PROJECT SUMMARY/ABSTRACT
The NIDA K23 Award proposes innovative research in opioid use disorder (OUD) treatment linkage after
release from incarceration. Recently incarcerated individuals are at significantly increased risk for overdose
death. Despite the clear benefits of medications for opioid use disorder (MOUD), uptake is low among
individuals with criminal-legal involvement (CLI). A critical knowledge gap that remains is how to overcome the
multiple structural barriers to post-release treatment engagement that lead to overdose-related morbidity and
mortality for this marginalized population. Telehealth-delivered buprenorphine may address gaps in provider
availability, competing social determinants of health, and access inequities related to buprenorphine treatment.
Interventions utilizing telehealth must be targeted to the specific needs of individuals with CLI and engage
relevant stakeholders across correctional and community settings. The objective of this application is to
develop a tele-buprenorphine clinical protocol to improve post-release treatment engagement. Specific aims
include:1) Identify rates and predictors of post-release buprenorphine treatment linkage among individuals with
OUD after jail incarceration; 2) Examine the perspectives of individuals with OUD and CLI, clinicians, and
administrators to inform the development of a tele-buprenorphine protocol for low-threshold treatment linkage
among jail-released adults; and 3) Conduct a pilot randomized-controlled trial utilizing tele-buprenorphine for
post-release treatment linkage among adults with OUD upon release from jail. An Intervention Mapping
protocol incorporating input from relevant stakeholders will be utilized to develop the intervention. These aims
will identify the target population and assess the needs and objectives of stakeholders, support the
development and testing of study measures, and assess the feasibility, acceptability, and preliminary efficacy
of the intervention. The proposed research will lead to an R01 randomized controlled trial to test the impact of
tele-buprenorphine on post-incarceration OUD treatment linkage, retention, and CLI outcomes. The mentorship
team brings together experts in health equity, health services research, clinical trials, addiction medicine,
substance use epidemiology, and correctional health care, as well as stakeholder advisors from correctional
health and reentry settings. This award will allow Dr. Utsha Khatri to develop as a clinician-investigator through
the pursuance of four training goals: 1) Develop advanced knowledge of correctional health care and addiction
treatment care transitions during reentry 2) Acquire advanced quantitative skills for clinical outcome
assessment using linked, administrative datasets 3) Design and conduct clinical trials on care delivery
interventions to address the needs of marginalized groups and 4) Attain grant writing and project management
skills to transition to independence. With the successful completion of this project, training activities, and
mentorship from a team of experienced investigators, Dr. Khatri will be exceptionally well prepared to lead an
independent research agenda designed to improve care and outcomes for individuals with CLI and addiction.