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dc.contributor.authorFerguson, Warren J.
dc.contributor.authorJohnston, Joan
dc.contributor.authorClarke, Jennifer G.
dc.contributor.authorKoutoujian, Peter J.
dc.contributor.authorMaurer, Kathleen
dc.contributor.authorGallagher, Colleen
dc.contributor.authorWhite, Julie
dc.contributor.authorNickl, Dyana
dc.contributor.authorTaxman, Faye S.
dc.date2022-08-11T08:09:55.000
dc.date.accessioned2022-08-23T16:48:39Z
dc.date.available2022-08-23T16:48:39Z
dc.date.issued2019-12-12
dc.date.submitted2020-01-13
dc.identifier.citation<p>Health Justice. 2019 Dec 12;7(1):19. doi: 10.1186/s40352-019-0100-2. <a href="https://doi.org/10.1186/s40352-019-0100-2">Link to article on publisher's site</a></p>
dc.identifier.issn2194-7899 (Linking)
dc.identifier.doi10.1186/s40352-019-0100-2
dc.identifier.pmid31832801
dc.identifier.urihttp://hdl.handle.net/20.500.14038/41309
dc.description.abstractBACKGROUND: Opioid use disorder (OUD) is among the most prevalent medical condition experienced by incarcerated persons, yet medication assisted therapy (MAT) is uncommon. Four jail and prison systems partnered with researchers to document their adoption of MAT for incarcerated individuals with opioid use disorders (OUD) using their established treatment protocols. Employing the EPIS (Exploration, Planning, Implementation, and Sustainment) framework, programs report on systematic efforts to expand screening, treatment and provide linkage to community-based care upon release. RESULTS: All four systems were engaged with implementation of MAT at the outset of the study. Thus, findings focus more on uptake and penetration as part of implementation and sustainment of medication treatment. The prevalence of OUD during any given month ranged from 28 to 65% of the population in the participating facilities. All programs developed consistent approaches to screen individuals at intake and provided care coordination with community treatment providers at the time of release. The proportion of individuals with OUD who received MAT ranged considerably from 9 to 61%. Despite efforts at all four sites to increase utilization of MAT, only one site achieved sustained growth in the proportion of individuals treated over the course of the project. Government leadership, dedicated funding and collaboration with community treatment providers were deemed essential to adoption of MAT during implementation phases. Facilitators for MAT included increases in staffing and staff training; group education on medication assisted therapies; use of data to drive change processes; coordination with other elements of the criminal justice system to expand care; and ongoing contact with individuals post-release to encourage continued treatment. Barriers included lack of funding and space and institutional design; challenges in changing the cultural perception of all approved treatments; excluding or discontinuing treatment based on patient factors, movement or transfer of individuals; and inability to sustain care coordination at the time of release. CONCLUSIONS: Adoption of evidence-based medication assisted therapies for OUD in prisons and jails can be accomplished but requires persistent effort to identify and overcome challenges and dedicated funding to sustain programs.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=31832801&dopt=Abstract">Link to Article in PubMed</a></p>
dc.rights© The Author(s). 2019 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectCriminal justice
dc.subjectImplementation science
dc.subjectMAT
dc.subjectOpioid
dc.subjectUptake
dc.subjectOpioid use disorder
dc.subjectincarcerated persons
dc.subjectmedication assisted therapy
dc.subjectCommunity Health and Preventive Medicine
dc.subjectCriminology
dc.subjectCriminology and Criminal Justice
dc.subjectHealth Law and Policy
dc.subjectHealth Policy
dc.subjectHealth Services Administration
dc.subjectHealth Services Research
dc.subjectLaw Enforcement and Corrections
dc.subjectSubstance Abuse and Addiction
dc.subjectTherapeutics
dc.titleAdvancing the implementation and sustainment of medication assisted treatment for opioid use disorders in prisons and jails
dc.typeJournal Article
dc.source.journaltitleHealth and justice
dc.source.volume7
dc.source.issue1
dc.identifier.legacyfulltexthttps://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=5114&amp;context=oapubs&amp;unstamped=1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/oapubs/4095
dc.identifier.contextkey16192403
refterms.dateFOA2022-08-23T16:48:39Z
html.description.abstract<p>BACKGROUND: Opioid use disorder (OUD) is among the most prevalent medical condition experienced by incarcerated persons, yet medication assisted therapy (MAT) is uncommon. Four jail and prison systems partnered with researchers to document their adoption of MAT for incarcerated individuals with opioid use disorders (OUD) using their established treatment protocols. Employing the EPIS (Exploration, Planning, Implementation, and Sustainment) framework, programs report on systematic efforts to expand screening, treatment and provide linkage to community-based care upon release.</p> <p>RESULTS: All four systems were engaged with implementation of MAT at the outset of the study. Thus, findings focus more on uptake and penetration as part of implementation and sustainment of medication treatment. The prevalence of OUD during any given month ranged from 28 to 65% of the population in the participating facilities. All programs developed consistent approaches to screen individuals at intake and provided care coordination with community treatment providers at the time of release. The proportion of individuals with OUD who received MAT ranged considerably from 9 to 61%. Despite efforts at all four sites to increase utilization of MAT, only one site achieved sustained growth in the proportion of individuals treated over the course of the project. Government leadership, dedicated funding and collaboration with community treatment providers were deemed essential to adoption of MAT during implementation phases. Facilitators for MAT included increases in staffing and staff training; group education on medication assisted therapies; use of data to drive change processes; coordination with other elements of the criminal justice system to expand care; and ongoing contact with individuals post-release to encourage continued treatment. Barriers included lack of funding and space and institutional design; challenges in changing the cultural perception of all approved treatments; excluding or discontinuing treatment based on patient factors, movement or transfer of individuals; and inability to sustain care coordination at the time of release.</p> <p>CONCLUSIONS: Adoption of evidence-based medication assisted therapies for OUD in prisons and jails can be accomplished but requires persistent effort to identify and overcome challenges and dedicated funding to sustain programs.</p>
dc.identifier.submissionpathoapubs/4095
dc.contributor.departmentHealth and Criminal Justice Program, Commonwealth Medicine
dc.contributor.departmentDepartment of Family Medicine and Community Health
dc.source.pages19


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© The Author(s). 2019 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Except where otherwise noted, this item's license is described as © The Author(s). 2019 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.