Rutgers research seeks to improve opioid addiction resources for recently incarcerated people

The Rutgers Institute for Health, Health Care Policy and Aging Research is conducting a study examining the effectiveness of certain medical interventions on prisoners with substance abuse disorders to combat the opioid epidemic.

Over the next five years, the study will use mixed methods of research to determine the efficacy of beginning opioid use disorder medications prior to a prisoner's release and using peer navigation to guide them through re-entering the community, according to a press release.

The study is providing opioid addiction medications such as methadone and buprenorphine, which are not offered in most jails, to patients while they are in prison, according to Grant Victor, an assistant professor in the School of Social Work and the study's co-investigator.

It will be funded, in large part, by a grant from the National Institute on Drug Abuse, which Stephen Crystal, a Board of Governors professor in the School of Social Work, director of the Center for Health Services Research and lead investigator of the study, said had an extensive review process involving multiple rounds of criticism and questioning on the study's practicality and methods.

The Daily Targum spoke to them and other researchers heading the project.

Release from prison is a particularly dangerous time for a formerly incarcerated person. According to Crystal, recently released individuals are 129 times more likely to have a opioid-related overdose than the rest of the population. Contributing factors include decreased tolerance for substances and decreased social support.

This problem has been heightened by the recent introduction of fentanyl, a synthetic opioid that is often mixed with other drugs and is 50 times more potent than heroin, according to the U.S. Drug Enforcement Administration.

Crystal said that from the study's first results, the programs show promise.

"We already have the first results, which are extremely encouraging," Crystal said. "These programs, separately and in combination, are very effective in getting people to be in treatment and remain on treatment."

An initial finding is that subjects who receive both medication before and after release, as well as peer navigation, have a higher rate of eligibility for Medicaid, according to Crystal.

He said these first results were recently presented at a conference in San Francisco by co-investigator and Rutgers alum Peter Treitler who is now an assistant professor at the Boston University School of Social Work.

Rusty Reeves, a professor in the Department of Psychiatry at Robert Wood Johnson Medical School, a psychiatrist and co-investigator of the study, said he provides information about released inmates he has worked with, including their medical mental health diagnoses and treatments. He then gives this data to Crystal's team who combines it with medical and state records.

Victor will be leading qualitative interviews with treatment providers, released patients receiving treatment and peer navigators.

According to Victor, his team will interview approximately 60 released inmates this year, with the first interview occurring within the first two weeks of their release and a follow-up interview six months later.

Victor added that some graduate students from the School of Social Work will be contributing to the study.

"We're really delighted to have a select number of really talented students from the School of Social Work," Victor said.

The students will be conducting interviews, recruiting interviewees, analyzing data and writing some of the findings for publication, Victor said.

According to Crystal and Victor, New Jersey is leading the charge on more robust substance abuse disorder treatments.

Crystal said one of the most unique aspects of the study was the dedication of the collaborating institutions as they navigate the introduction of new methods within existing medical systems.

"It's really inspiring to see the work of people that are really committed to provide good, evidence-based services for a group of people that … were stigmatized and (are) easy to neglect," he said.

One of Crystal's goals with the study is to understand the implementation of these treatments so they can be administered in other states.

Crystal commended the cooperation of public institutions, like Medicaid and the New Jersey Department of Corrections, for their cooperation with a private study.

While access to health care for prisoners is considered a right under the Eighth Amendment of the U.S. Constitution, states like New York have repeatedly denied incarcerated individuals access to critical medical care, according to a 2021 lawsuit. Similarly, Arizona has been held liable in federal courts for insufficient medical care in state prisons, according to a 2022 ruling.

Crystal said he hopes studies like these will help the ongoing battle to enforce prisoners' rights to health care and substance abuse treatment.

"If we're not going to decriminalize drug use, and we're not going to make really grand policy changes around regulating drugs, then we need to really build up our legal system," Victor said. "I think the first place to start is providing humane and equitable treatments that (are) evidence-based to folks who are incarcerated and also providing the structure and aid once they are released to maintain the treatment program if they choose."