NSYPI Awarded NIH Grant to Support Research Addiction Treatment for OUD in Criminal Justice Settings

The New York State Psychiatric Institute has been awarded one of 12 grants from the National Institutes of Health (NIH) to form the Justice Community Opioid Innovation Network (JCOIN) to support research on quality addiction treatment for opioid use disorder (OUD) in criminal justice settings nationwide.

JCOIN is an initiative funded by the National Institute of Drug Abuse (NIDA), part of the NIH, with the goal of studying approaches to increase high quality care for people in the justice system with opioid misuse and disorder. JCOIN funds are part of a larger initiative at the NIDA called HEAL (Helping to End Addition Long-term), which is an aggressive, trans-agency effort to speed scientific solutions to stem the national opioid public health crisis.

The NYSPI Clinical Research Center will be led by Dr. Katherine Elkington, Dr. Edward Nunes, and Dr. Milton Wainberg. The Center’s research will focus on studying the real-time implementation of the opioid court model in New York State (NYS). The goal of the opioid court model is to address the flaws of existing drug courts and reduce overdose deaths, OUD, and recidivism through rapid screening and linkage to medication to treat OUD. The Clinical Research Center will develop and evaluate an implementation intervention developed to improve the roll out of the opioid court model in 10 counties in NYS, looking at the impact on screening/identification, referral, treatment enrollment, and initiation of medication to treat OUD.

JCOIN funds both implementation studies as well as treatment effectiveness studies. Dr. Elkington and her team will be studying (increased) access to medication to treat OUD, via successful implementation of the opioid court model. As part of this work, the project will be working with treatment agencies in each county to understand challenges to providing medication to treat OUD for justice populations and building capacity through technical assistance and education as needed.

Dr. Elkington’s team will develop and evaluate an intervention to rigorously implement the opioid court model by building cross-system partnerships and to optimize implementation tailoring to diverse counties. They will leverage the unique, real world, scheduled NYS roll-out of the opioid court model. “Using a cluster-randomized (stepped-wedge), hybrid effectiveness- implementation type-2 trial, we will compare the implementation intervention to treatment as usual (drug courts),” Dr. Elkington said. “Such real-world evaluation will permit development of generalizable yet tailored strategies that allow the opioid court model to be scaled up across a variety of contexts in NYS.”

The New York State Unified Court System has mandated that all court jurisdictions in NYS implement the opioid court model and develop new opioid drug courts; a center piece of the opioid court model includes rapidly identifying and linking individuals to medications for OUD.

Ultimately, this study has the potential to improve the outcomes for defendants by detecting OUD and/or overdose risk and rapidly linking high risk individuals to necessary care and treatment via the opioid court model.

Moreover, as opioid court model guidelines have been developed at the national level, Dr. Elkington and her team hope to design an implementation intervention that will build cross-system partnerships and optimize the implementation of opioid courts tailored to diverse counties not just in NYS but across the nation.

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Opioid Addiction Crisis