By Brady P. Horn, Aakrit Joshi and Paul Guerin

Substance use disorders (SUD) are very prevalent and costly in the United States and New Mexico. Over 20 million individuals in the US meet diagnostic criteria for SUD and over 65 thousand US residents died from drug opioid overdose in 2020. It is well known that there is a strong correlation between SUD and incarceration. National studies have found that on average two thirds of prisoners have SUD and approximately 30% of inmates report having an opioid use disorder (OUD). There is growing momentum nationally to incorporate SUD, particularly OUD treatment, into incarceration systems and numerous studies have found that providing medication for opioids use disorder (MOUD) in incarceration systems is clinically effective. Since 2005, there has been a Methadone Maintenance Treatment (MMT) continuation program within the Metropolitan Detention Center (MDC) where individuals who were already receiving community-based treatment could continue their treatment within the jail. Prior work has found that this program was associated with reduced crime. In 2017 this program was expanded and started providing treatment to individuals who had not been receiving methadone in the community prior to incarceration. In this study we evaluate the impact of this treatment program. Data was collected from numerous different sources, linked, thoroughly cleaned, and a difference-in-difference empirical strategy is used. Robust evidence is found that MMT initiation reduced reincarceration. Our main results find that MMT initiation is associated with a per-person reduction in 19 incarceration days in the one-year period after jail-based MMT was received. We also find evidence confirming prior studies that found MMT continuation reduces recidivism. We find that jail-based MMT continuation is associated with a per-person reduction in 31 incarceration days in the one-year period post release. Also, a heterogenous treatment effect is found where individuals that received jail-based MMT for longer periods of time had larger reductions in reincarceration. Individuals who received MMT initiation for 70 days or more were associated with 22 fewer reincarceration days and individuals that received MMT continuation were associated with 60 fewer reincarceration days.

Albuquerque: University of New Mexico, Institute for Social Research, 2023. 43p

By William Ash-Houchen, Avery Sorensen, Monica Benton, Kaysea Beck

The Improving People’s Access to Community-based Treatment, Supports and Services (IMPACTS) grant program was established in by the Oregon Legislature through Senate Bill (SB) 973 (2019) in recognition of the shortage of comprehensive community supports and services for individuals with mental health or substance use disorders that lead to their involvement with the criminal justice system, hospitalizations, and institutional placements.1 The Oregon Legislature has appropriated a total of $30 million to the IMPACTS grant program since its inception in 2019. This funding is available to Oregon’s counties and federally recognized tribal governments to increase the availability of community-based supports and services to a target population of individuals with a behavioral health condition and frequent criminal justice system and/or emergency services involvement. Grantees currently represent 11 counties across the state and five federally recognized tribal governments. The overall aim of each program is to reduce the frequency with which persons served by the program are involved with the criminal justice system and rely on emergency healthcare services. Per SB 973, this report will explore several outcomes that have emerged from grantee-reported data, ongoing evaluation efforts, and the potential state government costs avoided due to the high utilizer IMPACTS grant program. It will also briefly highlight the interplay between these high utilizer programs and the recent creation of the Oregon Behavioral Health Deflection Grant Program. Key findings: • Co-occurring mental health and substance use disorders were reported among 54 percent of IMPACTS clients. Participants with co-occurring disorders return for services more often than clients enrolled in IMPACTS without a mental health disorder. • More than one third of IMPACTS clients report one of the following mental health disorders: trauma and stressor related disorders, depression, and/or anxiety. • Among the 74 percent of clients with known substance use disorder, 61 percent reported use of methamphetamine, and 46 percent reported alcohol use. • Those releasing from prison engage in IMPACTS services at a higher rate than those without a recent prison stay history. • Importantly, five IMPACTS programs are operated by federally recognized tribal governments. 29 percent of IMPACTS clients identify as American Indian and Alaskan Native (AIAN). Reported data show that this population returns for services in subsequent months at a significantly higher rate than those who do not identify as AIAN. • Grantees are reporting unique overlap opportunities between IMPACTS and Oregon Behavioral Health Deflection programs, which both deliver services to distinct but related populations. • From July 2023 through June 2024, IMPACTS served a total of 839 people. At the end of June 2024, more than 550 humans were actively enrolled. • The IMPACTS grantees are funded through June 30, 2025, and will not be sustained without further investment from the legislature.

Salem: Oregon Criminal Justice Commission 2025. 42p.