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Patient identification
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Participant in DOC Substance Abuse Program (SAP), modified therapeutic community during incarceration
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Individuals in jail preparing for release; screening protocols to identify transition to supervision in target county and release dates (including court dates and pleas)
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Patient eligibility
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Only state inmates in state-funded jail and prison SAP programs with OUD who meet eligibility criteria
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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
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OUD and physical dependence determination
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Assessment of OUD through state data collection system, includes DSM criteria; negative urine drug screen
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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
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Oral naltrexone dosing, First XR-NTX administration and other ancillary services during incarceration
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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
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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
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On-going XR-NTX administrations in the community
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Referrals made to community providers based on re-entry plan
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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
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Patient documentation
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Medical evaluation results (including laboratory results) and XR-NTX administration notes included in individuals’ medical record at the facility
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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
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