Investigator/Economist
Weill Cornell Medical College
smm2010@med.cornell.edu
Phone: 917-721-7836
Isabella Cheremeteff, M.A.
Project Manager
Friends Research Institute
icheremeteff@friendsresearch.org
Phone: 410.837.3977 ext. 236
Fax: 410.752.4218
Project Manager
Friends Research Institute
icheremeteff@friendsresearch.org
Phone: 410.837.3977 ext. 236
Fax: 410.752.4218