Perceptions of extended-release buprenorphine among people who received medication for opioid use disorder in jail: a qualitative study

IF 3.7 2区医学 Q1 SUBSTANCE ABUSE

Addiction Science & Clinical Practice Pub Date : 2024-09-12 DOI:10.1186/s13722-024-00486-2

Thomas J. Stopka, Rebecca Rottapel, Peter D. Friedmann, Ekaterina Pivovarova, Elizabeth A. Evans

{"title":"Perceptions of extended-release buprenorphine among people who received medication for opioid use disorder in jail: a qualitative study","authors":"Thomas J. Stopka, Rebecca Rottapel, Peter D. Friedmann, Ekaterina Pivovarova, Elizabeth A. Evans","doi":"10.1186/s13722-024-00486-2","DOIUrl":null,"url":null,"abstract":"Incarceration provides an opportunity for health interventions, including opioid use disorder (OUD) treatment and prevention of opioid-related overdoses post-release. All FDA-approved forms of medication for OUD (MOUD) treatment were mandated in several Massachusetts jails in 2019, with some jails offering extended-release buprenorphine (XR-Bup). Little is known about patient perspectives on and experiences with XR-Bup in carceral settings. We conducted semi-structured interviews in 2022 with community-dwelling people who received MOUD during a recent incarceration in a Massachusetts jail. We asked participants about their experiences with and perspectives on XR-Bup while in jail. Qualitative data were double-coded deductively and reviewed inductively to identify emergent themes, which were structured using the Theoretical Framework of Acceptability (TFA). Participants (n = 38) had a mean age of 41.5 years, were 86% male, 84% White, 24% Hispanic, and 95% continued to receive MOUD at the time of their interview, including 11% receiving XR-Bup. Participants who viewed XR-Bup favorably appreciated avoiding the taste of sublingual buprenorphine; avoiding procedural difficulties and indignities associated with daily dosing in carceral settings (e.g., mouth checks, stigmatizing treatment from correctional staff); avoiding daily reminders of their addiction; experiencing less withdrawal; having extra time for other activities, such as work; and reduction of diversion of MOUD within the jail setting. Participants who viewed XR-Bup less favorably preferred to maintain their daily dosing routine; liked daily time out of their housing unit; wanted to know what was “going into my body everyday”; and feared needles and adverse events. Participants also reported that jail clinicians used XR-Bup for patients who were previously caught diverting sublingual buprenorphine, suggesting limited patient participation in decision-making around XR-Bup initiation in some jails. People who received MOUD in Massachusetts jails had both favorable and unfavorable views and experiences with XR-Bup. Understanding these preferences can inform protocols in jails that are considering implementation of XR-Bup treatment.","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"54 1","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Addiction Science & Clinical Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13722-024-00486-2","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SUBSTANCE ABUSE","Score":null,"Total":0}

引用次数: 0

Abstract

Incarceration provides an opportunity for health interventions, including opioid use disorder (OUD) treatment and prevention of opioid-related overdoses post-release. All FDA-approved forms of medication for OUD (MOUD) treatment were mandated in several Massachusetts jails in 2019, with some jails offering extended-release buprenorphine (XR-Bup). Little is known about patient perspectives on and experiences with XR-Bup in carceral settings. We conducted semi-structured interviews in 2022 with community-dwelling people who received MOUD during a recent incarceration in a Massachusetts jail. We asked participants about their experiences with and perspectives on XR-Bup while in jail. Qualitative data were double-coded deductively and reviewed inductively to identify emergent themes, which were structured using the Theoretical Framework of Acceptability (TFA). Participants (n = 38) had a mean age of 41.5 years, were 86% male, 84% White, 24% Hispanic, and 95% continued to receive MOUD at the time of their interview, including 11% receiving XR-Bup. Participants who viewed XR-Bup favorably appreciated avoiding the taste of sublingual buprenorphine; avoiding procedural difficulties and indignities associated with daily dosing in carceral settings (e.g., mouth checks, stigmatizing treatment from correctional staff); avoiding daily reminders of their addiction; experiencing less withdrawal; having extra time for other activities, such as work; and reduction of diversion of MOUD within the jail setting. Participants who viewed XR-Bup less favorably preferred to maintain their daily dosing routine; liked daily time out of their housing unit; wanted to know what was “going into my body everyday”; and feared needles and adverse events. Participants also reported that jail clinicians used XR-Bup for patients who were previously caught diverting sublingual buprenorphine, suggesting limited patient participation in decision-making around XR-Bup initiation in some jails. People who received MOUD in Massachusetts jails had both favorable and unfavorable views and experiences with XR-Bup. Understanding these preferences can inform protocols in jails that are considering implementation of XR-Bup treatment.

查看原文本刊更多论文

在监狱中接受阿片类药物使用障碍药物治疗的人对缓释丁丙诺啡的看法：一项定性研究

监禁为健康干预提供了机会，包括阿片类药物使用障碍（OUD）治疗和预防释放后与阿片类药物相关的过量使用。2019 年，马萨诸塞州的一些监狱强制要求使用所有经 FDA 批准的药物治疗 OUD（阿片类药物使用障碍），其中一些监狱提供缓释丁丙诺啡（XR-Bup）。在囚禁环境中，患者对 XR-Bup 的看法和使用经验鲜为人知。2022 年，我们对最近在马萨诸塞州监狱监禁期间接受过 MOUD 治疗的社区居民进行了半结构化访谈。我们向参与者询问了他们在狱中使用 XR-Bup 的经历和看法。我们对定性数据进行了双重编码演绎和归纳审查，以确定新出现的主题，并使用可接受性理论框架（TFA）对这些主题进行了结构化。参与者（n = 38）的平均年龄为 41.5 岁，86% 为男性，84% 为白人，24% 为西班牙裔，95% 在接受访谈时仍在服用 MOUD，其中 11% 在服用 XR-Bup。对XR-Bup评价较高的参与者表示：避免了舌下含服丁丙诺啡的味道；避免了在囚禁环境中与每日服药相关的程序性困难和侮辱（如检查口腔、管教人员的侮辱性对待）；避免了每日提醒他们上瘾；减少了戒断；有额外的时间从事其他活动，如工作；减少了监狱环境中的MOUD转移。对 XR-Bup 持负面看法的参与者则倾向于保持每天的服药习惯；喜欢每天有时间离开监舍；想知道 "每天进入我身体的是什么"；害怕针头和不良事件。参与者还报告说，监狱临床医生将 XR-Bup 用于之前被抓获的转移舌下丁丙诺啡的患者，这表明在一些监狱中，患者对开始使用 XR-Bup 的决策参与有限。在马萨诸塞州监狱接受 MOUD 治疗的患者对 XR-Bup 的看法和经历既有好的一面，也有不好的一面。了解这些偏好可以为考虑实施 XR-Bup 治疗的监狱提供参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Addiction Science & Clinical Practice Psychology-Clinical Psychology

CiteScore

3.90

自引率

10.80%

发文量

审稿时长

28 weeks

期刊介绍： Addiction Science & Clinical Practice provides a forum for clinically relevant research and perspectives that contribute to improving the quality of care for people with unhealthy alcohol, tobacco, or other drug use and addictive behaviours across a spectrum of clinical settings. Addiction Science & Clinical Practice accepts articles of clinical relevance related to the prevention and treatment of unhealthy alcohol, tobacco, and other drug use across the spectrum of clinical settings. Topics of interest address issues related to the following: the spectrum of unhealthy use of alcohol, tobacco, and other drugs among the range of affected persons (e.g., not limited by age, race/ethnicity, gender, or sexual orientation); the array of clinical prevention and treatment practices (from health messages, to identification and early intervention, to more extensive interventions including counseling and pharmacotherapy and other management strategies); and identification and management of medical, psychiatric, social, and other health consequences of substance use. Addiction Science & Clinical Practice is particularly interested in articles that address how to improve the quality of care for people with unhealthy substance use and related conditions as described in the (US) Institute of Medicine report, Improving the Quality of Healthcare for Mental Health and Substance Use Conditions (Washington, DC: National Academies Press, 2006). Such articles address the quality of care and of health services. Although the journal also welcomes submissions that address these conditions in addiction speciality-treatment settings, the journal is particularly interested in including articles that address unhealthy use outside these settings, including experience with novel models of care and outcomes, and outcomes of research-practice collaborations. Although Addiction Science & Clinical Practice is generally not an outlet for basic science research, we will accept basic science research manuscripts that have clearly described potential clinical relevance and are accessible to audiences outside a narrow laboratory research field.