Impact of a jail-based treatment decision-making intervention on post-release initiation of medications for opioid use disorder

•Treatment-decision making was associated with opioid use disorder medication uptake.•The intervention effect only lasted one month after jail release.•Most with suspected opioid addiction did not start treatment medications.•Men and non-whites were less likely to initiate treatment medications. Opi...

Full description

Saved in:
Bibliographic Details
Published in:Drug and alcohol dependence 2020-02, Vol.207, p.107799-107799, Article 107799
Main Authors: Banta-Green, C.J., Williams, J.R., Sears, J.M., Floyd, A.S., Tsui, J.I., Hoeft, T.J.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Behavior Therapy - methods
Buprenorphine
Buprenorphine - therapeutic use
Cohort analysis
Decision Making
Demography
Drug addiction
Ex-convicts
Felony
Female
Humans
Imprisonment
Intervention
Jail
Jails
Male
Methadone
Middle Aged
Modelling
Naltrexone
Naltrexone - therapeutic use
Narcotics
Opiate Substitution Treatment - psychology
Opiate Substitution Treatment - statistics & numerical data
Opioid
Opioid-Related Disorders - drug therapy
Opioid-Related Disorders - psychology
Opioids
Patient Acceptance of Health Care - psychology
Patient Acceptance of Health Care - statistics & numerical data
Patient Education as Topic - methods
Prisoners
Prisoners - psychology
Prisons
Proportional Hazards Models
Release
Retrospective Studies
Substance use disorder
Treatment
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:•Treatment-decision making was associated with opioid use disorder medication uptake.•The intervention effect only lasted one month after jail release.•Most with suspected opioid addiction did not start treatment medications.•Men and non-whites were less likely to initiate treatment medications. Opioid use disorder (OUD) is common among people in jail and is effectively treated with medications for OUD (MOUD). People with OUD may have an incomplete or inaccurate understanding of OUD and MOUD, and of how to access care. We evaluated an OUD treatment decision making (TDM) intervention to determine whether the intervention increased MOUD initiation post-release. We conducted an observational retrospective cohort study of the TDM intervention on initiation of MOUD, individuals with records data indicating confirmed or suspected OUD incarcerated in four eligible jails were eligible to receive the intervention. Time-to-event analyses of the TDM intervention were conducted using Cox proportional hazard modeling with MOUD as the outcome. Cox proportional hazard modeling, with the intervention modeled as having a time-varying effect due to violation of the proportionality assumption, indicated that those receiving the TDM intervention (n = 568) were significantly more likely to initiate MOUD during the first month after release from jail (adjusted hazard ratio 6.27, 95 % C.I. 4.20–9.37), but not in subsequent months (AHR 1.33 95 % C.I. 0.94–1.89), adjusting for demographics, prior MOUD, or felony or gross misdemeanor arrest in the prior year compared to those not receiving the intervention (n = 3174). The TDM intervention was associated with a significantly higher relative hazard of starting MOUD, specifically during the first month after incarceration. However, a minority of all eligible people received any MOUD. Future research should examine ways to increase initiation on MOUD immediately after (or ideally during) incarceration.
ISSN:0376-8716
1879-0046
DOI:10.1016/j.drugalcdep.2019.107799