Centerstone’s Treatment and Recovery Court (C-TRC) will expand substance use disorder (SUD) treatment and recovery support services in Giles, Lawrence, Maury, and Wayne counties, Tennessee. C-TRC will serve an unduplicated 200 adults (ages 18+) with SUD as their primary condition participating in Tennessee’s 22nd Judicial District Recovery Court (i.e., Y1-5: 40, yearly). Focus population demographics are expected to mirror those of current drug court participants, with 47% male, 53% female, 91% White, and 3% Black individuals.
Each year, the Court serves 34 and another 76 may be eligible for drug court participation; of those, at least 30% (10) are expected to have opioid use disorder (OUD) and up to 40% (14), co-occurring SUD and mental health disorders (COD). At rates per 100,000, Black/African Americans (ages 15-64) in Lawrence represent 1,067 of the population yet 6,063 of those incarcerated (vs. White individuals at 92,716 yet 1,100). The 62 unsheltered homeless individuals in the TN-503 Continuum of Care, which includes all C-TRC counties, are 9 times more likely to spend time in jail than those in shelters; from 2013-2019, adult incarceration rates increased in rural areas (26%), while urban (-22%) and suburban (-6%) rates decreased. In the U.S., compared to adults overall, 3 times as many LGB adults are incarcerated and 7% (vs. 4%) had past year opioid misuse.
C-TRC’s culturally appropriate and evidence-based strategies will be implemented in alignment with NADCP’s Defining Drug Courts: Key Components and guided by SAMHSA’s Harm Reduction Framework and TIP 59: Improving Cultural Competence. Treatment interventions include the Matrix Model for Criminal Justice Settings and will be complemented by Hazelden’s Co-Occurring Disorders Program; Moral Reconation Therapy; Dialectical Behavior Therapy; Seeking Safety; Parent Management Training; Medication Assisted Treatment, as guided by SAMHSA’s TIP 63: Medications for OUD and TIP 49: Incorporating Alcohol Pharmacotherapies into Medical Practice; and DIMENSIONS: Tobacco Free Advanced Techniques Program. Case management services will be guided by the TASC Specialized Case Management Model, and SAMHSA’s Opioid Overdose Prevention and Response Toolkit will inform harm reduction education. C-TRC’s goals include: 1) Implement a comprehensive project to expand access to SUD treatment and recovery support services; 2) Implement capacity-building activities to expand, enhance, and sustain services; 3) Use evidence-based Treatment & Case Management Planning (TCMP) to address behavioral health disparities; social determinants of health; and diversity equity, inclusion, and accessibility; 4) Improve client health status/outcomes via evidence-based, population appropriate treatment services; and 5) Develop/disseminate a documented service model for agency replication/adoption throughout the state. C-TRC will achieve the following measurable objectives: provide training for 5 C-TRC staff and 50 Centerstone/other providers in SUD/COD identification, culturally/linguistically-appropriate care, harm reduction, and relapse prevention; provide/facilitate comprehensive screening/assessment, drug testing, TCMP, and evidence-based SUD treatment for an unduplicated 200 focus population adults; link 100% of those in need to appropriate resources (e.g., housing/recovery housing, employment, transportation, language access services); increase substance use abstinence among 70%; reduce mental health symptoms among 60% with COD; reduce tobacco/nicotine use among 30% 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 retain 60% in service for treatment/completion.