U.S. Department of Health & Human Services
Justice Community Opioid Innovation Network (JCOIN)
Overview
The Research Need
Many people with opioid use disorder pass through the criminal justice system. Improved access to high-quality, evidence-based addiction treatment in justice settings is critical to addressing the opioid crisis.
About the Program
This program studies approaches to increase high-quality care for people in justice settings with opioid misuse or opioid use disorder. The research tests strategies to expand effective treatment and care in partnership with local and state justice systems and community-based treatment providers.
The program generates real-world evidence through a range of research approaches including implementation research, national surveys, and novel use of existing data. The program also provides opportunities for HEAL grantees to study the impacts of emerging policies and programs, and it introduces new and underrepresented investigators in justice-related research.
#NIHHEAL: The Justice Community Opioid Innovation Network with Dr. Faye Taxman
Faye Taxman, PhD discusses the Women's Justice Community Opioid Innovation Network.
#NIHHEAL: Dr. Rosemarie Martin on Telehealth Services for OUD in the Criminal Justice System
Rosemarie Martin, PhD discusses how a telehealth program could improve outcomes for justice-involved women.
Program Details
To date, through the Helping to End Addiction Long-term® Initiative, or NIH HEAL Initiative®, NIH has funded 32 grants for this program, totaling $128.2 million, to support research activities over multiple years. JCOIN consists of research hubs and two centers providing supportive infrastructure—the Coordination and Translation Center and the Methodology and Advanced Analytic Resource Center.
The research hubs conduct large multisite clinical trials that each involve five or more communities, engaging with justice settings and with local service providers. These studies focus on expanding the use of evidence-based medications, behavioral interventions, digital therapeutics, and comprehensive patient-centered treatments in justice systems across 27 states and Puerto Rico.
The Coordination and Translation Center manages network logistics, engagement with practitioners and other key stakeholders in the justice and behavioral health fields, and dissemination of products and key research findings. It also conducts research to identify effective dissemination strategies for reaching criminal justice stakeholders, and provides funding for innovative, rapid-turnaround pilot studies. An educational component provides mentorship and support to researchers and practitioners on conducting rigorous studies in justice settings.
The Methodology and Advanced Analytic Resource Center provides data infrastructure and statistical and analytic expertise to support individual JCOIN studies and cross-site data harmonization. The center also conducts novel empirical research to understand changes in state policies, public opinion, and service delivery within the criminal justice system as they relate to the opioid crisis.
Research Examples
Through the research hubs, JCOIN addresses gaps in opioid use disorder treatment and related services in a wide range of criminal justice settings, including jails, probation and parole, drug and other problem-solving courts, and juvenile justice systems. JCOIN’s studies are particularly focused on ensuring continuity of care as individuals move between the criminal legal system and community-based services.
Examples of studies undertaken by the research hubs include:
- Studying the effectiveness and adoption of new medications for opioid use disorder
- Evaluating the impacts of new state mandates for opioid use disorder services in jails and drug courts
- Assessing strategies to connect individuals with treatment for opioid use disorder as they transition from jail to the community (e.g., telehealth, patient navigation, peer recovery support services)
- Conducting implementation research to learn how to scale up effective practices
- Examining agency staff perspectives on integrating opioid use disorder services into criminal legal systems
- Assessing whether criminal legal involvement influences intervention effectiveness or treatment adherence
