# Transitions Clinic Network: Post Incarceration Addiction Treatment, Healthcare, and Social Support (TCN PATHS) study

> **NIH NIH UG1** · YALE UNIVERSITY · 2020 · $2,270,391

## 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 in 2016, and individuals just
released from jail have an eight times higher risk of drug overdose compared with the general population after
adjustment for age, gender, race, and residential neighborhood. Given this risk, several jails now treat OUD
with medications, but these efforts will be ineffective if they fail to connect people to OUD treatment 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. Our long-term goal is to
reduce morbidity and mortality from OUD among justice-involved individuals. 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 just released from jails
on medications for OUD. The underlying rationale for this study is that social needs must be addressed, in this
case through a community health worker, to support OUD treatment engagement, and a primary care home
provides an agile structure for people’s shifting priorities, needs, and preferences for OUD treatment following
release. We will conduct a hybrid type I effectiveness-implementation trial and randomize 800 people on
medications for OUD released from 6 local jails (Minneapolis, MN, Rochester, NY, 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. We will also study the cost effectiveness of the
TCN, as well as barriers and facilitators to transitioning the care of people with OUD to the TCN. TCN PATHS
is highly innovative in its partnership with and prioritizat...

## Key facts

- **NIH application ID:** 9978016
- **Project number:** 5UG1DA050072-02
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Emily Ai-hua Wang
- **Activity code:** UG1 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $2,270,391
- **Award type:** 5
- **Project period:** 2019-07-15 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9978016

## Citation

> US National Institutes of Health, RePORTER application 9978016, Transitions Clinic Network: Post Incarceration Addiction Treatment, Healthcare, and Social Support (TCN PATHS) study (5UG1DA050072-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9978016. Licensed CC0.

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