NCJ Number
230320
Journal
Drug and Alcohol Dependence Volume: 99 Issue: 1-3 Dated: January 2009 Pages: 222-230
Date Published
January 2009
Length
10 pages
Annotation
A comparative analysis was conducted to determine whether buprenorphine was at least as effective as methadone when initiated in a jail setting.
Abstract
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 percent vs. 14 percent, p less than .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 percent vs. 44 percent, p less than .001). Buprenorphine patients were also less likely than methadone patients to withdraw voluntarily from medication while in jail (3 percent vs. 16 percent, p less than .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. Figure, tables, and references