The impact of the communities that HEAL intervention on the provision of jail-based medication for opioid use disorder & linkage programs at release: Results from a randomized, wait-list controlled trial.

INTRODUCTION

This article examines whether the Communities That HEAL (CTH) intervention implemented by the HEALing (Helping to End Addiction Long-term®) Communities Study (HCS) expanded Medication for Opioid Use Disorder (MOUD) in jails and linkage to MOUD upon release.

METHODS

Communities were randomized to the CTH intervention group (N = 34) to implement an integrated set of community coalition-selected evidence-based practices or to the wait-list control group (N = 33). A three-wave survey of jail administrators assessed changes in jails' provision of OUD-related services. Community-level generalized estimating equation (GEE)-based Poisson models regressed the effect of the CTH intervention on whether a community's jail (1) inducts clients onto MOUD and (2) links to MOUD on release.

RESULTS

At baseline, more wait-list control communities' jails, compared to intervention communities' jails, inducted people on MOUD (75.9 % vs 63.3 %) and linked to MOUD upon release (79.3 % vs 66.7 %). During the evaluation period (July 2021 to June 2022), 71.0 % of CTH jails inducted people on MOUD (compared to 63.3 % at baseline), and 90.3 % of CTH jails linked persons to MOUD on release (compared to 66.7 % at baseline). Adjusted analyses detected no significant effect of the CTH intervention on MOUD induction or linkage.

CONCLUSIONS

Most CTH communities implemented linkage programs in jails. Compared to wait-list control communities, intervention communities' jails showed no difference in providing MOUD. Community coalitions can play an important role in facilitating MOUD linkage during reentry.