A research initiative co-led by Weill Cornell Medicine and the University of Miami’s Miller School of Medicine has secured a five-year, $4 million award from the National Institute on Drug Abuse (NIDA) to advance health economics studies focused on substance use disorder (SUD) treatments. The funding will support analysis of treatment cost-effectiveness and overdose prevention strategies, particularly for individuals interacting with the U.S. criminal legal system.
People with SUD often receive insufficient care within jails, prisons, and community supervision programs, contributing to high risks of relapse and overdose after release. This project aims to assess the economic value of various interventions across diverse legal settings, helping stakeholders make informed decisions about resource allocation.
The grant will establish the Criminal-Legal Economic Analysis & Resource (CLEAR) Center, embedded within the Justice Community Overdose Innovation Network (JCOIN-II), a NIDA-supported program since 2019 now entering its second funding phase. CLEAR will generate data-driven insights into which treatment models offer the best return on investment while developing practical tools for policymakers and administrators.
Dr. Sean Murphy, professor in population health sciences at Weill Cornell Medicine and co-principal investigator, emphasized the importance of timely intervention: “We aim to initiate treatment during incarceration and ensure continuity of evidence-based care immediately post-release, when the danger of fatal overdose is greatest.”
Dr. Kathryn McCollister, professor and interim chair in public health sciences at the University of Miami, serves as the other co-principal investigator. The U.S. criminal legal system includes numerous entities—such as police departments, courts, correctional facilities, and supervision programs—each facing distinct financial and staffing constraints. Historically, individuals with SUD have faced abrupt withdrawal without follow-up support upon release, a gap that initiatives like JCOIN seek to address through integrated, scalable solutions.
The CLEAR Center will support JCOIN-II by conducting cost-effectiveness evaluations of clinical trials, advising on trial design, building budget-impact and cost-benefit calculators, and offering technical guidance to treatment providers and decision-makers.
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New Funding for Health Economics Research on Substance Use Disorder Treatments
A team led by Weill Cornell Medicine and University of Miami’s Miller School of Medicine investigators has been awarded a five-year, $4 million grant from the National Institute on Drug Abuse (NIDA) for health economics research. The team will study the economics of substance use disorder treatments and overdose prevention strategies for individuals who are incarcerated or otherwise involved in the United States’ criminal legal system. n nInterventions for people with substance use disorders are often inadequate in the criminal-legal system. That can lead to other health and behavioral problems, including overdose when incarcerated individuals are released to their communities. Health economics researchers in this area evaluate and compare the economic value of available interventions in the many different criminal-legal settings. n nThe new grant will support the establishment of a health economics research facility called the Criminal-Legal Economic Analysis & Resource (CLEAR) Center, within a larger research program known as the Justice Community Overdose Innovation Network. The latter helps develop and test strategies for substance-use-disorder care within the criminal legal system. It has been supported by NIDA since 2019, and now in its second phase of funding is known as JCOIN-II. n n“The CLEAR Center will not only generate rigorous economic evidence regarding which care strategies deliver the greatest value, but also develop tools and resources that administrators and policymakers can use to identify strategic and sustainable investments,” said CLEAR Center co-principal investigator Dr. Sean Murphy, professor in the department of population health sciences at Weill Cornell Medicine. n nThe other co-principal investigator is Dr. Kathryn McCollister, professor and interim chair of the department of public health sciences at the University of Miami’s Miller School of Medicine. n nThe U.S. criminal-legal system comprises police stations, courts, jails, prisons, halfway houses and other community supervision contexts, each of which has its own budgetary, staffing and other constraints. Traditionally, Dr. Murphy said, individuals with substance use disorder who entered this system would be deprived of the drugs they had been using—forcing untreated withdrawal—and given little or no further assistance when released. The challenge for initiatives such as JCOIN has been to find ways to integrate effective, evidence-based care at every level of this multifarious and notoriously budget-limited system. n n“Ideally we want to get people on treatment as soon as they are incarcerated, and link them to evidence-based care immediately upon release—when the risk of overdose and other adverse outcomes is typically highest,” Dr. Murphy said. n nDrs. Murphy and McCollister and their colleagues at the CLEAR Center will provide health economics support for JCOIN-II in the form of cost-effectiveness analyses of clinical trials of substance use disorder interventions, advice on trial designs, creation of cost-benefit and budget-impact calculators for decision makers and treatment providers, and general consultation and technical assistance.