Impact of Jail-Based Methadone on Overdose, Recidivism, HIV & Health Outcomes & Costs in New York City: 2012–2017
This study, also called MOR HEALTH, is a multi-agency collaboration between NYC Correctional Health Services, the NYC Department of Health and Mental Hygiene, the NYU Langone Department of Population Health, and Cornell Weill Medical College (CHERISH). Methadone maintenance treatment (MMT) has been available routinely and at scale for prior and new methadone male and female patients in New York City jails since 1987, and buprenorphine induction of new patients expanded significantly beginning in 2014. An electronic medical record (EMR) instituted in 2012 allows matching of individual jail health records to city and state community health datasets in New York, including vital statistics, Medicaid claims, jail incarceration, homeless shelter data, and HIV and HCV registries. The long-standing and widespread access to drug treatment in NYC jails, which has been captured in the EMR, presents a unique opportunity to evaluate the influence of criminal justice system-based MMT on post-release overdose risk and other wellbeing and health outcomes.
We currently are conducting a secondary data analysis of approximately 36,000 individuals with opioid use disorder on prison entry categorized by treatment status prior to release: in-jail MMT (methadone or buprenorphine) versus detoxification only. Using inverse probability of treatment weighting, we propose to estimate causal effects of in-jail methadone and buprenorphine maintenance treatment versus detoxification-only treatment on rates of post-release overdoses, recidivism, homelessness, HIV control, and HCV control to estimate cost implications from 2012-2017.
This study is sponsored by the National Institute on Drug Abuse (Grant # 1R01DA045042).