Centerstone’s Treatment and Recovery Court (C-TRC) will expand substance use disorder (SUD) treatment and recovery support services in existing drug courts for an unduplicated 200 adults (i.e., Yrs. 1-5: 40, annually) diagnosed with SUD as their primary condition participating in partnering courts, the 17th Judicial District Misdemeanor and Felony Recovery Courts and Lincoln County Recovery Court, within the catchment area of Bedford, Lincoln, Marshall, and Moore counties, Tennessee.
Focus population demographics are expected to mirror those of current drug court program participants, with 57% male; 43% female; 95% White; and 5% Black individuals. An estimated 310 in the local criminal justice system will be eligible for drug court participation; of those, up to 30% (93) are anticipated to have opioid use disorder (OUD) and up to 40% (124), co-occurring SUD and mental health disorders (COD). Of the 120+ with COD; an estimated 74% will experience anxiety and 68.5%, depression; up to 49% with COD are expected to be unstably housed. In 2020, 12% of HIV cases in Bedford were attributed to injection drug use vs. 7% of the state’s; per public health surveillance, the focus population in Lincoln and Marshall experience increased risk of HIV/hepatitis C virus due to injection drug use.
C-TRC’s evidence-based strategies/interventions include NADCP’s Defining Drug Courts: The Key Components, NHRC’s Harm Reduction Principles, and SAMHSA’s TIP 59: Improving Cultural Competence to guide activities; Hazelden’s Matrix Model and COD Program, Moral Reconation Therapy, Dialectical Behavior Therapy, Seeking Safety, and Medication Assisted Treatment according to SAMHSA’s TIP 63: Medications for OUD and TIP 49: Incorporating Alcohol Pharmacotherapies Into Medical Practice to treat SUD/COD; TASC Case Management Model to guide case management; and SAMHSA’s Opioid Overdose Prevention Toolkit to guide/inform harm reduction services and education. C-TRC’s goals include: (1) Implement a comprehensive project to expand access to SUD treatment and recovery support services, including harm reduction services; (2) Develop a sound infrastructure/capacity to expand, enhance, and sustain services; (3) Use evidence-based/best practice Treatment & Case Management Planning to address behavioral health disparities; social determinants of health; and diversity equity, inclusion, and accessibility; (4) Improve client health status and outcomes via evidence-based, population appropriate treatment services; and (5) Develop/disseminate a documented service model for agency replication/adoption throughout the state. As a result of these goals, C-TRC will achieve the following measurable objectives: train 5 project staff and 50 other providers in SUD/COD identification, culturally-/linguistically-appropriate care, harm reduction, and relapse prevention; provide/facilitate comprehensive screening/assessment, drug testing, treatment and case management plans, and evidence-based SUD treatment for an unduplicated 200 focus population adults; establish an Advisory Council comprising 20% focus population/families, court staff, etc.; conduct 5 policy/procedure reviews with partnering courts; outreach to 200 community organizations/stakeholders; develop a sustainability plan with linkages to 2 funding mechanisms; link 100% of those in need to appropriate resources (e.g., housing/recovery housing, employment/skills training, transportation, language access services); increase substance use abstinence among 70%; reduce consequence of substance use among 75%; reduce mental health symptoms among 60% with COD; reduce tobacco/nicotine use among 50% with such goals; improve employment/education status among 60% who received such services; improve housing stability among 60% who received such supports; reduce past 30-day criminal justice involvement among 60%; improve individual/family functioning among 70%; increase social connectedness among 70%; and achieve an 80% follow-up rate.