Improving Access and Linkage to Substance Use Treatment for Formerly Incarcerated Persons Applying a Complex Systems Approach

Johns Hopkins University, Baltimore MD

Investigators

Abstract

PROJECT SUMMARY This project aims to enhance the health and well-being of individuals transitioning from correctional facilities to community settings by addressing barriers to accessing and engaging in medications for opioid use disorder (MOUD) treatment using an innovative complex systems approach. A complex systems approach aims to address social determinants of health and expressly acknowledges that achieving health equity requires more than just individual interventions; it necessitates systemic changes that improve coordination, communication, and resource allocation across various organizations and agencies involved in the reentry process. This approach focuses on transforming the interconnected components of the reentry system to create a supportive environment that facilitates continuous and effective access to MOUD treatment. Specific aims include: 1) examination of the structure and function of organizational networks and strength of relationships among organizations that provide reentry and linkage services for MOUD treatment, 2) provider perspectives on how network connectivity and multi-level interactions impact linkage for MOUD treatment, and 3) perspectives of formerly incarcerated individuals with current or prior illicit opioid use on interactions with the complex reentry system for linkage to MOUD treatment. The research design employs a multi-method approach, combining quantitative and qualitative data collection and analysis. Quantitative data will be collected from organizational leaders and reentry service providers using a network survey consisting of a network inventory and a relational coordination assessment. Qualitative data will be gathered through in-depth interviews with reentry service providers and formerly incarcerated individuals, focusing on their experiences with access and linkage to MOUD treatment. The project will utilize complex systems and organizational network analysis to understand the structure and dynamics of reentry organizations involved in MOUD linkage and treatment. The findings will inform the development of policy recommendations and intervention strategies aimed at improving the coordination and integration of reentry services. This research is highly relevant to the mission of the National Institute on Drug Abuse (NIDA) as it addresses critical gaps in the provision and care continuity of MOUD, which is essential for reducing opioid-related morbidity and mortality among populations with criminal legal system involvement. By focusing on the systemic and organizational factors affecting MOUD access, this project seeks to create a more effective and equitable reentry system that supports the health and recovery of formerly incarcerated individuals.