NEADCP Relapse Prevention Demonstration Pilot

Retrospective Analysis Draft

The Board of Directors of NEADCP has made the decision to implement a demonstration project involving the use of extended-release injectable naltrexone (XR-NTX) in participating New England Drug Courts. All states that have, or can organize, the necessary infrastructure will be invited to select courts to participate in the demonstration project.

Extent of the problem: The population of focus is male and female non-violent adult offenders engaged in treatment within a Drug Court setting. These individuals are assessed as having an opioid and/or alcohol problem and have no prior conviction of violent offense. Each participant has a legal disposition that includes potential for incarceration or a defined county house of correction sentence that has been suspended. Demographics will vary by jurisdiction.

Heroin addiction is a chronic relapsing disease that is difficult to cure, but stabilization and harm reduction can greatly increase the life time expectancy and the quality of life of the patient, his or her direct environment and society as a whole.

In 2007, about 10.7 million persons aged 12 to 20 (27.9 percent of this age group) reported drinking alcohol in the past month. Approximately 7.2 million (18.6 percent) were binge drinkers, and 2.3 million (6.0 percent) were heavy drinkers (SAMHSA 2007). Alcohol is a factor in about half of all fatalities from motor vehicle crashes, homicides, and suicides in the United States. Families of heavy drinkers are more likely than others to be characterized by violence between spouses, child abuse, and a higher than average likelihood of raising children who themselves become heavy drinkers (Robert Wood Johnson Foundation, 1993).

The abuse of alcohol and other drugs is part of a pattern that includes dysfunctional interpersonal relationships, unemployment, crime, violence, and mental health disorders. Problem solving court programs represent a successful way to confront emerging issues in our nation, notably addiction. More research has been published on the effects of adult Drug Courts than virtually all other criminal justice programs combined (Marlowe 2010).

This project will examine the effectiveness of treating Drug Court participants with alcohol dependence or opioid dependence with XR-NTX as an additional treatment option available in the drug court setting as compared to Drug Court participants who are engaged in other behavioral health treatment and/or recovery supports. In total, this New England project aims to involve at least 50 participants in aggregate.

This project will examine the following outcomes: reduction in positive urine screens, abstinence/reduction in opioid use/drinking, referrals to higher levels of care, number of days in jail, number of probation violations, treatment retention/compliance within the program, number of days to completion of program, and long term cost-effectiveness.

Each participating court will need to have (or arrange for) a medical provider to conduct the medical assessment for each participant to screen for the appropriateness of, to prescribe and to administer XR-NTX. Medication (XR-NTX) used during the demonstration project will be paid for by each state’s Medicaid program. Each state will need to seek alternative funding sources to cover the medication costs for Participants without insurance.

The project will include a referral for administration, standardized screening and medical assessment for each potential participant, participant consent, and a MOU between relevant parties. Training and technical assistance will be provided to assist courts with the implementation of this project.

Participants will be followed for 12 months.

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For questions about the NEADCP Pilot Project, please contact John Hamilton, President of NEADCP at