Receipt of pharmacotherapy for opioid use disorder by justice-involved U.S. Veterans Health Administration patients

Finlay, Andrea K.; Harris, Alex H. S.; Rosenthal, Joel; Blue‐Howells, Jessica; Clark, Sean; McGuire, Jim; Timko, Christine; Frayne, Susan M.; Smelson, David A.; Oliva, Elizabeth M.; Binswanger, Ingrid A.

doi:10.1016/j.drugalcdep.2016.01.013

Cited by 36 publications

(38 citation statements)

References 28 publications

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“…36 Targeted efforts to enhance the capacity of treatment programs to administer medication treatment or connect patients with providers who will administer it, as well regulatory changes to require certified programs to allow and even encourage the use of agonist medications as standard treatment for opioid use disorder, could help significantly expand the number of people who receive these treatments. Certain health organizations, such as the Veterans Health Administration, have been found to have greater utilization rates of agonist treatment for clients who are and those who are not justice involved, 37 and these organizations could be used as examples for other programs seeking to increase access to the treatment.…”

Section: Discussionmentioning

confidence: 99%

Only One In Twenty Justice-Referred Adults In Specialty Treatment For Opioid Use Receive Methadone Or Buprenorphine

et al. 2017

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People in the US criminal justice system experience high rates of opioid use disorder, overdose, and other adverse outcomes. Expanding treatment is a key strategy for addressing the opioid epidemic, but little is known about whether the criminal justice system refers people to the highest standard of treatment: the use of the opioid agonist therapies methadone or buprenorphine. We used 2014 data from the national Treatment Episode Data Set to examine the use of agonist treatment among justice-involved people referred to specialty treatment for opioid use disorder. Only 4.6 percent of justice-referred clients received agonist treatment, compared to 40.9 percent of those referred by other sources. Of all criminal justice sources, courts and diversionary programs were least likely to refer people to agonist treatment. Our findings suggest that an opportunity is being missed to promote effective, evidence-based care for justice-involved people who seek treatment for opioid use disorder.

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Section: Discussionmentioning

confidence: 99%

Only One In Twenty Justice-Referred Adults In Specialty Treatment For Opioid Use Receive Methadone Or Buprenorphine

et al. 2017

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“…Despite decades of evidence supporting the use of agonist therapies, methadone and buprenorphine remain mostly unused in US jails and prisons, as well as among outpatient CJS-involved adults [15,37]. As the NYC jail opioid treatment program statistics detailed in the Introduction make clear, however, even when methadone maintenance for out-of-treatment heroin users is standard of care, too few access this treatment.…”

Section: Discussionmentioning

confidence: 99%

Extended-release naltrexone opioid treatment at jail reentry (XOR)

McDonald

Tofighi

Laska

et al. 2016

Contemporary Clinical Trials

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Background Extended-release naltrexone (XR-NTX) is an injectable monthly sustained-release mu opioid receptor antagonist, which blocks the typical effects of heroin and other opioid agonists. Use of XR-NTX among opioid dependent persons leaving jails and prisons is increasing despite scant high-quality evidence regarding XR-NTX’s effectiveness at re-entry. Methods This 24-week, open-label randomized controlled trial examines the effectiveness of XR-NTX as opioid relapse prevention at release from jail (N = 85) compared to enhanced treatment as usual (ETAU, N = 85). A third, non-randomized, quasi-experimental naturalistic arm of participants who have newly initiated a jail-to-community methadone treatment program (MTP, N = 85) allows for comparisons to a methadone standard-of-care. Results We describe the rationale, design, and primary and secondary outcomes of the study. The primary outcome is an opioid relapse event; the primary contrast is a time-to-relapse comparison of XR-NTX and ETAU over a 24-week treatment phase. Secondary outcomes are rates of: (a) post-release opioid treatment participation, (b) opioid, alcohol, and cocaine use, (c) injection drug use and HIV sexual risk behaviors, (d) overdose (fatal and non-fatal) and all-cause mortality, and, (e) re-incarceration. Conclusions XR-NTX is a potentially important, effective treatment and relapse prevention option for a large US population of persons with opioid use disorders leaving jails. This study will estimate XR-NTX’s effectiveness relative to existing standards of care, including counseling-only treatment-as-usual and methadone maintenance.

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“…This group of articles examines how buprenorphine treatment impacts incarceration status and criminality. In this secondary analysis of a randomized clinical trial discussed earlier [35], the authors examined the effects of pre-and post-release buprenorphine initiation on arrest outcomes over a twelve-month period: rearrested, time to re-arrest, number of rearrests, and severity of charges [40]. The results found 43.1% were rearrested, but there was no effect of treatment condition on any arrest outcome measure.…”

Section: Buprenorphine Treatment and Incarceration Statusmentioning

confidence: 99%

Routes of non-traditional entry into buprenorphine treatment programs

Champagne‐Langabeer

Swank

Langabeer

2020

Subst Abuse Treat Prev Policy

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Background: Excessive prescribing, increased potency of opioids, and increased availability of illicit heroin and synthetic analogs such as fentanyl has resulted in an increase of overdose fatalities. Medications for opioid use disorder (MOUD) significantly reduces the risk of overdose when compared with no treatment. Although the use of buprenorphine as an agonist treatment for opioid use disorder (OUD) is growing significantly, barriers remain which can prevent or delay treatment. In this study we examine non-traditional routes which could facilitate entry into buprenorphine treatment programs. Methods: Relevant, original research publications addressing entry into buprenorphine treatment published during the years 1989-2019 were identified through PubMed, PsychInfo, PsychArticles, and Medline databases. We operationalized key terms based on three non-traditional paths: persons that entered treatment via the criminal justice system, following emergencies, and through community outreach. Results: Of 462 screened articles, twenty studies met the inclusion criteria for full review. Most studies were from the last several years, and most (65%) were from the Northeastern region of the United States. Twelve (60%) were studies suggesting that the criminal justice system could be a potentially viable entry route, both pre-release or post-incarceration. The emergency department was also found to be a cost-effective and viable route for screening and identifying individuals with OUD and linking them to buprenorphine treatment. Fewer studies have documented community outreach initiatives involving buprenorphine. Most studies were small sample size (mean = < 200) and 40% were randomized trials. Conclusions: Despite research suggesting that increasing the number of Drug Addiction Treatment Act (DATA) waived physicians who prescribe buprenorphine would help with the opioid treatment gap, little research has been conducted on routes to increase utilization of treatment. In this study, we found evidence that engaging individuals through criminal justice, emergency departments, and community outreach can serve as non-traditional treatment entry points for certain populations. Alternative routes could engage a greater number of people to initiate MOUD treatment.

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Receipt of pharmacotherapy for opioid use disorder by justice-involved U.S. Veterans Health Administration patients

Abstract: Targeted efforts to improve receipt of pharmacotherapy for opioid use disorder among veterans exiting prison is needed as they have lower odds of receiving these medications.

Cited by 36 publications

References 28 publications

Only One In Twenty Justice-Referred Adults In Specialty Treatment For Opioid Use Receive Methadone Or Buprenorphine

Only One In Twenty Justice-Referred Adults In Specialty Treatment For Opioid Use Receive Methadone Or Buprenorphine

Extended-release naltrexone opioid treatment at jail reentry (XOR)

Routes of non-traditional entry into buprenorphine treatment programs

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