Assessment of Correctional Center Educational Needs to Promote Treatment with Medications for Opioid Use Disorder (Project ACCEPT-MOUD)

Individuals in the criminal justice system are at increased risk of opioid overdose compared to the general population, with the greatest risk occurring immediately after release from jail or prison. Realizing the dire need for treatment services for this vulnerable sub-population, the state of Maryland passed House Bill 116 (HB-116), legislation mandating that by January 2023, local correctional facilities make all three FDA-approved medications for opioid use disorder (MOUD) options available within 24 hours of incarceration to any individual in need. This policy change represents an important step in treating OUD and preventing post-release overdose deaths. However well-intended, this abrupt change has been met with resistance from within the system, challenging implementation efforts. Strategies to facilitate the introduction of MOUD in carceral settings are desperately needed, as is the identification of implementation barriers, including stigma.

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The goal of this project is to extend a previous pilot study of MOUD acceptance to a larger and wider geographic sample, and to examine potential barriers to staff acceptability. Our specific aims are: 1. Assess staff acceptance of the soon-to-be-implemented MOUD programs at four geographically diverse Maryland jails; and 2. Assess for presence and types of stigmas held by staff, including (1) perceptions of MOUD efficacy, (2) attitudes towards MOUD, and (3) stigma against people who use opioids. For both aims, survey assessments will be delivered across each of the four levels of staff (leadership, line officer, health/medical, discharge coordination staff).

 

Findings from this work will represent an important step towards characterization of staff perceptions and attitudes towards MOUD in Maryland jails that are either offering, or will soon offer, MOUD for incarcerated patients. By elucidating the types of stigmas that serve as barriers to MOUD treatment for incarcerated patients, this study will provide important educational endpoints, supporting the groundwork for successful implementation of HB-116