Introducing NIDA's Justice Community Opioid Innovation Network (JCOIN)

By Tisha R.A. Wiley, PhD, and Lori J. Ducharme, PhD
National Institute on Drug Abuse

In the context of addressing the overdose epidemic, the U.S. criminal justice system presents significant opportunities for intervention, challenges for service delivery, and potential for creating essential linkages to community-based services for individuals upon release. More than half of individuals in U.S. jails and prisons meet diagnostic criteria for substance use disorder, and a substantial proportion report regular opioid use (Bronson et al., 2017). Research that can inform and improve service delivery and treatment engagement is critical for this vulnerable population.

In 2019, the National Institutes of Health (NIH) launched the Helping to End Addiction Long-term Initiative, or NIH HEAL InitiativeSM, an ambitious effort to address the opioid crisis through research on the effective management of chronic pain, and the prevention and treatment of opioid misuse and opioid use disorder (OUD). As part of that initiative, the National Institute on Drug Abuse (NIDA), established the Justice Community Opioid Innovation Network (JCOIN) to study approaches to improve OUD treatment services for individuals involved in the justice system.

The delivery of substance use treatment services within correctional settings remains rare, and is challenged by a number of logistical, regulatory, philosophical, and resource hurdles (Fiscella et al., 2018). Continuity of care, both upon incarceration and upon release, is a particular challenge (Joudrey et al., 2019). JCOIN provides an opportunity to test alternative service delivery models to better engage individuals in ongoing treatment, and to support interagency collaborations that can facilitate the transition between criminal-legal and community settings.

JCOIN is a cooperative agreement that supports an array of clinical trials, pilot studies, stakeholder engagements, and dissemination activities. It begins with the perspective that every individual involved in the justice system should have access to evidence-based SUD treatment services, while detained and while in the community. Thirteen large clinical trials are designed to generate evidence about “what works” in these settings and how best to implement those services. Briefly, they can be described in four thematic clusters...click on View Resource to read the full article.