Buprenorphine and medication management in a community corrections population: a pilot study

J Addict Med. 2013 May-Jun;7(3):210-5. doi: 10.1097/ADM.0b013e31828e6b21.

Abstract

Aims: This project sought to demonstrate the feasibility and acceptability of providing on-site buprenorphine treatment to individuals under community corrections supervision.

Methods: Seventeen women and 13 men were enrolled on-site over a 2-week period at a community corrections location. Study participants received open-label study medication dispensed weekly over 12 weeks, weekly medication management therapy, and returned for a 1-month follow-up.

Results: Participants were predominantly female (56%) and white (90%) with an average age of 31.7 ± 7.4 years. More than half (53%) had hepatitis C virus infection and 75.9% reported intravenous use of opioids in the 30 days before treatment. Rates of illicit substance use was high, as 37.9% of urines were positive for benzodiazepines, 31.7% were positive for cocaine, and 13.7% were positive for alcohol across the time in the study. Although rates of positive urines for opiate use and sex with multiple partners did not change during treatment, rates of injection drug use significantly decreased during treatment. Overall, 86.7% of participants were retained through the 1-month follow-up with low rates of adverse events.

Conclusions: Acceptability and feasibility of this approach were demonstrated by the ability to enroll and randomize the target sample of participants over 2 weeks with high retention and low rates of adverse events through 1-month follow-up. This pilot study demonstrated that this population could be successfully engaged in treatment and show reductions in risky behaviors. However, more intensive interventions may be needed to reduce opiate use to reach this vulnerable population at their point of contact with the criminal justice system.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alabama / epidemiology
  • Buprenorphine* / administration & dosage
  • Buprenorphine* / adverse effects
  • Delivery of Health Care* / methods
  • Delivery of Health Care* / statistics & numerical data
  • Dose-Response Relationship, Drug
  • Drug Monitoring
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Medication Adherence
  • Medication Therapy Management / organization & administration*
  • Narcotic Antagonists / administration & dosage
  • Narcotic Antagonists / adverse effects
  • Opiate Substitution Treatment / methods
  • Opiate Substitution Treatment / statistics & numerical data
  • Patient Acceptance of Health Care / statistics & numerical data
  • Pilot Projects
  • Random Allocation
  • Substance Abuse Detection* / methods
  • Substance Abuse Detection* / statistics & numerical data
  • Substance-Related Disorders* / diagnosis
  • Substance-Related Disorders* / drug therapy
  • Substance-Related Disorders* / epidemiology
  • Substance-Related Disorders* / psychology
  • Treatment Outcome

Substances

  • Narcotic Antagonists
  • Buprenorphine