Community buprenorphine continuation post-release following extended release vs. sublingual buprenorphine during incarceration: a pilot project in Maine

Community buprenorphine continuation post-release following extended release vs. sublingual buprenorphine during incarceration: a pilot project in Maine

Background The aim of our study was to evaluate the post-release outcomes of incarcerated individuals with opioid use disorder (OUD) treated with extended-release buprenorphine (XRB) in a rural county jail. Administrative data were collected from a pilot program within a jail in Maine that introduce...

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Bibliographic Details
Published in:Health & justice Vol. 12; no. 1; pp. 28 - 11
Main Authors: O’Connor, Alane B., Gelsinger, Catherine, Donovan, Sadie M., Marshall, Jessica, Ahrens, Katherine A.
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 28-06-2024
Springer Nature B.V
BMC
Subjects:
Community and Environmental Psychology
Criminology and Criminal Justice
Extended-release buprenorphine
Imprisonment
Incarceration
Law and Criminolgy
Opioid use disorder
Overdose
Pilot projects
Prisons
Public Health
Research Article
Rural jail
Social Policy
United States > US
Maine
Incarceration
Opioid use disorder
Extended-release buprenorphine
Rural jail
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Summary:Background The aim of our study was to evaluate the post-release outcomes of incarcerated individuals with opioid use disorder (OUD) treated with extended-release buprenorphine (XRB) in a rural county jail. Administrative data were collected from a pilot program within a jail in Maine that introduced XRB treatment in 2022 and a comparable jail utilizing sublingual buprenorphine (SLB) during the same period to compare post-release outcomes. Log-binomial regression models were used to estimate the risk ratio (RR) and 95% confidence interval (CI) for jail use of XRB vs. SLB on post-release community buprenorphine continuation. Results From September 2022 to September 2023, 70 individuals who received XRB were released from the pilot jail and 130 individuals who received SLB were released from the comparison jail. After adjusting for age, sex, and buprenorphine use at entry to jail, individuals released from the pilot jail were almost 3 times (adjusted RR = 2.67, 95% CI 1.84, 3.88) as likely to continue community buprenorphine treatment post-release relative to the comparison jail. In addition, utilization of XRB allowed for expanded access to OUD treatment, was well tolerated, and reduced medication diversion. Conclusions In this pilot program in Maine, XRB treatment during incarceration was associated with higher post-release community buprenorphine continuation when compared to individuals treated with SLB. These findings provide strong evidence for the superiority of XRB vs. SLB for the treatment of OUD in jail settings. Highlights • Utilization of extended-release buprenorphine (XRB) in jail reduced diversion. • Using XRB reduced staffing demands and expanded access to treatment. • XRB may have reduced post-release overdose deaths. • Those treated with XRB were 3 times as likely to continue buprenorphine post-release.
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ISSN:2194-7899
2194-7899
DOI:10.1186/s40352-024-00281-w