A randomized controlled trial of prison-initiated buprenorphine: prison outcomes and community treatment entry.

Abstract

BACKGROUND:

Buprenorphine is a promising treatment for heroin addiction. However, little is known regarding its provision to pre-release prisoners with heroin dependence histories who were not opioid-tolerant, the relative effectiveness of the post-release setting in which it is provided, and gender differences in treatment outcome in this population.

METHODS:

This is the first randomized clinical trial of prison-initiated buprenorphine provided to male and female inmates in the US who were previously heroin-dependent prior to incarceration. A total of 211 participants with 3-9 months remaining in prison were randomized to one of four conditions formed by crossing In-Prison Treatment Condition (received buprenorphine vs. counseling only) and Post-release Service Setting (at an opioid treatment center vs. a community health center). Outcome measures were: entered prison treatment; completed prison treatment; and entered community treatment 10 days post-release.

RESULTS:

There was a significant main effect (p=.006) for entering prison treatment favoring the In-Prison buprenorphine Treatment Condition (99.0% vs. 80.4%). Regarding completing prison treatment, the only significant effect was Gender, with women significantly (p<.001) more likely to complete than men (85.7% vs. 52.7%). There was a significant main effect (p=.012) for community treatment entry, favoring the In-Prison buprenorphine Treatment Condition (47.5% vs. 33.7%).

CONCLUSIONS:

Buprenorphine appears feasible and acceptable to prisoners who were not opioid-tolerant and can facilitate community treatment entry. However, concerns remain with in-prison treatment termination due to attempted diversion of medication.

• Authors: Michael S Gordon, Timothy W Kinlock, Robert P Schwartz, Terrence T Fitzgerald, Kevin E O'Grady, Frank J Vocci
• Journal: Drug and alcohol dependence (Drug Alcohol Depend) Vol. 142 Pg. 33-40 (Sep 01 2014) ISSN: 1879-0046 [Electronic] Ireland
• PMID: 24962326 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Narcotics
• Buprenorphine

Topics

• Adult
• Buprenorphine (therapeutic use)
• Combined Modality Therapy
• Counseling
• Female
• Heroin Dependence (drug therapy, psychology, therapy)
• Humans
• Male
• Middle Aged
• Narcotics (therapeutic use)
• Prisoners
• Prisons
• Treatment Outcome