CJ-PRISM: Understanding the Impact of Criminolegal System Involvement on a Peer-Delivered Intervention to Improve Retention and Polysubstance Use

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Project Summary Incarcerated individuals with opioid use disorder (OUD) are at disproportionately high risk of death from overdose upon community release—a key window of opportunity for interventions aiming to engage and retain individuals in life-saving OUD treatment. Our parent grant (PRISM) is evaluating a peer recovery specialist-delivered behavioral activation intervention to address polysubstance use as a primary barrier to OUD treatment retention. The overall goal of this supplement is to understand how the peer role may support linkage from jail to the MTU and how criminal and legal system involvement (CLI) may affect the parent study outcomes. Our specific aims are: (SA1) to understand perspectives of recently incarcerated individuals on (i) the impact of CLI on polysubstance use and OUD treatment retention; and (ii) considerations for adaptation of the PRISM peer-delivered intervention to meet the needs of people with CLI; (SA2) to obtain key stakeholder perspectives on how to strengthen the linkage between discharge from jail and the MTU, and how a peer (and the PRISM intervention) could best support that linkage; and in an exploratory aim (SA3), to characterize and evaluate the impact of criminolegal system involvement on polysubstance use and treatment adherence and retention. By gathering patient and key stakeholder input, we will understand how PRISM may be adapted to be delivered during the critical period of jail discharge and re-entry into the community. Further, this study will inform on the impact of CLI on the parent award primary outcomes of polysubstance use and OUD treatment adherence and retention.