TY - JOUR
T1 - Use of non–prescribed buprenorphine in the criminal justice system
T2 - Perspectives of individuals recently released from incarceration
AU - Gryczynski, Jan
AU - Lee, Joshua D.
AU - Dusek, Kristi
AU - McDonald, Ryan
AU - Sharma, Anjalee
AU - Malone, Mia
AU - Monico, Laura B.
AU - Cheng, Anna
AU - DeVeaugh-Geiss, Angela
AU - Chilcoat, Howard D.
N1 - Funding Information:
Study team members received funding from Indivior for the present research, which included standard salary support provided via contract or subcontract to their institutions (Friends Research Institute, New York University). HDC and AD-G are employees of Indivior. Unrelated to the present study, JG is part owner of COG Analytics, LLC, which has received funding from the National Institutes of Health to develop various healthcare technologies, including applications focused on opioid use disorder and criminal justice-involved populations. JDL reports receiving grant support and study medication from Alkermes and study medication from Indivior, all unrelated to the present study.
Funding Information:
This study was funded by Indivior, Inc. , the pharmaceutical company that manufactures Suboxone® and Sublocade® buprenorphine products, via a contract to Friends Research Institute. Neither the content of the manuscript nor the decision to submit it for publication required the funder's approval. HDC and AD-G, who are employed by Indivior, are co-authors on the manuscript.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/8
Y1 - 2021/8
N2 - Buprenorphine, an effective treatment for opioid use disorder (OUD), remains underutilized in many U.S. jails and prisons. However, use of non–prescribed (i.e., diverted) buprenorphine has been reported in these settings. The current study examined non–prescribed buprenorphine use experiences in correctional and community contexts. The study conducted face-to-face interviews with 300 adults with OUD/opioid misuse and recent incarceration, recruited in Baltimore, MD, and New York, NY (n = 150 each). Illicit/non–prescribed opioid use during incarceration was reported by 63% of participants; 39% reported non–prescribed buprenorphine. Non–prescribed buprenorphine was considered the most widely available opioid in jails/prisons in both states (81% reported “very” or “somewhat” easy to get). The average price of non–prescribed buprenorphine in jail/prison was ~10× higher than in the community (p < 0.001). Participants were more likely to endorse getting high/mood alteration as reasons for using non–prescribed buprenorphine during incarceration, but tended to ascribe therapeutic motives to use in the community (e.g., self-treatment; p < 0.001). Multivariable logistic regression analyses showed that different individual-level characteristics were associated with history of non–prescribed buprenorphine use during incarceration and in the community. Use of non–prescribed buprenorphine during incarceration was associated with younger age (p = 0.006) and longer incarceration history (p < 0.001), while use of non–prescribed buprenorphine in the community was associated with MD recruitment site (p = 0.001), not being married (p < 0.001), prior buprenorphine treatment experience (p < 0.001), and housing situation (p = 0.01). These findings suggest that different dynamics and demand characteristics underlie the use of non–prescribed buprenorphine in community and incarceration contexts, with implications for efforts to expand OUD treatment in correctional settings.
AB - Buprenorphine, an effective treatment for opioid use disorder (OUD), remains underutilized in many U.S. jails and prisons. However, use of non–prescribed (i.e., diverted) buprenorphine has been reported in these settings. The current study examined non–prescribed buprenorphine use experiences in correctional and community contexts. The study conducted face-to-face interviews with 300 adults with OUD/opioid misuse and recent incarceration, recruited in Baltimore, MD, and New York, NY (n = 150 each). Illicit/non–prescribed opioid use during incarceration was reported by 63% of participants; 39% reported non–prescribed buprenorphine. Non–prescribed buprenorphine was considered the most widely available opioid in jails/prisons in both states (81% reported “very” or “somewhat” easy to get). The average price of non–prescribed buprenorphine in jail/prison was ~10× higher than in the community (p < 0.001). Participants were more likely to endorse getting high/mood alteration as reasons for using non–prescribed buprenorphine during incarceration, but tended to ascribe therapeutic motives to use in the community (e.g., self-treatment; p < 0.001). Multivariable logistic regression analyses showed that different individual-level characteristics were associated with history of non–prescribed buprenorphine use during incarceration and in the community. Use of non–prescribed buprenorphine during incarceration was associated with younger age (p = 0.006) and longer incarceration history (p < 0.001), while use of non–prescribed buprenorphine in the community was associated with MD recruitment site (p = 0.001), not being married (p < 0.001), prior buprenorphine treatment experience (p < 0.001), and housing situation (p = 0.01). These findings suggest that different dynamics and demand characteristics underlie the use of non–prescribed buprenorphine in community and incarceration contexts, with implications for efforts to expand OUD treatment in correctional settings.
KW - Buprenorphine
KW - Criminal justice system
KW - Diversion
KW - Opioid use disorder
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U2 - 10.1016/j.jsat.2021.108349
DO - 10.1016/j.jsat.2021.108349
M3 - Article
C2 - 34134866
AN - SCOPUS:85102142485
SN - 0740-5472
VL - 127
JO - Journal of Substance Abuse Treatment
JF - Journal of Substance Abuse Treatment
M1 - 108349
ER -