Project Managing Opiate Dependence (MOD):

Project MOD, started in 2002, is a five-year service initiative funded by SAMHSA-CSAT (H79-TI-014562) that aims to treat addiction, improve health, reduce re-incarceration and increase personal stability through linkage to methadone treatment for opiate addicted ex-offenders. Participants are recruited through the Rhode Island Department of Corrections, The Miriam Hospital Immunology Center, and through community referrals. Project MOD provides assistance with methadone maintenance therapy (MMT) program intake requirements, arranges clinic entry, pays for 100% of MMT program costs for 12 weeks and 50% of costs for the next 12 weeks. Project MOD staff provides referrals for employment, health care, and social services. We follow participants for one year with assessments at baseline, six and 12 months.

At 12 months (n=232), statistically significant reductions (p<.005) are reported in injection drug use, sharing behaviors, heroin, cocaine, benzodiazepine, and polysubstance use. Likewise, there are significant increases in full or part-time employment and entitlement benefits as compared to baseline.

Our follow-up rate at 12 months is 87%. Of the 224 participants who have completed 12 months: 55% are in treatment at six months and 44% are in treatment at 12 months. Twenty-five percent are continuously enrolled for more than 300 days, indicating that some participants drop out of treatment for a time and then re-enter within their year of project participation.

Of the participants who were recruited directly from the RI Department of Corrections and subsequently released (n=494), 58% (n=286) initiated treatment at a community-based clinic. Thirty-three percent (n=166) never initiated treatment and 9% (n=42) refused participation. For those participants who initiated treatment, length of time between prison release and attending clinic varied between 24 hours and several weeks. In all cases, a clinic appointment was arranged within 60 hours of release.

Project MOD has demonstrated that it is possible to follow and treat opioid dependent ex-offenders through the provision of methadone maintenance therapy (MMT) and ongoing case management services following prison release. Intended initially as a “service” initiative, the positive impact that project MOD has had on participants in reducing drug dependence and increasing employment has motivated a controlled follow-up study, Project ROMEO.

Selected Publications:

1. McKenzie, M., G. Macalino, et al. (2005). "Opiate replacement therapy at time of release from incarceration: Project MOD, a pilot program." J Opioid Manag 1(3): 147-51.

2. Rich, J.D., et al., Linkage with methadone treatment upon release from incarceration: a promising opportunity. J Addict Dis, 2005. 24(3): p. 49-59.