Community buprenorphine continuation post-release following extended release vs. sublingual buprenorphine during incarceration: a pilot project in Maine.

IF 3 Q1 CRIMINOLOGY & PENOLOGY
Alane B O'Connor, Catherine Gelsinger, Sadie M Donovan, Jessica Marshall, Katherine A Ahrens
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引用次数: 0

Abstract

Background: The aim of our study was to evaluate the post-release outcomes of incarcerated individuals with opioid use disorder (OUD) treated with extended-release buprenorphine (XRB) in a rural county jail. Administrative data were collected from a pilot program within a jail in Maine that introduced XRB treatment in 2022 and a comparable jail utilizing sublingual buprenorphine (SLB) during the same period to compare post-release outcomes. Log-binomial regression models were used to estimate the risk ratio (RR) and 95% confidence interval (CI) for jail use of XRB vs. SLB on post-release community buprenorphine continuation.

Results: From September 2022 to September 2023, 70 individuals who received XRB were released from the pilot jail and 130 individuals who received SLB were released from the comparison jail. After adjusting for age, sex, and buprenorphine use at entry to jail, individuals released from the pilot jail were almost 3 times (adjusted RR = 2.67, 95% CI 1.84, 3.88) as likely to continue community buprenorphine treatment post-release relative to the comparison jail. In addition, utilization of XRB allowed for expanded access to OUD treatment, was well tolerated, and reduced medication diversion.

Conclusions: In this pilot program in Maine, XRB treatment during incarceration was associated with higher post-release community buprenorphine continuation when compared to individuals treated with SLB. These findings provide strong evidence for the superiority of XRB vs. SLB for the treatment of OUD in jail settings.

缅因州的一个试点项目。
背景:我们的研究旨在评估农村县监狱中接受缓释丁丙诺啡(XRB)治疗的阿片类药物使用障碍(OUD)患者的释放后疗效。我们从缅因州一所监狱(该监狱于 2022 年引入 XRB 治疗)的试点项目和同期使用丁丙诺啡舌下含服法(SLB)的同类监狱收集了管理数据,以比较释放后的治疗效果。使用对数二项式回归模型估算了监狱使用 XRB 与使用 SLB 对释放后继续服用社区丁丙诺啡的风险比 (RR) 和 95% 置信区间 (CI):从 2022 年 9 月到 2023 年 9 月,试点监狱释放了 70 名接受 XRB 治疗的患者,对比监狱释放了 130 名接受 SLB 治疗的患者。在对入狱时的年龄、性别和丁丙诺啡使用情况进行调整后,与对比监狱相比,试点监狱释放的人员在释放后继续接受社区丁丙诺啡治疗的可能性几乎是对比监狱的 3 倍(调整后 RR = 2.67,95% CI 1.84,3.88)。此外,使用 XRB 可以扩大 OUD 治疗的可及性、良好的耐受性并减少药物转用:在缅因州的这项试点计划中,与接受 SLB 治疗的患者相比,在监禁期间接受 XRB 治疗的患者在释放后继续接受社区丁丙诺啡治疗的比例更高。这些发现有力地证明了 XRB 与 SLB 相比,在监狱环境中治疗 OUD 的优越性。
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来源期刊
Health and Justice
Health and Justice Social Sciences-Law
CiteScore
4.10
自引率
8.60%
发文量
34
审稿时长
13 weeks
期刊介绍: Health & Justice is open to submissions from public health, criminology and criminal justice, medical science, psychology and clinical sciences, sociology, neuroscience, biology, anthropology and the social sciences, and covers a broad array of research types. It publishes original research, research notes (promising issues that are smaller in scope), commentaries, and translational notes (possible ways of introducing innovations in the justice system). Health & Justice aims to: Present original experimental research on the area of health and well-being of people involved in the adult or juvenile justice system, including people who work in the system; Present meta-analysis or systematic reviews in the area of health and justice for those involved in the justice system; Provide an arena to present new and upcoming scientific issues; Present translational science—the movement of scientific findings into practice including programs, procedures, or strategies; Present implementation science findings to advance the uptake and use of evidence-based practices; and, Present protocols and clinical practice guidelines. As an open access journal, Health & Justice aims for a broad reach, including researchers across many disciplines as well as justice practitioners (e.g. judges, prosecutors, defenders, probation officers, treatment providers, mental health and medical personnel working with justice-involved individuals, etc.). The sections of the journal devoted to translational and implementation sciences are primarily geared to practitioners and justice actors with special attention to the techniques used.
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