Evaluating the Impact of Peer Based Services and Multi-Sector Collaboration on Opioid Use, Overdose, and Treatment Utilization Among Criminal Justice-Involved Individuals with Opioid Use or Misuse

Background: The Empowered Communities Opioid Project (ECOP) is a peer-based initiative designed to support individuals with opioid use or misuse who have intersected with the criminal justice system. This study evaluated the relationship between ECOP retention and opioid use, overdose, and utilization of Medication for Opioid Use Disorder (MOUD) among participants. A longitudinal study was conducted with 265 participants who voluntarily enrolled in ECOP post-incarceration. Program retention, self-reported overdose rates, opioid use patterns, and MOUD utilization were evaluated using surveys delivered at four intervals: baseline, 1 month, 6 months, and 12 months between 2018 and June 2024. Results: Statistical analyses, including chi-square tests and descriptive statistics were used to assess relationships between program retention and recovery outcomes. The analysis revealed a significant association between ECOP retention and improved recovery outcomes. Participants retained in the program demonstrated lower rates of opioid use (p < 0.05), overdose (p < 0.001), and increased MOUD utilization (p < 0.05). Most strikingly, the self-reported overdose rates showed a dramatic reduction. Overdose decreased by 23% in 2022, 42% in 2023, and 51% in 2024 for those retained in ECOP. Conclusions: Participation in ECOP is significantly associated with reduced opioid use, overdose, and increased MOUD utilization. These findings highlight the critical role of peer-based interventions and multi-sector collaboration in supporting recovery. While the program shows substantial success, challenges remain in improving long-term retention. Future research should prioritize strategies to enhance retention, assess additional factors influencing recovery, and adapt the program for diverse populations.