TY - JOUR
T1 - Buprenorphine and methadone maintenance in jail and post-release
T2 - A randomized clinical trial
AU - Magura, Stephen
AU - Lee, Joshua D.
AU - Hershberger, Jason
AU - Joseph, Herman
AU - Marsch, Lisa
AU - Shropshire, Carol
AU - Rosenblum, Andrew
PY - 2009/1/1
Y1 - 2009/1/1
N2 - Buprenorphine has rarely been administered as an opioid agonist maintenance therapy in a correctional setting. This study introduced buprenorphine maintenance in a large urban jail, Rikers Island in New York City. Heroin-dependent men not enrolled in community methadone treatment and sentenced to 10-90 days in jail (N = 116) were voluntarily randomly assigned either to buprenorphine or methadone maintenance, the latter being the standard of care for eligible inmates at Rikers. Buprenorphine and methadone maintenance completion rates in jail were equally high, but the buprenorphine group reported for their designated post-release treatment in the community significantly more often than did the methadone group (48% vs. 14%, p < .001). Consistent with this result, prior to release from Rikers, buprenorphine patients stated an intention to continue treatment after release more often than did methadone patients (93% vs. 44%, p < .001). Buprenorphine patients were also less likely than methadone patients to withdraw voluntarily from medication while in jail (3% vs. 16%, p < .05). There were no post-release differences between the buprenorphine and methadone groups in self-reported relapse to illicit opioid use, self-reported re-arrests, self-reported severity of crime or re-incarceration in jail. After initiating opioid agonist treatment in jail, continuing buprenorphine maintenance in the community appears to be more acceptable to offenders than continuing methadone maintenance.
AB - Buprenorphine has rarely been administered as an opioid agonist maintenance therapy in a correctional setting. This study introduced buprenorphine maintenance in a large urban jail, Rikers Island in New York City. Heroin-dependent men not enrolled in community methadone treatment and sentenced to 10-90 days in jail (N = 116) were voluntarily randomly assigned either to buprenorphine or methadone maintenance, the latter being the standard of care for eligible inmates at Rikers. Buprenorphine and methadone maintenance completion rates in jail were equally high, but the buprenorphine group reported for their designated post-release treatment in the community significantly more often than did the methadone group (48% vs. 14%, p < .001). Consistent with this result, prior to release from Rikers, buprenorphine patients stated an intention to continue treatment after release more often than did methadone patients (93% vs. 44%, p < .001). Buprenorphine patients were also less likely than methadone patients to withdraw voluntarily from medication while in jail (3% vs. 16%, p < .05). There were no post-release differences between the buprenorphine and methadone groups in self-reported relapse to illicit opioid use, self-reported re-arrests, self-reported severity of crime or re-incarceration in jail. After initiating opioid agonist treatment in jail, continuing buprenorphine maintenance in the community appears to be more acceptable to offenders than continuing methadone maintenance.
KW - Buprenorphine treatment
KW - Jail
KW - Methadone treatment
KW - Prisoners
KW - Substance abuse treatment
UR - http://www.scopus.com/inward/record.url?scp=57049126482&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=57049126482&partnerID=8YFLogxK
U2 - 10.1016/j.drugalcdep.2008.08.006
DO - 10.1016/j.drugalcdep.2008.08.006
M3 - Article
C2 - 18930603
AN - SCOPUS:57049126482
SN - 0376-8716
VL - 99
SP - 222
EP - 230
JO - Drug and alcohol dependence
JF - Drug and alcohol dependence
IS - 1-3
ER -