Research

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  September 2024

  Naloxone vending machines in county jail

  The overdose epidemic in the United States has intensified following the introduction of illicitly manufactured fentanyl to drug markets with recent estimates indicating 110,000 deaths in 2022 and longer-term trends adversely impacting national life expectancy. A period of incarceration has been identified as a critical touchpoint for overdose prevention given its strong association with risk of overdose. This paper describes efforts funded by the Centers for Disease Control and Prevention (CDC) Overdose Data to Action (OD2A) grant to design and implement naloxone vending machines that provide free naloxone within county jails to returning citizens and those visiting county jail facilities.

  Treatment ecosystems

  Harm reduction

  Publication
• 
  June 2024

  Mediational pathways among drug use initiation, use-related consequences, and quit attempts

  This study investigated drug use-related consequences as a predictor of drug quit attempts and treatment seeking among two cohorts of persons who use drugs. Results showed that experiencing more drug-specific consequences was associated with increased attempts to quit drugs and a higher likelihood of seeking treatment for drug use. The study found that these consequences fully mediated the relationship between age at initial drug use and the number of quit attempts, highlighting the impact of adverse consequences on attempts to discontinue drug use. These findings underscore the importance of assessing drug-related consequences in treatment planning and intervention strategies for individuals with substance use disorders.

  Treatment ecosystems

  Publication
• 
  June 2024

  "If everyone knew about this, how many lives could we save?": Do drug suppliers have a role in reducing overdose risk?

  An unpredictable illicit drug supply is driving high overdose death rates in North America. Prior research underscores the importance of involving people who use drugs in harm reduction, but the inclusion of those who supply drugs is limited. This study explores this by interviewing people targeted by a harm reduction educational program for drug suppliers. Conducted in 2022 in Indianapolis, thematic analysis of six interviews revealed diverse harm reduction strategies practiced by participants. Drug suppliers were identified as key actors in reducing overdose risks, motivated by a moral imperative to protect their communities. Enhancing harm reduction training for suppliers could mitigate drug-related harms.

  Harm reduction

  Publication
• 
  March 2024

  2023 Michigan Data Landscape

  This Landscape 2.0 project builds from the first in reporting and updating similar overview data on both adults and youth. However, this report goes further by providing reports on prospective data collection in two areas: 1) Collection of admission/booking data in a dozen jails across the state to assess implementation of legislation associated with the Jail Task Force recommendations; and 2) a review of one county's implementation, and associated outcomes, of a risk/needs screening instrument used with youth who come to the attention of the court. These two chapters not only illustrate this original data, but also lay the groundwork for future and ongoing transformative work across the state.

  Other

  Report
• 
  November 2023

  Resources for Stepping Up and in-jail behavioral health programming

  Stepping Up seeks to bolster cross-systems collaboration and build out community-based services and supports to reduce incarceration and reincarceration, respond effectively to people in crisis, and ultimately prevent contact with the justice system in the first place. This list seeks to provide resources for community partners receiving Stepping Up Technical Assistance from the Center for Behavioral Health and Justice in their work to implement in-jail behavioral health programming.

  Diversion

  Resource
• 
  October 2023

  Assessing the reentry needs of incarcerated individuals with co-occurring opioid use and mental health concerns

  This sample included 490 adults from a targeted jail/prison reentry program for individuals experiencing COD in a Midwestern state. Program participants had histories of trauma, homelessness, and inpatient psychiatric care. Most participants reported needing medical attention for a physical problem. Participants had extensive criminal-legal system exposures. The findings have important implications for expanding reentry services to support individuals with COD, including the need to begin services prior to release and ensure the coordination and continuity of care with community-based treatment providers.

  Reentry

  Publication
• 
  October 2023

  The imperative of comprehensive care for EMS-administered naloxone-reversed overdose survivors

  Jail records were record-linked EMS records, Medicaid/TEDS billing records, and Michigan State Police records to create a rare window into the status of care for and risk identification for EMS-attended overdose survivors booked into jail. This brief looks at measures of opioid use disorder risk identification prior to and at jail booking as well as at OUD treatment provided prior to jail, in the jail, and following release. An overdose reversal may be viewed as a flag in a much larger narrative, one that underscores the imperative of providing comprehensive care and support, preemptively and reactively, to those at greatest risk.

  Treatment ecosystems

  Policy brief
• 
  October 2023

  Jail screening practices and services in response to the opioid risk

  Our data integration project allowed us to expand our view of who is booked into jail to include more measures of OUD risk, such as prior nonfatal overdose and prior OUD treatment. By doing so, we were able to examine whether our efforts at identifying this high risk subgroup through screening at booking were effective. Understanding that fatalities attributed to overdose among the recently released population is much higher than community samples, finding methods of identification at critical junctures such as jail intake, is essential to combating mortality rates within the state and one of our continued aims at the CBHJ.

  Treatment ecosystems

  Policy brief
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  August 2023

  Creating the best possible youth justice system

  This report reviews the change management process the Center for Behavioral Health and Justice facilitated for the Wayne County Third Circuit Court. The process sought to include strategic facilitation, strong community leadership and a building of collaboration among key partners who hold different perspectives.

  Youth justice

  Report
• 
  June 2023

  Community overdose surveillance: Fentanyl involvement in overdose deaths in rural Michigan

  This publication describe toxicology results from overdose deaths that occurred between January 1, 2018, and December 31, 2020, in 11 rural counties in Michigan, a state with relatively high rates of overdose mortality. The number of observed overdose deaths increased considerably from 2019 to 2020, with an increase of 72.4%. Fentanyl was the most common substance detected and had a 94% increase during the three-year period to present in 70% of all the deaths in these counties in 2020. Among the deaths we examined where cocaine was detected, 69% also contained fentanyl, and in deaths where methamphetamine was detected, 77% also contained fentanyl.

  Other

  Publication