Justice Community Overdose Innovation Network (JCOIN)

The Justice Community Overdose Innovation Network (JCOIN) is a nationwide program that tests strategies to expand effective treatment, recovery, and related services for individuals involved in the criminal justice system. Launched in 2019, JCOIN brings together research institutions, local and state justice systems, and community-based treatment programs to create actionable, translatable insights to reduce overdose risk and improve access to evidence-based addiction treatment. Many people with opioid and other substance use disorders pass through the criminal justice system. Individuals who do not receive effective treatment while incarcerated will return to the community with a significantly heightened risk of relapse, overdose, and death in the first few weeks post-release. Thus, the criminal justice system represents a key intervention touchpoint to address the overdose crisis.

JCOIN Phase 1 (2018 to 2025)

In 2018 to 2019, NIDA provided funding to existing research projects to support the addition of data collection, analyses, or other activities focused on opioid use and opioid treatment in criminal justice settings and populations. These Accelerator Supplements allowed for rapid accumulation of current knowledge about the impact of the overdose crisis in this population and provided a baseline to measure progress over time.

After establishing this baseline, NIH awarded an estimated $172 million from 2019 to 2024 to fund 12 JCOIN research hubs and two centers providing supportive infrastructure—the JCOIN Coordination and Translation Center and the JCOIN Methodology and Advanced Analytic Resource Center. This work was completed in close collaboration with the Bureau of Justice Assistance, which provided additional funding to support efforts to integrate findings into practice.

During the COVID-19 pandemic, three JCOIN research hubs received supplemental awards under the NIH Rapid Acceleration of Diagnostics for Underserved Populations (RADx-UP) Initiative to address the unique COVID testing, treatment, and vaccination needs among incarcerated and criminal justice-involved populations.

Research hubs conduct large multisite clinical trials each involving justice settings and treatment programs in five or more communities (typically counties). These studies focus on expanding the use of evidence-based medications, behavioral interventions, digital therapeutics, and other comprehensive patient-centered interventions in justice systems across 28 states and Puerto Rico.

The Coordination and Translation Center manages network logistics, engagement with practitioners and other key stakeholders in the justice and behavioral health fields, and dissemination of products and key research findings. It also conducts research to identify effective dissemination strategies for reaching criminal justice stakeholders, and provides funding for innovative, rapid-turnaround pilot studies. An educational component provides mentorship and support to researchers and practitioners on conducting rigorous studies in justice settings.

The Methodology and Advanced Analytic Resource Center provides data infrastructure and statistical and analytic expertise to support individual JCOIN studies and to harmonize data across sites. The center also conducts empirical research to understand changes in state policies, public opinion, and service delivery within the criminal justice system as they relate to the opioid crisis. Collectively, the JCOIN Phase 1 network executed 88 research protocols in justice settings in 137 counties across 38 states and Puerto Rico. In addition to the multisite clinical trials conducted by the research hubs, other protocols included national surveys, data modeling projects, geospatial and service mapping projects, and several pilot projects and diversity supplements led by practitioners and early-career researchers. The JCOIN Phase 1 research projects gathered data on more than 23,000 individuals.

JCOIN Phase 2 (2024-2030)

As of the 2025 fiscal year, the wording of JCOIN’s official name was changed from “Opioid” to “Overdose” to reflect the shifting epidemiology of the overdose crisis. The network remains focused on the prevention of overdose among the high-risk justice-involved population. In Phase 2, its work will expand to include the following:

• Studies of interventions at earlier intercept points – including crisis response, policing and police deflection programs, and pre-trial services
• Examination of important policy changes with direct implications for substance use services in criminal justice populations (for example, the Medicaid 1115 waiver demonstration projects)
• Research on strategies to systematically scale-up effective treatment practices to a wide range of jurisdictions
• Providing more opportunities for early career investigators
• Centering the voices of individuals with lived experience in JCOIN research

The JCOIN Coordination and Translation Center and the Methodology and Advanced Analytic Resource Center were re-competed in the 2024 fiscal year and awarded for another five years. These awards ensure continuity of network operations during the transition from Phase 1 to Phase 2.

Participating NIH Institutes, Centers, and Offices

• National Institute on Drug Abuse (NIDA)