From: Routes of non-traditional entry into buprenorphine treatment programs
# | Article | Study Design | Sample | Route of Entry | Intervention | Results | Conclusion | Limitations |
---|---|---|---|---|---|---|---|---|
1 | Gordon et al., 2018 | RA | N = 199 | CJ | Initiating buprenorphine treatment prior to versus after release from prison. | No significant differences. | Treatment condition did not predict likelihood of arrest. | Number of rearrests may have been biased. During the following 12 months after release, many remain detained. |
2 | Busch et al., 2017 | RCT | N = 329 | ED | Cost-effectiveness of ED-initiated buprenorphine. | Patient costs significantly lower in ED-initiated treatment group. | ED-initiated buprenorphine treatment is cost-effective. | Comparability of data. Length of follow-up was 30-days post-randomization. |
3 | Lee et al., 2017 | RCT | N = 72 | O | Predictors of retention in office-based treatment after hospitalization. | Prior treatment, older age, and non-minority status were associated with more time in office-based opioid treatment. | Linking hospitalized patients to office treatment may improve addiction treatment. | Small sample size; no measures of mental disorders other than PTSD. |
4 | Gordon et al., 2017 | RCT | N = 211 | CJ | Initiating buprenorphine treatment prior to versus after release from prison. | In-prison group had higher number of treatment days after release than those who without treatment in prison. | In-prison buprenorphine was correlated with more days of treatment after release. | Fewer women and mostly African American population; results may not be generalizable. |
5 | Riggins et al., 2017 | Cohort | N = 305 | CJ | Buprenorphine treatment retention among HIV-positive patients with a history of incarceration. | No significant differences in groups | Recently incarcerated were more likely to be homeless, unemployed, and previously diagnosed with mental illness. | As an observational study, clear causative relationships could not be established. |
6 | Finlay et al., 2016 | RA | N = 48,689 | CJ | Likelihood of US Veterans to receive treatment for opioid use disorder at Veteran Health Association hospitals. | Veterans exiting prison receive lowest rates of treatment among all justice-involved US Veterans. | Targeted efforts to reach prison-involved veterans necessary as they have lowest odds of receipt. | Study limited to veterans who received treatment at VHA facilities. |
7 | Sigmon et al., 2015 | Pilot study | N = 10 | O | Feasibility of interim buprenorphine treatment to bridge delays during patient navigation. | Opioid abstinence:70% of participants retained through 12-week treatment program. | Interim treatment might reduce illicit drug use and drug-related risk behaviors among waitlisted. | Unrandomized pilot trial with limited sample size. |
8 | D’Onofrio 2015 | RCT | N = 329 | ED | Determine success of three intervention options for ED patients with OUD. | After 30 days, group receiving buprenorphine reported greatest reduction of illicit opioid use per week. | ED-initiated buprenorphine vs. brief interventions and referral significantly increased engagement. | Study involved only physicians approved to prescribe buprenorphine,. May not be reflective most ED physicians. |
9 | Liebschutz et al., 2014 | RCT | N = 139 | O | Methods of treatment among hospitalized patients post-discharge. | Linkage (intervention) more likely to enter treatment in office setting than those in detox group (72% vs. 11.9%). | Initiation to treatment is effective for hospitalized patients not initially seeking addiction treatment. | Study conducted as single institution with an associated buprenorphine outpatient treatment program. |
10 | Gordon et al., 2014 | RCT | N = 211 | CJ | Success of buprenorphine treatment to addicted prison inmates nearing release versus after release | In-prison treatment group more likely to continue treatment post-release; women more likely to complete prison treatment than men (86% vs 53%) | Buprenorphine appears feasible and acceptable to inmates who are NOT opioid-tolerant | Study not generalizable to all geographic locations; 70% of participants were male. |
11 | Zaller et al., 2013 | Pilot study | N = 44 | CJ | Initiating treatment prior to release from incarceration and linking participants to community treatment. | Eleven of 32 participants remained in treatment for entire 6 months. | Initiating buprenorphine treatment during incarceration; continuing in community is feasible; may increase retention post-release. | Small sample size; self-report nature of data, particularly drug use and criminal history. |
12 | Schwarz et al., 2012 | RA | N = 209 | O | Effect of treatment retention on reducing ED utilization among treatment seeking patients. | Treatment retention was strongly correlated with a decline in ED visits (1 month = 1.6% decline per person). | Buprenorphine maintenance treatment significantly reduces ED utilization. | Lack of randomization does not allow for control of selection. |
13 | Lee et al., 2012 | Cohort | N = 142 | CJ | Comparing treatment retention and opioid misuse among those seeking treatment after release from jail. | Treatment retention over time was similar between groups. | Primary care appears to a feasible model of opioid treatment once released from incarceration. | Study participants were largely uninsured but received treatment through the study; whereas uninsured community referrals had no assistance. |
14 | Cropsey et al., 2011 | RCT | N = 36 | CJ | Efficacy of buprenorphine for relapse prevention among women in criminal justice system transitioning to community. | Treatment was effective in maintaining abstinence compared to placebo (92% placebo vs 33% buprenorphine were opioid positive per urinalysis). | Initiating buprenorphine in prison prior to release appears to reduce opioid use when participants reenter community. | Small sample size; limited generality as participants were women with criminal justice involvement. |
15 | Wang et al., 2010 | RA | N = 166 | CJ | Determine whether history of incarceration affects response to primary care office-based treatment. | Participants with history of incarceration have similar treatment outcomes with primary care office-based treatment than those w/o history of incarceration | Formerly incarcerated patients ar emore likely to have been treated with methadone, but do not have substantially different outcomes than those without prior incarceration. | Measurement of incarceration was self-reported and time incarcerated was grouped (patients with one month and multi-years were in same group). |
16 | Marzo et al., 2009 | Cohort | N = 507 | CJ | Describe the profile of imprisoned French opioid-dependent patients | 77% of pts. received MAT at imprisonment, these patients were in poorer health & were more isolated than other population; 238/478 pts. were re-incarcerated within 3 years | MAT has increased in the criminal justice system in France, but maintenance therapy not associated with lower rate of reincarceration. | Conclusions on mortality are not well-supported as study was not designed for mortality analysis; pt. selection not random |
17 | Magura et al., 2009 | RCT | N = 116 | CJ | Test the efficacy of buprenorohine versus methadone while incarcerated and follow-up. | Patients in buprenorphone group reported to treatment significantly more than patients taking methadone. | There were no significant differences between groups for re-incarceration, relapse, re-arrests. | Findings may not be generalizable in other nations where methadone distribution protocols vary. |
18 | D’Onofrio et al., 2017 | RA | N = 290 | ED | Outcomes assessment of previous RCTs to determine long-term outcomes. | Patiengts in the buprenorphine group showed greater engagement in treatement at 2 months which was statistically significant. | Gains did not persist after 2 months when measure at the 6 and 12 month time points. | Buprenorphine treatment initiatied in the ED was associated with increased engagement during 2 month interval when treatment was continued at PCP. |
19 | Vocci et al., 2015 | RA | N = 104 | CJ | Assessed prior RCT to examine if induction into buprenorphine during incareceration was associated with seeking treatment post-release. | Participants were rapidly inducted onto buprenorphine with no serious side effects whle incarecerated. | Buprenorphine administered to non-opioid tolerant adults may be used to reduce rates of withdrawal and re-use post-incarceration. | None noted. |
20 | Cushman et al., 2016 | RA | N = 113 | O | To assess whether inpatient initiation to buprenorphine and linkage to counselling reduces illicit opioid use. | Patients who were linked to outpatients ervices versus patients in detox (inpatient) were more successful in the short term. | Differences did not persist between groups (linking versus detox) as far as injection opiate use at 1, 3, or 6 month timepoints. | May not be generalizable with a small population. |