Fatal and Non-Fatal Opioid Overdose Risk Following Prison Release: Associations with Individual Risk Factors, In-Prison Medications for Opioid Use Disorder, and Peer Navigation

出狱后致命和非致命阿片类药物过量风险：与个人风险因素、监狱内治疗阿片类药物使用障碍的药物以及同伴导航的关联

• 批准号: 10370150
• 负责人: Stephen Crystal
• 金额: $ 18.24万
• 依托单位: RUTGERS, THE STATE UNIV OF N.J.
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-03-01 至 2023-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10370150
• 关键词: Accident and Emergency department; Address; Amendment; American; Award; COVID-19; COVID-19 pandemic; Caring; Cause of Death; Characteristics; Clinical; Complement; Computerized Medical Record; Criminal Justice; Data; Data Collection; Data Set; Databases; Diagnosis; Disease; Dropout; Drug usage; Emergency department visit; Enrollment; General Population; Hand; Health; Homicide; Hospitalization; Imprisonment; Individual; Intervention; Interview; Jail; Justice; Link; Medicaid; Mental Health; Modality; New Jersey; Opioid; Outcome; Overdose; Parents; Participant; Pattern; Policies; Population; Prisoner; Prisons; Recording of previous events; Recovery; Relapse; Risk; Risk Factors; Services; Structure; Subgroup; Substance Use Disorder; Suicide; Surveys; System; Time; Vital Statistics; Washington; base; behavioral health; beneficiary; billing data; cohort; comorbidity; effective intervention; ethnic minority population; experience; follow-up; heroin use; high risk population; improved; improved outcome; innovation; mortality; opioid epidemic; opioid overdose; opioid use disorder; outcome prediction; overdose risk; peer; prescription opioid; prison population; programs; protective factors; racial and ethnic; racial and ethnic disparities; recidivism; substance use; therapy design; uptake

Project Abstract Addressing opioid use disorder (OUD) and overdose among individuals released from incarceration is crucial for reducing the opioid epidemic's harms. Relapse and overdose are frequent following release. It is vital to identify effective interventions to improve these outcomes. Promising interventions include medications for opioid use disorder (MOUD) initiation prior to release, and peer navigator programs to support care transitions, re-entry, and recovery. However, more evidence is needed on outcomes of these interventions. In the proposed supplemental study, we will use linked New Jersey databases to examine overdoses and other substance use disorder (SUD) related outcomes following release in a cohort of New Jersey prisoners with SUD released from 2016-2020 . Outcomes examined include overdoses (fatal and non-fatal) and other SUD- related emergency department visits and hospitalizations. Data will be linked from: 1.) Administrative data from NJ Department of Corrections (NJDOC) on incarceration history, services and diagnoses received while incarcerated, release dates and recidivism; 2.) Electronic medical record data on all released state prisoners in New Jersey, including a substance use disorder assessment and data on pre-release participation in MOUD; 3.) Post-release mortality and cause-of-death data from NJ's Vital Statistics system, and 4.) post-release data on hospitalizations and emergency department (ED) visits, from all-payer Universal Billing (UB) data in NJ's Discharge Data Collection System (DDCS). These linked data will be used to address the following aims. 1.) Among inmates with SUDs, examine patterns and time course of fatal and non-fatal overdose risk, and risk of other SUD-related ED visits and hospitalization, following prison release. Assess associations of risk with demographic, clinical, and criminal justice histories of inmates, including mental health and substance use comorbidity. Assess changes in risk during the COVID-19 epidemic. 2.) Among inmates with OUD, examine take-up of: a.) pre-release MOUD, by modality and duration, and b.) participation in a peer-navigator re-entry program. Examine associations between participation in these programs and post-release outcomes, including fatal and non-fatal opioid overdose; other opioid-related ED and hospitalization encounters; post-release mortality from overdose, suicide, homicide, and other behavioral health related causes; and recidivism. Assess racial/ethnic disparities in receipt and outcomes of interventions. 3.) Conduct semi-structured participant and peer navigator interviews, to better identify facilitators and barriers for receipt of MOUD and peer navigator services among individuals released from prison, and participant/peer navigator perspectives on interventions as actually delivered. Results will identify factors that drive post-release outcomes and effects of innovative interventions designed to improve care for this high-risk population, and will provide actionable evidence to improve outcomes for justice-involved populations.

项目摘要 解决刑满释放人员的阿片类药物使用障碍 (OUD) 和过量用药问题至关重要 减少阿片类药物流行的危害。释放后经常出现复发和用药过量的情况。至关重要的是 确定有效的干预措施来改善这些结果。有希望的干预措施包括药物治疗 阿片类药物使用障碍 (MOUD) 在释放前启动，以及支持护理过渡的同伴导航计划， 再入和恢复。然而，需要更多证据来证明这些干预措施的结果。在 拟议的补充研究，我们将使用链接的新泽西数据库来检查药物过量和其他 一组新泽西州囚犯获释后出现物质使用障碍 (SUD) 相关结果 SUD于2016-2020年发布。检查的结果包括过量（致命和非致命）和其他 SUD- 相关的急诊科就诊和住院治疗。数据将链接至： 1.) 管理数据 新泽西州惩教署 (NJDOC) 提供关于监禁历史、服务和诊断的信息 被监禁、释放日期和累犯； 2.) 所有被释放的国家囚犯的电子病历数据 新泽西州，包括物质使用障碍评估和 MOUD 发布前参与情况的数据； 3.) 来自新泽西州生命统计系统的发布后死亡率和死因数据，以及 4.) 发布后数据 关于住院和急诊科 (ED) 就诊的信息，来自新泽西州的所有付款人通用账单 (UB) 数据 排放数据收集系统（DDCS）。这些关联数据将用于实现以下目标。 1.) 在患有 SUD 的囚犯中，检查致命和非致命用药过量风险的模式和时间过程，以及 出狱后其他与 SUD 相关的急诊就诊和住院治疗。评估风险与 囚犯的人口统计、临床和刑事司法历史，包括心理健康和药物使用 合并症。评估 COVID-19 流行期间的风险变化。 2.) 在患有 OUD 的囚犯中，检查 接受：a.) 按方式和持续时间预发布 MOUD，以及 b.) 参与同行导航器重新进入 程序。检查参与这些计划与发布后结果之间的关联，包括 致命和非致命阿片类药物过量；其他与阿片类药物相关的急诊科和住院治疗；发布后 因服药过量、自杀、他杀和其他行为健康相关原因造成的死亡；和累犯。 评估干预措施的接受和结果方面的种族/民族差异。 3.) 进行半结构化 参与者和同行导航员访谈，以更好地识别接受 MOUD 的促进因素和障碍 出狱人员之间的同伴导航服务，以及参与者/同伴导航的观点 实际实施的干预措施。结果将确定推动发布后结果和影响的因素 旨在改善对这一高危人群的护理的创新干预措施，并将提供可行的 改善参与司法的人群的结果的证据。

项目成果

Perspectives of opioid use disorder treatment providers during COVID-19: Adapting to flexibilities and sustaining reforms.

COVID-19 期间阿片类药物使用障碍治疗提供者的观点：适应灵活性和持续改革。

• 发表时间: 2022-01
• 影响因子: 3.9
• 作者: Treitler, Peter C;Bowden, Cadence F;Lloyd, James;Enich, Michael;Nyaku, Amesika N;Crystal, Stephen
• 通讯作者: Crystal, Stephen

Association of medications for opioid use disorder with reduced risk of repeat opioid overdose in Medicaid: A cohort study.

阿片类药物使用障碍药物与医疗补助中重复阿片类药物过量风险降低的关联：一项队列研究。

• 发表时间: 2024-02
• 作者: Tipping, Andrew D;Nowels, Molly;Moore, Clara;Samples, Hillary;Crystal, Stephen;Olfson, Mark;Williams, Arthur Robinson;Heaps
• 通讯作者: Heaps

A survey of barriers and facilitators to the adoption of buprenorphine prescribing after implementation of a New Jersey-wide incentivized DATA-2000 waiver training program.

在新泽西州范围内实施激励性 DATA-2000 豁免培训计划后，对采用丁丙诺啡处方的障碍和促进因素进行了调查。

• 发表时间: 2024-02-08
• 影响因子: 2.8
• 作者: Nyaku, Amesika N;Zerbo, Erin A;Chen, Clement;Milano, Nicole;Johnston, Barbara;Chadwick, Randall;Marcello, Stephanie;Baston, Kaitlan;Haroz, Rachel;Crystal, Stephen
• 通讯作者: Crystal, Stephen