Shelby County Medically Assisted Treatment and Referral to Services for Justice-Involved Adults (M.A.T.R.S)

Abstract

In Shelby County, Tennessee, the impact of substance use/opioid use disorder (SUD/OUD) is growing. More people are being treated at local emergency departments (ED) for opioid-related issues and overdose (OD) deaths have been steadily increasing. Through June 19, 2021, 236 people died from OD, more than half the number in 2020 with more than 6 months remaining in the year. Moreover, the demographics of those impacted by opioids are changing; through June 19, 2021, 58% of opioid-related ED visits and 56% of OD deaths were by Black males and females, who are increasingly less likely to seek treatment. Justice involvement contributes to OD risk. Although we lack direct data on substance-involvement in this population, the percentage of clients at the Shelby County Office of Reentry (SCOR) with substance-use histories has increased, as has the percentage with non-violent drug offenses.  In Shelby County, where agencies traditionally have been reluctant to trust MOUD, few treatment options exist, especially for justice-involved individuals. To address these issues, the Shelby County Community Services Agency (CSA) proposes to implement a program called “Shelby County Medically Assisted Treatment and Referral to Services for Justice-Involved Adults” (SC-MATRS) that will assess non-violent justice-involved individuals for risk of overdose and refer those at high risk (HROD) to Integrated Addiction Care (IAC) for medication-assisted treatment for opioid use disorder (MOUD), wrap-around care, and referral to other treatment and services. West Tennessee Forensic Services (WTFS) will conduct forensic evaluation of Shelby County adults charged with non-violent offenses, to include an overdose risk assessment, and will encourage defense attorneys (PDs) to refer those at HROD to treatment at Integrated Addiction Care (IAC). A Peer Treatment/Recovery Coordinator (PTRC) will facilitate these referrals, as well as referrals from Drug Court (DC) and the Shelby County Office of Reentry (SCOR). In addition to the peer specialist, IAC will use a Social Worker/Case Manager and Clinical Therapist to assess client need and work to provide treatment and services required for recovery. A maximum of 50 referrals per month will be provided treatment, to include MOUD as necessary. If referral volume is sufficient, 100 referrals per month will be randomly selected from all referrals, and 50 will be randomly assigned to treatment while the other 50 will be a control group. This will allow for a more rigorous examination of program impact on the incarceration of individuals with SUD/OUD and on ODs among non-violent justice-involved individuals.