From the Justice Community Overdose Innovation Network Newsletter, March 2025
In a recent study published in Implementation Science, researchers from JCOIN’s Coordination and Translation Center (CTC) examined strategies to provide more effective technical assistance models to help jails implement medications for opioid use disorder (MOUD) and enhance public safety.
The JCOIN trial tested three technical assistance approaches to determine their effectiveness in increasing MOUD use in 29 county jails and 21 affiliated community-based providers across 14 states, spanning from Hawaii to Maine to Florida. The approaches included high-intensity organizational coaching, low-intensity organizational coaching, and the use of Extension for Community Healthcare Outcomes (ECHO), a case study learning approach for clinicians. Results showed that high-dose organizational coaching was the most effective approach. However, its impact was not significantly different from low-dose organizational coaching, which proved to be the most cost-efficient.
Across all coaching approaches, MOUD use among incarcerated individuals with an opioid use disorder increased by 45% over one year, showing a dramatic increase. This improvement was achieved by coaches helping sites activate the “cascade of care,” which includes:
- Increasing screening rates
- Increasing the types of MOUDs offered
- Improving MOUD treatment initiation processes inside jails
- Enhancing patient safety
- Improving the hand-off from the jail to continuing care through community-based MOUD providers
The trial demonstrated that while implementing MOUDs in correctional settings can be difficult, providing coaching to assist with setting up or improving the cascade of care will increase access to these life-saving treatments. The study was conducted by Dr. Todd Molfenter, Jessica Vechinski, Jessica Tveit, Dr. Jee-Seon Kim, Jingru Zhang, and Lionel Meng from the University of Wisconsin, Dr. Lynn Madden from Yale School of Medicine and the APT Foundation, and Dr. Faye S. Taxman from George Mason University.
The research was conducted as part of the NIH-Funded Fostering Medications for Opioid Use Disorder (MOUD) Use in Justice Populations implementation core, led by Dr. Todd Molfenter.
Molfenter, T., Vechinski, J., Kim, J. S., Zhang, J., Meng, L., Tveit, J., … & Taxman, F. S. (2025). Assessing the comparative effectiveness of ECHO and coaching implementation strategies in a jail/provider MOUD implementation trial. Implementation Science, 20(1), 1-12.