A public health researcher from the University of Massachusetts Amherst has secured an impressive total of $17.9 million in grants from the National Institutes of Health (NIH) to advance pioneering research focusing on incarcerated populations suffering from opioid use disorder and HIV. This extensive funding aims to expand and refine medical treatment programs within correctional facilities and strengthen prevention and intervention strategies post-incarceration.
The centerpiece of this innovative effort is the Justice Community Overdose Innovation Network (JCOIN), an initiative begun by the NIH in 2019. JCOIN represents the first evidence-based framework for delivering medication-assisted treatment (MAT) to individuals with opioid use disorder while they are incarcerated—a critical step forward in addressing the opioid epidemic, which continues to ravage communities across the United States. JCOIN’s success is vital given the unique vulnerabilities and health disparities faced by incarcerated populations.
During the first phase of the Massachusetts JCOIN Hub, led by Elizabeth Evans, a professor and associate chair in community health education and health policy at UMass Amherst’s School of Public Health and Health Sciences, the research team partnered with seven correctional facilities spanning urban and rural settings. Their goal was to evaluate a pilot program offering medications for opioid use disorder (MOUD) within jail environments, while also monitoring the implementation processes, treatment outcomes, and economic costs. These findings emphasized both the effectiveness and challenges of jail-based interventions.
One of the stark findings from this study was that incarcerated individuals receiving MOUD showed significantly improved health outcomes compared to those who did not receive such treatment. However, a substantial hurdle emerged: many individuals discontinued their MOUD regimen after release, which diminishes the long-term efficacy of treatment programs started within jail facilities. This discontinuity in care has severe consequences, including heightened risks of relapse and overdose mortality during the critical reentry period.
Building on this insight, Evans’ new line of research will focus on developing strategies to enhance continuity of care after release. Specifically, this involves launching an intervention at four Massachusetts jails designed to support formerly incarcerated individuals in maintaining their MOUD therapy. A critical component of this work investigates barriers to access, with particular attention paid to the historical suspension or freezing of Medicaid coverage during incarceration.
Medicaid access has long been a barrier for incarcerated populations, impeding their ability to secure timely and effective treatment upon reentry into the community. Massachusetts has taken a pioneering step by securing federal approval through a Section 1115 waiver, which allows Medicaid benefits to activate up to 90 days before an individual’s release. This policy aims to facilitate uninterrupted healthcare access—including crucial substance use disorder treatments—bridging detention and community life.
The intervention developed by Evans and her team will rigorously evaluate whether this Medicaid waiver provision effectively increases healthcare access, improves health outcomes, and supports sustained MOUD engagement. Collaborators on this project include UMass Amherst’s Michal Horný, an expert in health policy and management, and Ekaterina “Kate” Pivovarova, who brings deep clinical expertise from her field of family medicine and community health at UMass Chan Medical School.
Massachusetts is serving as a critical testbed for these innovative correctional health initiatives. Should the approaches prove successful, they may offer scalable and adaptable models for other states grappling with similar opioid-related challenges within their criminal justice systems. The state’s existing pilot sites, including jails in Western Massachusetts and the Boston area, continue to function as vital research grounds.
A related NIH-funded project led by Pivovarova and Evans is designed to forge alliances between court systems and MOUD providers, seeking to redirect individuals with opioid use disorder towards treatment programs instead of incarceration. This approach recognizes the intersection between the legal system and public health imperatives and aims to circumvent cycles of recidivism and untreated addiction.
Moreover, Evans, alongside Dr. Alysse Wurcel from Boston Medical Center, will spearhead a new $4.7 million initiative focused on HIV prevention and treatment among incarcerated populations. This program was prompted by a recent HIV outbreak in a Boston-area jail and underscores the urgent need for integrated health interventions within correctional settings, where both infectious diseases and substance use disorders concurrently pose severe public health risks.
Correctional institutions are often overlooked healthcare access points; yet they offer strategic opportunities to deliver critical testing, prevention, and treatment services for both infectious diseases and substance use disorders. By embedding comprehensive health services within jails, these programs aim to turn correctional facilities into pivotal components of the broader public health infrastructure, reducing disparities and improving long-term community health outcomes.
With these comprehensive efforts, the University of Massachusetts Amherst and its partners are pushing boundaries in public health research aimed at vulnerable populations. This multifaceted approach leverages policy reform, healthcare innovation, and cross-sector collaboration to address systemic issues that have long perpetuated health disparities among incarcerated individuals. In doing so, the research sets a precedent for evidence-driven models that could reshape addiction and infectious disease treatment paradigms within the criminal justice context nationwide.
These initiatives underscore an urgent, science-based response to the intertwined epidemics of opioid addiction and HIV within justice-involved populations. Their success could pave the way for transformative public health policies that not only improve individual outcomes but also generate broader societal benefits by reducing overdose deaths, curbing infectious disease transmission, and improving pathways to recovery and rehabilitation.
Subject of Research:
Public health interventions addressing opioid use disorder and HIV among incarcerated populations, including jail-based medication-assisted treatment and Medicaid-linked care continuity.
Article Title:
Massachusetts Research Pioneers Innovative Jail-Based Treatments for Opioid Use Disorder and HIV Amidst the National Epidemics
News Publication Date:
Not specified
Web References:
https://www.umass.edu/public-health-sciences/about/directory/elizabeth-evans
https://www.umass.edu/public-health-sciences/academics
https://www.jcoinctc.org/
https://reporter.nih.gov/search/EHZAUseXuEmZozB9wq6zyw/project-details/11261921
Image Credits:
UMass Amherst
