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Advancing the Evidence

People involved in the criminal justice and child welfare systems are among those at highest risk for opioid overdose and substance-related death. Jails, prisons, courts, and the child welfare system are key intervention points for people with substance use disorders to receive treatment. The Advancing the Evidence project is focused on ensuring access to evidence-based treatment in these settings as an immediate and targeted measure that will save lives.

Original Research

 

Reports

Big Ideas: Correctional Institutions as an Intervention Point for Opioid Use Disorder (OUD) Treatment

The standard of care for OUD is treatment using medications such as methadone and buprenorphine. However, few correctional facilities offer this treatment. As a result, people with OUD experience a significantly higher rate of overdose and death following release. 

Correctional facilities are beginning to recognize that access to evidence-based treatment and medication for substance use disorder saves lives and is a fundamental component of an effective treatment program.

To accelerate the momentum on this issue, the Addiction and Public Policy Initiative hosted the Applying the Evidence Summer Series. These virtual roundtables highlighted best practices, challenges, and opportunities in implementing medication-based treatment in correctional settings. Each session focused on a different critical issue, and gathered criminal justice professionals, health care providers, scientists, researchers, and people with lived experience.    

The report below shares the highlights from this series:

(An accessible version of Big Ideas: Correctional Institutions as an Intervention Point for Opioid Use is available for download.)

Applying the Evidence: Legal and Policy Approaches to Address Opioid Use Disorder in Criminal Justice and Child Welfare Settings. 

Approximately 130 people die every day in the United States from opioid-related drug overdose  leading to 47,000 deaths in 2017. Criminal justice and child welfare settings have traditionally been involved in the response to addiction and its related consequences, particularly for members of marginalized communities. This report lays out how strategic reforms in the criminal justice and child welfare systems present an opportunity to address overdose deaths and disparities in access to care for substance use disorders. Read the report here.

Model State Law and Tracking Legislation

The Addiction and Public Policy team has partnered with the Legislative Analysis and Public Policy Association to create model state legislation for access to medication for Opioid Use Disorder in correctional settings. Read the model law here.

Map of State Legislation on Medication for Opioid Use Disorder in CorrectionsMap developed for this project by American Institutes for Research (AIR)

This interactive map shows which states have proposed or passed state-level legislation on medication for opioid use disorder. Click through for more details, including links to each piece of proposed legislation.

The federal government has also proposed multiple pieces of legislation aimed at medication for treatment of opioid use disorder. Check the tracker here.

Policy Briefs: Key Strategies for Addressing Opioid Use Disorder

Key Strategy 1: Access to Medication for Opioid Use Disorder in Jails and Prisons

To save lives, correctional facilities can adopt evidence-based strategies to address substance use disorder. People who received medication for opioid use disorder during their incarceration are 85% less likely to die of overdose upon release. Read more

Key Strategy 2: Access to Medication for Opioid Use Disorder in Drug Courts/Treatment Courts

To save lives, treatment courts can adopt evidence-based strategies to address substance use disorder, including ensuring access to methadone, buprenorphine, and naltrexone, the three medications approved by the U.S. Food and Drug Administration (FDA) and the recognized standard of care for treating opioid use disorder. Read more.

Key Strategy 3: Reimagine the Systems Serving Families 

Pregnant women and parents with opioid use disorder often face stigma and adverse consequences, even when seeking and receiving treatment. Despite the success of medication as a treatment modality, parents enrolled in such programs often face serious limits on treatment availability. Systems should treat, rather than punish, addiction. Read more

Events and Presentations

 

The Addiction and Public Policy Initiative has hosted a series of convenings, bringing together health care providers, criminal justice professionals, scientists, researchers, and advocates. In October of 2019, the Addiction and Public Policy team hosted the conference, “Applying the Evidence: Legal and Policy Approaches to Address Opioid Use Disorder in Criminal Justice and Child Welfare,” which provided a forum for experts to discuss best practices and models. During the summer of 2020, Applying the Evidence Summer Series continued the conversation with national leaders in the field of addiction treatment, recovery, and the legal system. 

Watch the event recordings on the playlist below.

The O’Neill Institute teamed up with the Matters Network for a poster presentation at the 2020 RxSummit on best practices and strategies to treat opioid use disorder in critical intervention points such as correctional settings and hospital emergency departments.

 

To stay up-to-date with the Addiction and Public Policy Initiative’s work, sign up to be a part of the Advancing the Evidence Listserv