Funding Source
NIDA Justice Community Opioid Innovation Network, 1UM1DA064531
Project Period
9/15/25-5/31/30
Principal Investigator
Joshua D. Lee, MD (New York University Grossman School of Medicine); Jan Gryczynski, PhD (Friends Research Institute); Lisa A. Marsch, PhD (Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth); Sandra Springer, MD (Yale University)
Other Project Staff
Co-Investigators: Ralph Brooks, MS (Yale University); Jillian Corbin, MS (St. Vincent de Paul Place); Keith Goldfeld, DrPH (NYU Grossman School of Medicine); Sean Murphy, PhD (Weill Cornell Medicine); Elizabeth Saunders, PhD (Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth); Anjalee Sharma, PhD (Friends Research Institute); Mishka Terplan, MD (Friends Research Institute); Sandra Violette, MS (CT Department of Corrections).
Research Team: Kathleen Bell, MS (Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth).
Project Summary
Buprenorphine is one of the most effective forms of medication for opioid use disorder (MOUD) in community and criminal-legal settings (CLS). Although the Bureau of Justice Administration has recommended expansion of buprenorphine treatment, implementation in the CLS system has been challenging due to numerous barriers. Further, among those who do initiate sublingual daily buprenorphine (SL-B) in carceral settings, retention after release is generally low. Given the high risk of overdose morality after release from incarceration, strategies to improve usual post-release retention in MOUD are critical. Extended-release buprenorphine (XR-B) formulations may enhance retention after release, but these formulations have not been widely adopted in the CLS due to high costs, logical and space constraints, and the familiarity of SL-B.
To address these barriers, the STAND study will evaluate the comparative effectivenesss of XR-B versus SL-B, and examine implementation and cost differences in a multi-site, corrections-to-community, open-label study. This study seeks to: 1) Assess the comparative effectiveness of XR-B versus SL-B for retention in buprenorphine treatment at 12-weeks post-release, and 2) Examine the implementation, feasibility, and relative costs of each model of buprenorphine provision within CLS settings using the Consolidated Framework for Implementation Research (CFIR) and mixed-methods assessments.
Public Health Relevance
Implementing effective treatments for OUD are critical within the CLS system. This study will address gaps in care for people involved in the CLS by identifying the most effective formulations of buprenorphine treatment. Additionally, this trial has the potential to reduce post-release overdose risk, enhance long-term recovery outcomes, and mitigate the broader societal and economic impact of opioid use, while improving access to evidence-based treatment.