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A randomized controlled trial of prison-initiated buprenorphine: Prison outcomes and community treatment entry
Open accessAbstract
Background Buprenorphine is a promising treatment for heroin addiction. However, little is known regarding its provision to pre-release prisoners with heroin dependence histories who were not opioid-tolerant, the relative effectiveness of the post-release setting in which it is provided, and gender differences in treatment outcome in this population.Methods This is the first randomized clinical trial of prison-initiated buprenorphine provided to male and female inmates in the US who were previously heroin-dependent prior to incarceration. A total of 211 participants with 3-9 months remaining in prison were randomized to one of four conditions formed by crossing In-Prison Treatment Condition (received buprenorphine vs. counseling only) and Post-release Service Setting (at an opioid treatment center vs. a community health center). Outcome measures were: entered prison treatment; completed prison treatment; and entered community treatment 10 days post-release.Results There was a significant main effect (p=.006) for entering prison treatment favoring the In-Prison buprenorphine Treatment Condition (99.0% vs. 80.4%). Regarding completing prison treatment, the only significant effect was Gender, with women significantly (p<.001) more likely to complete than men (85.7% vs. 52.7%). There was a significant main effect (p=.012) for community treatment entry, favoring the In-Prison buprenorphine Treatment Condition (47.5% vs. 33.7%).Conclusions Buprenorphine appears feasible and acceptable to prisoners who were not opioid-tolerant and can facilitate community treatment entry. However, concerns remain with in-prison treatment termination due to attempted diversion of medication.
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“Evidence-based opioid-agonist maintenance therapies for opioid dependence (methadone and buprenorphine) are effective in prison, jail, and community reentry (i.e., parole) settings2–5 but have historically been unavailable or discouraged among criminal justice clients.6–8”
From Extended-release naltrexone to prevent opioid relapse in criminal justice offenders (2016) · cites this paper as [4]
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Additional file 2 of The impact of the opioid crisis on U.S. state prison systems
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Metadata
- Authors
- Gordon, M. S., Kinlock, T. W., Schwartz, R. P., Fitzgerald, T. T., O’Grady, K. E., & Vocci, F. J.
- Affiliations
- Stevenson University (US)
- Friends Research Institute (US)
- University of Maryland, Baltimore (US)
- University of Maryland, College Park (US)
- Corresponding author
- Gordon, Michael S.
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2014-09
- Volume
- 142
- Pages
- 33-40
- ISSN
- 0376-8716 (ISSN-L)
- PMC
- PMC4129444
- OpenAlex
- W1979097541
- Cited by
- 112
- References
- 46
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 12 · 2023: 12 · 2022: 10 · 2021: 12 · 2020: 9 · 2019: 13 · 2018: 8 · 2017: 5 · 2016: 11 · 2015: 9 · 2014: 1
- FWCI
- 8.59
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Drug and Alcohol Dependence (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (R01DA021579)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Sociology and Political Science › Criminal Justice and Corrections Analysis
- Keywords
- buprenorphine, heroin addiction, opioid use disorder, opioid-tolerant patients, community-based treatment, gender differences, treatment completion, drug diversion
- MeSH terms
- Adult, Buprenorphine, Combined Modality Therapy, Counseling, Female, Heroin Dependence, Humans, Male, Middle Aged, Narcotics, Prisoners, Prisons, Treatment Outcome
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