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U.S. prisons are experimenting with Vivitrol, which could help addicted inmates stay off heroin and other opioid drugs after they are released. (Carla K. Johnson/​The Associated Press)

Houston — The opioid epidemic is now considered to be one of the worst drug crises in U.S. history. More than 28,000 people die every year from heroin and other opioids, and the number of fatal heroin overdoses alone has increased by 439 percent in the past two decades. The problem impacts individuals, families, and society as a whole — estimates indicate that one-third of heroin users are incarcerated each year due to crimes related to their addictions.

As part of its effort to address pressing issues and improve the criminal justice system, the Laura and John Arnold Foundation (LJAF) has committed more than a million dollars to study three promising programs. The programs are designed to help low-level offenders access treatment that may support their long-term recovery and keep them from committing future crimes. Two of the programs provide medication assisted treatment (MAT) to eligible offenders in Wake County, North Carolina, and in King County, Washington. The third targets one of the nation’s largest heroin markets — the west side of Chicago — by diverting certain individuals into treatment instead of arresting them.

The grants are associated with a broader $8.6 million package of research projects announced today. The projects were selected through a request for proposals (RFP) to evaluate promising programs in criminal justice. Specifically, the RFP was designed to help build the evidence base about the approaches, innovations, and strategies that work best to increase public safety and improve fairness and efficiency in the criminal justice system. The full list of projects is outlined in this fact sheet.

Though the RFP did not directly call for proposals focused on opioid addiction, LJAF received several submissions related to this issue given the urgency of the problem and its impact on the criminal justice system.

Heroin and other opioid addiction has quickly become one of the issues of greatest concern to criminal justice and public health officials across the country,” said LJAF Vice President of Criminal Justice Matt Alsdorf. Given the toll these addictions take on individuals and communities — as well as the strain they place on criminal justice resources — it is critical that we find innovative solutions to this complex set of problems. We are hopeful that these studies will provide evidence of what works in reducing recidivism and providing relief from addiction.”

The studies involving opioid addiction that are being funded in response to the RFP are as follows:

$339,516 to Duke University for an initial study of how MAT impacts recidivism and other outcomes for drug court participants in Wake County, North Carolina

Research indicates that people who participate in drug court are less likely to reoffend than those who receive traditional sentences — but only half of those who start a drug court program actually graduate. While MAT has been shown to help people stop using drugs and achieve long-term recovery, it has not traditionally been available in drug courts. However, in 2015, the Office of National Drug Control Policy began requiring all federally funded drug courts to lift any existing bans on MAT and allow interested clients to use the treatment. This grant will fund Duke University to conduct an initial study of the effects of Vivitrol, one of the newest forms of opioid-related MAT, on opioid-dependent drug court participants in Wake County, North Carolina. Vivitrol is a non-narcotic, once-monthly injection that can dramatically improve treatment adherence, reduce cravings, and block the euphoric effects of opioids, allowing an individual to focus on other fundamental aspects of his or her recovery. Researchers will randomize study participants to either their standard treatment plan or their standard treatment plan plus Vivitrol, and will review a variety of measures, including missed court appointments, positive drug screens, and instances of arrest and incarceration. This preliminary study will help determine whether the program is a good candidate for a larger evaluation of how MAT affects relapse and recidivism.

$495,373 to the University of Washington to study a program that provides MAT to addicted offenders upon their release from state prison in King County, Washington 

An analysis conducted by the Washington State Department of Corrections shows that the number of prisoners who report opioid use has more than quadrupled since 2007. In an effort to break the cycle of addiction and criminal activity, the University of Washington will implement a program in King County that assists patients in making treatment decisions and helps them navigate the process to access MAT options, including methadone, buprenorphine, or Vivitrol. The program is administered to a select group of offenders with opioid-use disorders shortly after their release from prison. It is designed to improve the continuity of care for people leaving prison — a critical time when there is an increased risk of relapse and fatal opioid overdose. Researchers will pilot test procedures that may reduce drug overdoses and criminal behaviors with the goal of determining whether MAT can play a role in decreasing recidivism, drug use, and hospitalization.

$199,367 to The University of Chicago to support a program focused on treating, instead of arresting, low-level offenders who buy and sell drugs to support their own addictions 

The west side of Chicago is a stronghold for gang-led narcotics operations. In 2015 alone, there were more than 8,750 drug crimes in the area, and nearly 35 percent of them were related to heroin. The Urban Labs at The University of Chicago is partnering with the Chicago Police Department, Chicago High Intensity Drug Trafficking Area, and three treatment providers — Thresholds, Haymarket Center, and Heartland Health Outreach — to develop and evaluate an innovative program that targets individuals who buy or sell narcotics primarily to support their addictions. Instead of arrest, the program diverts these low-level offenders who are addicted to opioids into treatment and counseling. The grant will provide funding to Urban Labs to evaluate whether this less punitive, harm reduction-based approach improves individuals’ health outcomes and social function, and whether the program can ultimately disrupt the pattern of drug use and incarceration.

Recognizing that this opioid-use disorder crisis is causing serious health, social, and financial consequences for individuals, as well as significant costs to society, LJAF is seeking additional proposals focused on improving treatment options for people with opioid addiction. The Foundation recently issued a request for proposals from organizations with ideas for rigorously evaluating existing treatment programs, testing new approaches to treatment, and re-orienting government spending around effective programs that demonstrate measurable results.

In order to help communities across the country facing this epidemic, we need to get smarter about which treatment programs work for which people and how the most effective programs can be scaled to meet the growing need,” LJAF Vice President of Evidence-Based Innovation Kathy Stack explained. We believe the research we are funding will teach us about approaches that can improve public safety and public health.”