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Individuals in treatment for substance use disorders (SUD) face major barriers to achieving and maintaining healthier drug use behaviors, particularly those eligible for Medicaid. Limited resources and criminal justice involvement create both direct and indirect challenges. Direct barriers include restricted access to employment and housing, while indirect effects—such as stigma, depression, and reduced self-efficacy—further hinder recovery. These challenges are often intensified for people of color due to systemic inequities in healthcare, criminal justice, housing, and labor markets.Criminal records intersect with social determinants of health, undermining stability and increasing the likelihood of relapse. Despite the potential of criminal record expungement (CRE) to improve quality of life, no studies have evaluated its feasibility or impact among people who use drugs. Expungement may help remove barriers that perpetuate cycles of substance misuse and justice involvement. This study has two aims: (1) adapt CRE for dissemination to Medicaid eligible addiction treatment clients, and (2) assess feasibility by piloting the adapted intervention.In Michigan, expungement occurs automatically or through petitions. Clean Slate laws implemented in 2023 led to over one million automatic expungements, but lack of notification limited their impact. Expungement removes records from public view, reducing stigma and improving access to employment and housing—if individuals are aware of their status. Meanwhile, millions of convictions remain eligible for petition-based expungement, yet uptake is low (~6.5%).
To address this gap, the study will adapt and test an intervention targeting both forms of expungement among Medicaid eligible recipients in addiction treatment centers. We gathered an 80-person pre-pilot sample to identify an appropriate recruitment pool and designing a feasibility study with an RCT framework to compare legal-assisted expungement services to self-help materials. Findings will inform whether expungement services are practical and cost-effective for delivery in community-based treatment settings, with potential to improve well-being, reduce stigma, and support treatment retention.