A new research center will tackle one of the most overlooked areas of the addiction crisis: the lack of effective treatment for people with substance use disorders inside the criminal legal system. The National Institute on Drug Abuse has awarded a five-year, $4 million grant to establish the Criminal-Legal Economic Analysis and Resource (CLEAR) Center, a facility dedicated to studying the economics of addiction care and overdose prevention for incarcerated individuals and those under community supervision.
The CLEAR Center will operate within the larger Justice Community Overdose Innovation Network (JCOIN-II), a NIDA-supported program now in its second phase. Researchers from Weill Cornell Medicine and the University of Miami’s Miller School of Medicine will conduct cost-effectiveness analyses of clinical trials for substance use disorder interventions. They will also create cost-benefit and budget-impact calculators to help administrators and policymakers identify which care strategies deliver the greatest value within tight budgets.
Interventions for people with substance use disorders are often inadequate in the criminal legal system, which includes police stations, courts, jails, prisons and halfway houses. Each setting has its own budgetary and staffing constraints. Traditionally, individuals entering the system would be forced into untreated withdrawal and given little assistance upon release. The risk of overdose is highest during that transition back to the community. “Ideally we want to get people on treatment as soon as they are incarcerated, and link them to evidence-based care immediately upon release,” said Dr. Sean Murphy, co-principal investigator of the CLEAR Center and professor at Weill Cornell Medicine.
Building on a Decade of Research
The new center builds on the researchers’ extensive experience through CHERISH, a NIDA-funded health economics center of excellence that studies substance use disorder alongside HIV and hepatitis C. Dr. Murphy and co-principal investigator Dr. Kathryn McCollister of the University of Miami have collaborated for years on economic evaluations of addiction treatments. CHERISH’s grant was renewed in August for a total of $10.9 million over five years, further strengthening the foundation for the CLEAR Center’s work.
The CLEAR Center will not only generate rigorous economic evidence but also develop tools and resources for decision makers. “Administrators and policymakers can use these to identify strategic and sustainable investments,” Dr. Murphy said. By providing technical assistance and consultation to JCOIN-II, the center aims to integrate evidence-based care at every level of a notoriously budget-limited system. The ultimate goal is to save lives by ensuring that effective treatment reaches the people who need it most, both inside and after they leave the criminal legal system.