Reducing Overdose After Release from Incarceration (ROAR)

项目摘要 药物过量是出狱后死亡的主要原因，这种风险明显更高 女性与男性相比（Binswanger，Blatchford，Mueller，& Stern，2013; Binswanger等人，2007年）。 在释放后的前两周内，因药物过量而死亡的风险是129倍。 一般人群，虽然女囚犯有较高的阿片类药物使用障碍（OUD）和后， 释放过量死亡，女性在矫正人口和MAT研究中代表性不足 干预（Lee等人，2016年）。我们建议试点和评估跨学科阿片类药物过量 预防方案“减少出狱后的过量用药”。注重成果的年度报告 提供阿片类药物使用障碍（OUD）成瘾治疗（MAT）药物， 认证恢复导师（CRM），以减少成年女性囚犯在释放时过量的风险 从监狱里ROAR是俄勒冈州的公共卫生、刑事司法和医疗部门之间的合作项目。 社区.我们的长期目标是减少释放到监狱的妇女中阿片类药物过量死亡的人数。 被监禁后的社区注重成果的年度报告有两个具体目标： 具体目标1：试行注重成果的年度报告干预措施，以减少获释成年妇女吸毒过量的风险 出狱。ROAR是提供给所有符合条件的女囚犯被释放到俄勒冈州的四个最 在18个月的招募期内，试点（预期n=100）包括一个过程 使用基于综合框架的定量和定性措施进行评估 实施研究。 具体目标2：评价注重成果的年度报告试点项目对获释成年妇女类阿片过量的影响 出狱。我们评估了参与ROAR与阿片类药物主要结局之间的相关性， 过量，包括致死性或非致死性过量事件。致命和非致命的阿片类药物过量是 在18个月研究期间，对从CCCF释放的所有成年女性进行评估（预期n= 1，000） 不论是否参加注重成果的年度报告的干预。使用俄勒冈州提供的管理数据 惩教署（例如，监禁日期）和俄勒冈州卫生局（即，医疗补助索赔 和遭遇），我们比较了ROAR参与者（预期n=100）与 在研究期间，至少有100名从监狱释放的女性作为对照组。 注重成果的年度报告的干预措施和评价提供了关于改进预防类阿片药物的干预措施的重要信息 在被忽视的高风险人群中使用过量药物：被监禁的妇女重新进入社区。的 建议全面的行政数据链接是第一次在我国，并提供了一个独特的 有机会在获释后的几年里跟踪参与司法的妇女的健康和安全。

PROJECT SUMMARY Drug overdose is the leading cause of death after release from prison, and this risk is significantly higher among women compared to men (Binswanger, Blatchford, Mueller, & Stern, 2013; Binswanger et al., 2007). Within the first two weeks after release, the risk of death from drug overdose is 129 times higher than the general population, and although female inmates have higher rates of opioid use disorder (OUD) and post- release overdose fatality, females are underrepresented in studies of corrections populations and MAT interventions (Lee et al., 2016). We propose to pilot and evaluate the cross-disciplinary opioid overdose prevention program “Reducing Overdose After Release from Incarceration” (ROAR). ROAR combines provision of medications for addiction treatment (MAT) for opioid use disorder (OUD) with support from Certified Recovery Mentors (CRMs) to reduce overdose risk in adult female inmates when they are released from prison. ROAR is a collaboration between Oregon's public health, criminal justice, and medical communities. Our long-term goal is to reduce opioid overdose deaths among women released to the community following incarceration. ROAR has two specific aims: Specific Aim 1: Pilot the ROAR intervention to reduce risk of overdose among adult women released from prison. ROAR is offered to all eligible female inmates being released to one of Oregon's four most populated counties over the 18-month recruitment period. The pilot (expected n=100) includes a process evaluation using quantitative and qualitative measures grounded in the Consolidated Framework for Implementation Research. Specific Aim 2: Evaluate the effect of the ROAR pilot on opioid overdose among adult women released from prison. We evaluate the association between ROAR participation and the primary outcome of opioid overdose, including either a fatal or non-fatal overdose event. Fatal and non-fatal opioid overdoses are assessed for all adult females released from CCCF during the 18 month study period (expected n=1,000) regardless of participation in the ROAR intervention. Using administrative data provided by the Oregon Department of Corrections (e.g., dates of incarceration) and Oregon Health Authority (i.e., Medicaid claims and encounters), we compare the odds of overdose among ROAR participants (expected n=100) versus a comparison group of at least 100 females released from prison during the study period. The ROAR intervention and evaluation provide critical information on improving interventions to prevent opioid overdose in an overlooked, high-risk population: incarcerated women re-entering the community. The proposed comprehensive administrative data linkage is the first of its kind in our state and offers a unique opportunity to follow the health and safety of justice-involved women in the years following release.