The Miriam Hospital receives NIH grant to study prison opioid program

October 12, 2017

The Miriam Hospital has been awarded a National Institutes of Health grant to study an innovative opioid addiction treatment program for incarcerated individuals that was expanded at the Rhode Island Department of Corrections in 2016.

The $215,157 federal grant will fund research into medication-assisted treatment to be led by principal investigator Josiah "Jody" Rich, M.D., an infectious disease specialist at the Lifespan-affiliated hospital and director of the hospital's Center for Prisoner Health and Human Rights.

The announcement of the grant comes as Rhode Island and the rest of the country confront a deadly opioid abuse problem. Rising opioid overdose fatalities have been linked to the availability of prescription narcotics and the spread of heroin laced with fentanyl, a synthetic opiate far stronger than heroin.

The program at the Rhode Island Department of Corrections treats individuals diagnosed with opioid use disorder by initiating and continuing them on synthetic narcotics – methadone and buprenorphine (Suboxone) – to stave off withdrawal symptoms and reduce cravings. The program also provides access to naltrexone (Vivitrol), which deters opioid abuse by blocking any high from narcotics. As they re-enter into the community, participants are linked up with providers of medication-assisted treatment to further decrease risks of relapse, overdose, and re-incarceration.

The program, the first of its kind in a statewide correctional system, has garnered national attention.

The grant from the National Institute on Drug Abuse is for "evaluating the implementation and impact of a novel medication-assisted treatment program in a unified jail and prison system." It was awarded to The Miriam, an affiliate of Lifespan, which earlier this year opened the Lifespan Recovery Center, a multidisciplinary, evidence-based, recovery-oriented program that meets the full spectrum of medical and social needs of individuals who have opioid use disorders.

"People with opioid use disorder who leave the correctional setting without medications are among those at the highest risk for overdose and death,” said Dr. Rich, who in addition to his work at The Miriam is a professor of medicine and epidemiology at Brown University's Warren Alpert Medical School.  “The comprehensive program developed at the Rhode Island Department of Corrections, in partnership with CODAC and others, is having and will continue to have a substantial impact on reducing overdose deaths in Rhode Island. This grant will allow this program to be optimized and replicated across the nation."

Dr. Rich serves as an expert advisor to Gov. Gina Raimondo's Overdose Prevention and Intervention Task Force. In response to a request from the governor, the General Assembly provided $2 million in the state's 2017 budget to expand the treatment program in the prisons.

"I am pleased that the National Institutes of Health and the National Institute on Drug Abuse recognize the innovative approach to addiction treatment and overdose prevention in Rhode Island,” said Gov. Raimondo. “I remain committed to doing all that we can to fight this devastating overdose epidemic in our state."

Ashbel T. Wall, II, director of the R.I. Department of Corrections (RIDOC), said, “With the support of the Governor and the General Assembly, we have been able to roll out treatment for opioid addiction to currently incarcerated individuals and link those individuals to ongoing treatment in the community. Our approach has been so successful that the Bureau of Justice Assistance has designated RIDOC as a ‘Center of Innovation’ and we have been receiving calls from colleagues around the country who are interested in our approach.”

The corrections program is run by CODAC Behavioral Healthcare, Rhode Island’s oldest and largest community provider of services for opioid use disorder.

“CODAC has been providing full service treatment to individuals, communities and families for over 45 years,” said Linda Hurley, CEO and president. “In 1994, we were honored to have been asked to provide treatment with medication for the extremely high-risk population transitioning from the Rhode Island Department of Corrections back into the community.  This program has grown exponentially over the ensuing years. CODAC is delighted to be invited to participate in this effort to explore a model that would increase access to care during a critical time when this population is particularly vulnerable to relapse.”

Dr. Rich’s research team is an interdisciplinary collaboration between Lifespan, Brown University’s Center for Alcohol and Addiction Studies, the University of Rhode Island’s Academic Health Collaborative, and the University of North Carolina at Chapel Hill. Lauren Brinkley-Rubinstein, PhD, is the lead co-investigator for the study and will oversee the qualitative component of this research. Other members of the research team are Traci Green, PhD, Brandon Marshall, PhD, Lyn Stein, PhD, and Rosemarie Martin, PhD.

Media Contact:

Richard Salit

The Miriam Hospital

(401) 793-7484; (401) 639-5328