# TCN PATHS Supplemental funding

> **NIH NIH UG1** · YALE UNIVERSITY · 2024 · $572,716

## Abstract

PROJECT SUMMARY
The opioid epidemic is inextricably intertwined with our nation's criminal justice system. At least 20% of people
with opioid use disorder (OUD) were involved in the criminal justice system, and individuals just released from
jail have an eight times higher risk of drug overdose compared with the general population. Given this risk,
several jails now treat OUD with medications, but these efforts will be ineffective if they fail to connect people
with OUD to care upon release. Housing instability, food insecurity, lack of social support, mistrust in the health
system, and co-morbid physical and mental health conditions threaten a person's ability to engage and remain
in community OUD treatment. Prior work has not identified effective strategies to engage justice-involved
individuals in OUD care that are feasible and honor patients' values, preferences, and needs. Until this
knowledge gap addressed, it will be difficult to reduce opioid-related morbidity and mortality in the United
States. The overall objective of this study is to assess whether the Transitions Clinic Network (TCN) program,
which provides enhanced primary care and OUD treatment for people recently released from incarceration,
improves measures in the opioid treatment cascade. In TCN, formerly incarcerated community health workers
are embedded within primary care teams and address social determinants of OUD, provide social support,
help patients build trust in the health system and advocate in interactions with the criminal justice system. The
central hypothesis of Transitions Clinic Network: Post Incarceration Addiction Treatment, Healthcare, and
Social Support (TCN PATHS) study is that TCN program participation improves opioid treatment cascade
measures among those with OUD just released from jails. TCN PATHS (1UG1DA050072-05) is a hybrid type I
effectiveness-implementation trial, the goal of which is to randomize 400 people with OUD just released from 5
local jails (Minneapolis, MN, Bridgeport, CT, Durham, NC, Caguas, PR, and Bronx, NY) to compare the
effectiveness of the TCN intervention versus referral to standard primary care on opioid treatment cascade
outcomes and whether housing, food access, criminal justice contact, and social support mediate this
association. To date, we have recruited 238 participants and are seeking additional funding to finish the study
and evaluate 6-month outcomes on OUD treatment cascade. The administrative supplement will thus preserve
the likelihood for the project to answer TCN PATHS's primary study question, and we will focus recruitment
and retention in only three of the sites but complete participant follow-up in two others. Furthermore, the
supplement will increase the likelihood of supporting independent scientific research careers for two junior
faculty who have received NIH supplements to study how novel factors, including sleep and self-stigma, affect
OUD treatment outcomes.

## Key facts

- **NIH application ID:** 11019307
- **Project number:** 3UG1DA050072-05S1
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Emily Ai-hua Wang
- **Activity code:** UG1 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $572,716
- **Award type:** 3
- **Project period:** 2019-07-15 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11019307

## Citation

> US National Institutes of Health, RePORTER application 11019307, TCN PATHS Supplemental funding (3UG1DA050072-05S1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/11019307. Licensed CC0.

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