Reducing Opioid Mortality in Illinois (ROMI)

降低伊利诺伊州阿片类药物死亡率 (ROMI)

• 批准号: 10671066
• 负责人: HAROLD Alexander POLLACK
• 金额: $ 212.59万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-15 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10671066
• 关键词: Accidents; Acute; Address; Attitude; Buprenorphine; Caring; Case Management; Chicago; Color; Communities; Community Outreach; Control Groups; Criminal Justice; Data; Discharge Plannings; Disease; Effectiveness; Effectiveness of Interventions; Enrollment; Ensure; Evidence based treatment; Face; Fentanyl; Funding; Future; Geography; Harm Reduction; Health; Health system; Heterogeneity; Hybrids; Illinois; Incidence; Individual; Infrastructure; Insurance; Intervention; Jail; Justice; Left; Mental Health Services; Methadone; Methods; Modeling; Naloxone; Narcotics; National Institute of Drug Abuse; Opioid; Outcome; Overdose; Patients; Persons; Pharmaceutical Preparations; Physicians; Positioning Attribute; Prisons; Provider; Public Health; Randomized, Controlled Trials; Research Design; Research Personnel; Resistance; Resources; Risk; Rural; Rural Population; Services; Site; Social Work; Social status; Stigmatization; Syringes; System; Testing; Therapeutic; Travel; Universities; Urban Community; Urban Population; Visit; Woman; Work; buprenorphine treatment; care coordination; care systems; community partnership; community-level factor; cultural competence; design; effectiveness testing; effectiveness/implementation design; experience; follow-up; geographic barrier; gun homicide; heroin overdose; high risk; implementation barriers; implementation efforts; implementation evaluation; improved; medication-assisted treatment; member; men; mortality risk; opioid epidemic; opioid mortality; opioid overdose; opioid use; opioid use disorder; opioid user; overdose death; participant retention; peer; peer recovery; pragmatic trial; primary outcome; randomized trial; rearrest; reincarceration; relapse risk; rural area; rural patients; rural setting; secondary outcome; service engagement; substance use; synthetic opioid; treatment arm; treatment group; urban setting; waiver

PROJECT ABSTRACT More than 2,700 Illinois residents died of opiate overdose in 2017—a number that surpassed the state’s combined fatalities from road accidents and gun homicide. Individuals leaving jail and prison may be at highest risk of fatal overdose and other drug-related harms. Severely vulnerable men and women face these risks at precisely the moment they cross boundaries of fragmented criminal justice, social service, and public health systems, and are thus most vulnerable to lost follow-up and disengagement from services, or to have other basic needs left unattended. The challenge may be most acute for detainees who rapidly flow through jail settings, where unpredictable departures hinder discharge planning and care coordination, and where justice stakeholders may hold attitudes that stigmatize substance use or resistant to harm reduction interventions. Individuals returning to Chicago communities of color are near relatively rich resources for both treatment and harm reduction. Yet they must navigate epicenters of illicit narcotics distribution that feature particularly high incidence of fatal overdose from heroin, fentanyl, and other synthetic opioids. Rural individuals in Southern Illinois, may have long travel distances from any methadone facility or any DEA-waivered physician available to prescribe buprenorphine. Rural patients also face geographic barriers to the provision of naloxone and SSPs. Many harm reduction services have been designed and implemented to serve urban populations in traditional centers of opioid use. The acceptability and cultural competence of such rural services remains understudied. Our proposed multi-site ROMI trial (Reducing Opioid Mortality in Illinois) seeks to address this public health challenge through improved supports and service linkages to medication-assisted treatment (MAT), naloxone distribution, and syringe support services (SSPs) provided to justice-involved individuals living with opioid use disorders. We seek to test whether a unified case management approach that includes peer recovery coaches can improve treatment engagement and retention in five diverse urban and rural contexts that all experience high rates of opioid disorders, overdose, and related harms. We request funds to implement a five-site Randomized Controlled Trial, enrolling at least 1,000 individuals living with OUD. The ROMI trial will be carried out using a hub-and-spoke model, with centralized long- standing social services infrastructure at the Community Outreach Intervention Projects (COIP) hosted at the University of Illinois at Chicago (UIC). COIP provides case management/transition of care services to justice- involved opioid users, extending resources and technical assistance to less-populated rural areas hardest-hit by the opioid epidemic. Using a hybrid type-one effectiveness implementation design, we propose a simple but effective package of treatment and harm reduction interventions to reduce subsequent opioid use and related harms in diverse contexts. Our pragmatic trial is thus well-positioned to test effectiveness while collecting contextual data for implementation.

项目摘要 2017年，超过2700名伊利诺伊州居民因优化过量而死亡，这一数字超过了该州 道路事故和枪杀杀人罪的致命造成。离开监狱和监狱的人可能处于最高 致命过量和其他与药物有关的危害的风险。严重脆弱的男人和女人面临这些风险 正是他们穿越碎片刑事司法，社会服务和公共卫生的界限 系统，因此最容易失去随访和脱离服务，或者拥有其他 基本需求无人看管。对于迅速流过监狱的细节而言，挑战可能最为严重 设置，不可预测的离开阻碍了出院计划和护理协调，以及正义的地方 利益相关者可能会举行会议，以使使用物质使用或抗药性损害减少干预措施。 返回芝加哥有色人种的个人几乎是相对丰富的治疗资源 减少伤害。然而，他们必须浏览非法麻醉品分布的中心，这些发行特别高 海洛因，芬太尼和其他合成阿片类药物的致命性过量发生率。南方农村人 伊利诺伊州，可能与任何MEDADADONE设施或任何DEA捕获物理学家的旅行距离很长 开处方丁丙诺啡。农村患者还面临纳洛酮和SSP提供的地理障碍。 已经设计和实施了许多减少危害的服务，以服务于传统的城市人口 阿片类药物使用中心。此类农村服务的可接受性和文化能力尚未被理解。 我们拟议的多站点ROMI试验（减少伊利诺伊州阿片类药物死亡率）旨在解决这一公共卫生 通过改进的支持和服务连接到药物辅助治疗（MAT），纳洛酮的挑战 分销和注射器支持服务（SSP）提供给涉及正义的人的阿片类药物使用 疾病。我们试图测试包括同行恢复教练在内的统一案例管理方法 可以在所有经历的五个潜水员城市和粗糙背景下改善治疗的参与和保留 阿片类疾病，过量和相关危害的高率。 我们要求资金实施五个站点的随机对照试验，至少注册1,000个人 与Oud一起生活。 Romi试验将使用轮毂和辐条模型进行，并具有集中式长期 在社区外展干预项目（COIP）举办的社会服务基础设施（COIP） 伊利诺伊大学芝加哥大学（UIC）。 COIP向司法提供案件管理/护理服务的过渡 - 涉及阿片类药物用户，将资源和技术援助扩展到人口较低的农村地区最艰难 由阿片类药物流行。使用混合类型的一种有效性实现设计，我们提出了一个简单但 有效的治疗和减少损害干预措施，以减少随后的阿片类药物使用和相关 在潜水员的情况下危害。因此，我们的务实试验在收集时具有很好的测试效果 用于实施的上下文数据。

项目成果

Ethical Approaches to Vaccine Allocation and Administration in Carceral Settings, With a Focus on Youth.

监狱环境中疫苗分配和管理的道德方法，重点关注青少年。

• DOI: 10.1089/jchc.21.05.0041
• 发表时间: 2022
• 期刊: Journal of correctional health care : the official journal of the National Commission on Correctional Health Care
• 作者: Enujioke,SharonC;Knopf,AmeliaS;Aalsma,MatthewC
• 通讯作者: Aalsma,MatthewC

Reducing Opioid Mortality in Illinois (ROMI): A case management/peer recovery coaching critical time intervention clinical trial protocol.

• DOI: 10.1016/j.jsat.2021.108348
• 发表时间: 2021-09
• 期刊: JOURNAL OF SUBSTANCE ABUSE TREATMENT
• 影响因子: 3.9
• 作者: Pho, Mai;Erzouki, Farah;Boodram, Basmattee;Jimenez, Antonio D.;Pineros, Juliet;Shuman, Valery;Claypool, Emily Jane;Bouris, Alida M.;Gastala, Nicole;Reichert, Jessica;Kelly, Marianne;Salisbury-Afshar, Elizabeth;Epperson, Matthew W.;Gibbons, Robert D.;Schneider, John A.;Pollack, Harold A.
• 通讯作者: Pollack, Harold A.