TY - JOUR
KW - Adult
KW - Analgesics, Opioid/therapeutic use
KW - Buprenorphine/therapeutic use
KW - Humans
KW - Jails
KW - Opiate Substitution Treatment
KW - Opioid-Related Disorders/drug therapy
KW - Recidivism
KW - buprenorphine
KW - Criminal justice settings
KW - Massachusetts Justice Community Opioid Innovation Network (MassJCOIN)
KW - Medications for opioid use disorder (MOUD)
KW - Mortality
KW - Naltrexone
AU - E. A. Evans
AU - D. Wilson
AU - P. D. Friedmann
A1 - 
AB - BACKGROUND: Buprenorphine is an effective medication for opioid use disorder (MOUD) when offered in community-based settings, but evidence is limited for incarcerated populations, particularly in relation to recidivism. In Massachusetts, Franklin County jail (FCSO) was among the first to provide buprenorphine; adjacent Hampshire County jail (HCHC) offered it more recently. These jails present a natural experiment to determine whether outcomes are different between individuals who did and did not have the opportunity to receive buprenorphine in jail. METHODS: We examined outcomes of all incarcerated adults with opioid use disorder (n = 469) who did (FCSO n = 197) and did not (HCHC n = 272) have the opportunity to receive buprenorphine. The primary outcome was post-release recidivism, defined as time from jail exit to a recidivism event (incarceration, probation violation, arraignment). Using Cox proportional hazards models, we investigated site as a predictor, controlling for covariates. We also examined post-release deaths. RESULTS: Fewer FCSO than HCHC individuals recidivated (48.2% vs. 62.5%; p = 0.001); fewer FCSO individuals were re-arraigned (36.0% vs. 47.1%; p = 0.046) or re-incarcerated (21.3% vs. 39.0%; p < 0.0001). Recidivism risk was lower in the FCSO group (hazard ratio 0.71, 95% confidence interval 0.56, 0.89; p = 0.003), net of covariates (adjusted hazard ratio 0.68, 95% confidence interval 0.53, 0.86; p = 0.001). At each site, 3% of participants died. CONCLUSIONS: Among incarcerated adults with opioid use disorder, risk of recidivism after jail exit is lower among those who were offered buprenorphine during incarceration. Findings support the growing movement in jails nationwide to offer buprenorphine and other agonist medications for opioid use disorder.
AD - Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, 312 Arnold House, 715 North Pleasant Street, Amherst, MA 01003, USA. Electronic address: eaevans@umass.edu.; University of Massachusetts Chan Medical School (UMCMS) - Baystate and Baystate Health, Springfield, MA, USA. Electronic address: Donna.Wilson@baystatehealth.org.; University of Massachusetts Chan Medical School (UMCMS) - Baystate and Baystate Health, Springfield, MA, USA. Electronic address: peter.friedmannmd@baystatehealth.org.
BT - Drug and alcohol dependence
C5 - Healthcare Disparities; Opioids & Substance Use
DO - 10.1016/j.drugalcdep.2021.109254
JF - Drug and alcohol dependence
LA - eng
M1 - Journal Article
N2 - BACKGROUND: Buprenorphine is an effective medication for opioid use disorder (MOUD) when offered in community-based settings, but evidence is limited for incarcerated populations, particularly in relation to recidivism. In Massachusetts, Franklin County jail (FCSO) was among the first to provide buprenorphine; adjacent Hampshire County jail (HCHC) offered it more recently. These jails present a natural experiment to determine whether outcomes are different between individuals who did and did not have the opportunity to receive buprenorphine in jail. METHODS: We examined outcomes of all incarcerated adults with opioid use disorder (n = 469) who did (FCSO n = 197) and did not (HCHC n = 272) have the opportunity to receive buprenorphine. The primary outcome was post-release recidivism, defined as time from jail exit to a recidivism event (incarceration, probation violation, arraignment). Using Cox proportional hazards models, we investigated site as a predictor, controlling for covariates. We also examined post-release deaths. RESULTS: Fewer FCSO than HCHC individuals recidivated (48.2% vs. 62.5%; p = 0.001); fewer FCSO individuals were re-arraigned (36.0% vs. 47.1%; p = 0.046) or re-incarcerated (21.3% vs. 39.0%; p < 0.0001). Recidivism risk was lower in the FCSO group (hazard ratio 0.71, 95% confidence interval 0.56, 0.89; p = 0.003), net of covariates (adjusted hazard ratio 0.68, 95% confidence interval 0.53, 0.86; p = 0.001). At each site, 3% of participants died. CONCLUSIONS: Among incarcerated adults with opioid use disorder, risk of recidivism after jail exit is lower among those who were offered buprenorphine during incarceration. Findings support the growing movement in jails nationwide to offer buprenorphine and other agonist medications for opioid use disorder.
PY - 2022
SN - 1879-0046; 0376-8716; 0376-8716
SP - 109254
T1 - Recidivism and mortality after in-jail buprenorphine treatment for opioid use disorder
T2 - Drug and alcohol dependence
TI - Recidivism and mortality after in-jail buprenorphine treatment for opioid use disorder
U1 - Healthcare Disparities; Opioids & Substance Use
U2 - 35063323
U3 - 10.1016/j.drugalcdep.2021.109254
VL - 231
VO - 1879-0046; 0376-8716; 0376-8716
Y1 - 2022
Y2 - Feb 1
ER -