Research poster describing project with goal of improving perceptions of Substance Use Disorder (SUD) and expanding knowledge surrounding the use of Medication Assisted Treatment (MAT) in corrections officers at the Cumberland County Jail.https://dune.une.edu/cecespring2020/1001/thumbnail.jp

DeMayo, Kristin

Edwards, Jasmine

Gallagher, Kristin

Parent, Arianna

English

University of New England

Printing:CCJ Corrections Officer Education Program: Medication Assisted Treatment in JailObjective IntroductionCurriculum Development:○ Learning Objectives - A lesson template, learning objectives, and feedback were provided by Prof. Jenifer Van Deusen of the College of Osteopathic Medicine.○ Design - An evidence-based curriculum was developed by an interprofessional student team targeting the concerns and questions identified by a CCJ survey given to the COs.○ Medium and Topics - Two simple, 10-minute PowerPoint presentations with a standardized script for presenters.■ SUD and Stigma - Promotes “disease model” of addiction and introduces the concept of Adverse Childhood Events. Encourages the use of non-stigmatizing language.■ MAT and Myths - Describes the medications used in MAT, focusing on those used in CCJ. Addresses myths and misconceptions about MAT and the benefits of MAT implementation for individuals, the prison system, and society as a whole.○ Consultation with Local Experts - Community health specialists at the Portland Needle Exchange offered their assistance to ensure our curriculum is accurate and consistent.○ Faculty Communication - Weekly or bi-weekly meetings with Prof. Van Deusen, Trisha Mason, and student participants allowed for discussion of logistics and project curriculum development.Curriculum Delivery:○ Date - Due to COVID-19, the delivery of our curriculum will be postponed until a later date.○ Participation Incentives - Each session will offer free food and raffle tickets for prizes.Pre-Post Survey:○ Study Population: COs at CCJ who have attended both curriculum presentations and who have signed an informed consent.○ Survey: Will consist of 7-10 questions and resemble existing surveys used in corrections facilities. The survey will be voluntary, anonymous, and address the COs thoughts and attitudes toward SUD and MAT. The survey will ask participants to reflect back on their initial perceptions before the presentations and if/how those perceptions have changed after completing the curriculum.○ Survey Delivery: To be given to COs willing to participate in the research portion of this project. The survey will be administered and collected by a CCJ employee after the second presentation.○ Data Analysis: The survey will use Likert scale answers. The responses will be analyzed for changes in attitudes toward topics discussed in the curriculum.MethodsResults1. Substance abuse and mental health services administration. Key substance use and mental health indicators in the United States: results from the 2017 national survey on drug use and health. https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHFFR2017/NSDUHFFR2017.pdf. Published September 2018. Accessed January 15, 2020. 2. National institute of health. Trends and statistics: costs of substance abuse. National institute on drug abuse website.https://www.drugabuse.gov/related-topics/trends-statistics. Updated April 2017. Accessed January 15, 2020.3. Ferguson WJ, Johnston J, Clarke JG, et al. Advancing the implementation and sustainment of medication assisted treatment for opioid use disorders in prisons and jails. Health Justice. 2019;7(1):19. Published 2019 Dec 12. doi:10.1186/s40352-019-0100-2.4. US department of health and human services. Medication assisted treatment (MAT). Substance abuse and mental health services administration website. https://www.samhsa.gov/medication-assisted-treatment. Updated September 9, 2019. Accessed January 15, 2020.5. Coffa D, Snyder H. Opioid Use Disorder: Medical Treatment Options. Am Fam Physician. 2019;100(7):416–425.6. Molero Y, Zetterqvist J, Binswanger IA, Hellner C, Larsson H, Fazel S. Medications for Alcohol and Opioid Use Disorders and Risk of Suicidal Behavior, Accidental Overdoses, and Crime. Am J Psychiatry. 2018;175(10):970–978. doi:10.1176/appi.ajp.2018.17101112.7. Services - Corrections. Cumberland County Sheriff - Official Website. https://www.cumberlandso.org/31/Services---Corrections. Accessed April 11, 2020.8. Andraka-Christou B, Gabriel M, Madeira J, Silverman RD. Court personnel attitudes towards medication-assisted treatment: A state-wide survey. J Subst Abuse Treat. 2019;104:72–82. doi:10.1016/j.jsat.2019.06.011.CitationsMedication assisted treatment is an evidence-based practice that is underutilized in the jail system. Only recently has it been implemented at the Cumberland County Jail. Our research demonstrates that MAT is often perceived negatively in the corrections community. With our educational program, we hope to improve perceptions of SUD and MAT by providing accurate information and reducing stigma. Ultimately, our goal is to improve treatment for the inmates and facilitate a safer, more amicable work environment for the COs at CCJ.We made the difficult decision to postpone our curriculum delivery in order to preserve engagement and authentic discussion between the COs and student presenters. Although we must work within the limitations of the COVID-19 pandemic, we plan to deliver our curriculum in Summer or Fall 2020. After our curriculum is delivered, we will utilize the survey to determine if we met our goals for this project. We also hope that the results of our survey will contribute to the body of knowledge surrounding this topic to be used in similar projects across the United States.Jasmine Edwards, Kristin Gallagher, Arianna Parent | Physician Assistant Program, Westbrook College of Health ProfessionsKristin DeMayo | College of Osteopathic MedicineConclusionBackgroundOur goal is to improve perceptions of SUD and expand knowledge surrounding the use of MAT in corrections officers at the Cumberland County Jail.This study will include results about changes in attitudes towards both SUD and MAT (methadone, buprenorphine, naltrexone). Pre and post survey questions will be modeled after the survey below8:The Results and Conclusions of this project will be determined after the curriculum is delivered and the survey results are collected and analyzed.  This project is the result of a collaboration with the University of New England and the Cumberland County Jail. In late 2019, the warden at the jail contacted UNE and identified the jail’s need for staff education about MAT for inmates. As an interprofessional student-led team including the Physician Assistant, College of Osteopathic Medicine, Social Work, and Pharmacy programs, we developed a curriculum that will educate corrections officers about MAT and SUD. With the help of experts in the field, we have developed relevant learning objectives into two topics that will be presented to the corrections officers. Each of the two topics will be offered to each of the three shifts on three separate occasions, for a grand total of eighteen educational sessions. After curriculum delivery, a retrospective pre-post survey will be administered to gauge if our curriculum accomplished this goal. Substance Use Disorder (SUD) has a profound physical, social, and financial impact on people in the United States. The National Survey on Drug Use and Health reported that 19.7 million Americans were struggling with SUD in 20171. Furthermore, SUD’s annual cost to society totals more than $740 billion in workplace productivity, healthcare expenses, and crime2. Medication Assisted Treatment (MAT) is one way the healthcare community is responding to the SUD crisis3. MAT is composed of behavioral therapy and the use of FDA-approved medications such as methadone, naltrexone, and buprenorphine to help individuals cope with Opioid Use Disorder (OUD)4. Full recovery from OUD is more likely with MAT5. Research also demonstrates that MAT appears to reduce suicidality and crime during treatment of alcohol use disorder and OUD6. In the prison system specifically, MAT has been proven effective in treating OUD and preventing overdose upon release from incarceration. Overall, MAT is an incredibly useful, yet underutilized resource - especially in prisons and jails3.The Cumberland County Jail (CCJ) in Portland, Maine recently received a grant to implement MAT for inmates who require this treatment. CCJ is in the early phases of incorporating the use of MAT for inmates who are pregnant or who have previously-established treatment with MAT prior to their incarceration. CCJ also provides Naloxone (a medication used to treat opioid overdose) to individuals upon their release. Due to lack of training on the subject, the security staff at the jail is experiencing issues such as misinformation and skepticism about the MAT process. They also have difficulties challenging their perceptions of people with SUD/OUD, which are rooted in the stigma attached to this chronic disease. Our research demonstrates that corrections officers (COs) often have negative perceptions of MAT and SUD in general8. Through an educational program created by UNE health professions students, we hope to improve the COs general knowledge and attitudes about SUD and MAT. Hopefully, our educational series will facilitate better medical treatment for the inmates and a healthier, more amicable work environment for the COs.Unfortunately, we had to postpone the delivery of our educational series until Summer or Fall 2020. Due to COVID-19, the Cumberland County Jail is not allowing visitors at this time. We are hopeful that students will be able to continue our mission in Summer or Fall 2020.Figure 1. The Cumberland County Jail in Portland, Maine7. The jail is in the process of introducing Medication Assisted Treatment for inmates. Figures 2 & 3. Above are original graphics from the SUD and Stigma presentation. The graphic on the left demonstrates the factors that contribute to SUD. The graphic on the right contrasts stigmatizing language with the preferred terms.Figure 4. The above survey is comparable to the survey we will administer at the Cumberland County Jail. 

CCJ Corrections Officer Education Program: Medication Assisted Treatment In Jail

https://dune.une.edu/cgi/viewcontent.cgi?article=1001&context=cecespring2020

CCJ Corrections Officer Education Program: Medication Assisted Treatment In Jail

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