Feasibility and effectiveness of extended-release buprenorphine (XR-BUP) among correctional populations: a systematic review.

IF 2.7 3区 医学 Q2 PSYCHOLOGY, CLINICAL
Cayley Russell, Tony P George, Nitin Chopra, Bernard Le Foll, Flora I Matheson, Jürgen Rehm, Shannon Lange
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引用次数: 0

Abstract

Background: Medications for opioid use disorder (MOUD) reduce risks for overdose among correctional populations. Among other barriers, daily dosing requirements hinder treatment continuity post-release. Extended-release buprenorphine (XR-BUP) may therefore be beneficial. However, limited evidence exists.Objectives: To conduct a systematic review examining the feasibility and effectiveness of XR-BUP among correctional populations.Methods: Searches were carried out in Pubmed, Embase, and PsychINFO in October 2023. Ten studies reporting on feasibility or effectiveness of XR-BUP were included, representing n = 819 total individuals (81.6% male). Data were extracted and narratively reported under the following main outcomes: 1) Feasibility; 2) Effectiveness; and 3) Barriers and Facilitators.Results: Studies were heterogeneous. Correctional populations were two times readier to try XR-BUP compared to non-correctional populations. XR-BUP was feasible and safe, with no diversion, overdoses, or deaths; several negative side effects were reported. Compared to other MOUD, XR-BUP significantly reduced drug use, resulted in similar or higher treatment retention rates, fewer re-incarcerations, and was cost-beneficial, with a lower overall monthly/yearly cost. Barriers to XR-BUP, such as side effects and a fear of needles, as well as facilitators, such as a lowered risk of opioid relapse, were also identified.Conclusion: XR-BUP appears to be a feasible and potentially effective alternative treatment option for correctional populations with OUD. XR-BUP may reduce community release-related risks, such as opioid use and overdose risk, as well as barriers to treatment retention. Efforts to expand access to and uptake of XR-BUP among correctional populations are warranted.

缓释丁丙诺啡(XR-BUP)在教养人群中的可行性和有效性:系统综述。
背景:治疗阿片类药物使用障碍(MOUD)的药物可降低矫治人群用药过量的风险。除其他障碍外,每日服药的要求阻碍了释放后治疗的连续性。因此,缓释丁丙诺啡(XR-BUP)可能是有益的。然而,现有证据有限:对 XR-BUP 在矫正人群中的可行性和有效性进行系统回顾:方法:于 2023 年 10 月在 Pubmed、Embase 和 PsychINFO 中进行检索。共纳入了 10 项报告 XR-BUP 可行性或有效性的研究,代表了 n = 819 人(81.6% 为男性)。提取的数据按以下主要结果进行叙述性报告:1)可行性;2)有效性;3)障碍和促进因素:研究结果各不相同。与非教养人群相比,教养人群更愿意尝试 XR-BUP 的比例是非教养人群的两倍。XR-BUP 既可行又安全,没有出现转用、过量或死亡的情况;但也有一些负面副作用的报道。与其他 MOUD 相比,XR-BUP 能显著减少毒品使用,使治疗保持率相近或更高、重新入狱人数更少,而且成本效益高,每月/每年的总费用更低。研究还发现了XR-BUP的障碍(如副作用和对针头的恐惧)和促进因素(如降低阿片类药物复吸风险):结论:XR-BUP 似乎是针对患有 OUD 的教养人群的一种可行且潜在有效的替代治疗方案。XR-BUP可降低与社区释放相关的风险,如阿片类药物的使用和过量风险,以及继续治疗的障碍。有必要努力扩大XR-BUP在矫治人群中的使用和接受范围。
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来源期刊
CiteScore
4.70
自引率
3.70%
发文量
68
期刊介绍: The American Journal of Drug and Alcohol Abuse (AJDAA) is an international journal published six times per year and provides an important and stimulating venue for the exchange of ideas between the researchers working in diverse areas, including public policy, epidemiology, neurobiology, and the treatment of addictive disorders. AJDAA includes a wide range of translational research, covering preclinical and clinical aspects of the field. AJDAA covers these topics with focused data presentations and authoritative reviews of timely developments in our field. Manuscripts exploring addictions other than substance use disorders are encouraged. Reviews and Perspectives of emerging fields are given priority consideration. Areas of particular interest include: public health policy; novel research methodologies; human and animal pharmacology; human translational studies, including neuroimaging; pharmacological and behavioral treatments; new modalities of care; molecular and family genetic studies; medicinal use of substances traditionally considered substances of abuse.
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