| DOC Protocol | XR-NTX Pilot Adaptations For Research Study |
---|---|---|
Patient identification | Participant in DOC Substance Abuse Program (SAP), modified therapeutic community during incarceration | Individuals in jail preparing for release; screening protocols to identify transition to supervision in target county and release dates (including court dates and pleas) |
Patient eligibility | Only state inmates in state-funded jail and prison SAP programs with OUD who meet eligibility criteria | All individuals (regardless of classification) in one target rural county jail with an OUD transitioning to community supervision in the same county who meet eligibility criteria |
OUD and physical dependence determination | Assessment of OUD through state data collection system, includes DSM criteria; negative urine drug screen | Additional tools were included in screening and assessment including DSM5 checklist assessment for OUD, negative opioid urine screen, and Clinical Opioid Withdrawal Scale (COWS) total score indicating no withdrawal |
Oral naltrexone dosing, First XR-NTX administration and other ancillary services during incarceration | XR-NTX administered by corrections health care and any ancillary services provided through SAP (during incarceration) after taking 50 mg oral naltrexone once daily for 3 days | XR-NTX administered by one community clinic partner in the jail; session includes counseling and case management. XR-NTX injection given two hours after tolerating single dose of oral naltrexone 12.5 mg |
On-going XR-NTX administrations in the community | Referrals made to community providers based on re-entry plan | Second XR-NTX administration scheduled at the clinic [comparison condition] or at the P&P office [experimental condition] (coordinated with report days) based on random assignment |
Patient documentation | Medical evaluation results (including laboratory results) and XR-NTX administration notes included in individuals’ medical record at the facility | Medical evaluation results, XR-NTX administration notes, counseling and case management notes recorded on paper forms in the jail and transferred to electronic medical record upon return to the clinic |