Does incarceration influence patients' goals for opioid use disorder treatment? A qualitative study of buprenorphine treatment in jail.
Attitudes toward substance use treatment
Buprenorphine treatment
Jail
Post-incarceration
Journal
Drug and alcohol dependence
ISSN: 1879-0046
Titre abrégé: Drug Alcohol Depend
Pays: Ireland
ID NLM: 7513587
Informations de publication
Date de publication:
01 05 2021
01 05 2021
Historique:
received:
04
11
2020
revised:
09
12
2020
accepted:
13
12
2020
pubmed:
4
4
2021
medline:
7
9
2021
entrez:
3
4
2021
Statut:
ppublish
Résumé
Correctional facilities increasingly offer medications for opioid use disorder (OUD), including buprenorphine. Nevertheless, retention in treatment post-incarceration is suboptimal and overdose mortality remains high. Our objectives were to understand how incarcerated patients viewed buprenorphine treatment and identify modifiable factors that influenced treatment continuation post-release. We conducted semi-structured interviews with 22 men receiving buprenorphine treatment in an urban jail. Interviews were audio recorded, professionally transcribed, and analyzed using a grounded-theory approach. Team members constructed preliminary case memos from transcripts, and then interactively discussed themes within respective memos. We established participant 'typologies' by consensus. Distinct typologies emerged based on participants' post-release treatment goals: (1) those who viewed buprenorphine treatment as a cure for OUD; (2) those who thought buprenorphine would help manage opioid-related problems; and (3) those who did not desire OUD treatment. Participants also described common social structural barriers to treatment continuation and community re-integration. Participants reported that post-release housing instability, unemployment, and negative interactions with parole contributed to opioid use relapse and re-incarceration. Participants had different goals for post-release buprenorphine treatment continuation, but their prior experiences suggested that social structural issues would complicate these plans. Incarceration can intensify marginalization, which when combined with heightened legal supervision, reinforced cycles of release, relapse, and re-incarceration. Participants valued buprenorphine treatment, but other structural and policy changes will be necessary to reduce incarceration-related inequities in opioid overdose mortality.
Sections du résumé
BACKGROUND
Correctional facilities increasingly offer medications for opioid use disorder (OUD), including buprenorphine. Nevertheless, retention in treatment post-incarceration is suboptimal and overdose mortality remains high. Our objectives were to understand how incarcerated patients viewed buprenorphine treatment and identify modifiable factors that influenced treatment continuation post-release.
METHODS
We conducted semi-structured interviews with 22 men receiving buprenorphine treatment in an urban jail. Interviews were audio recorded, professionally transcribed, and analyzed using a grounded-theory approach. Team members constructed preliminary case memos from transcripts, and then interactively discussed themes within respective memos. We established participant 'typologies' by consensus.
RESULTS
Distinct typologies emerged based on participants' post-release treatment goals: (1) those who viewed buprenorphine treatment as a cure for OUD; (2) those who thought buprenorphine would help manage opioid-related problems; and (3) those who did not desire OUD treatment. Participants also described common social structural barriers to treatment continuation and community re-integration. Participants reported that post-release housing instability, unemployment, and negative interactions with parole contributed to opioid use relapse and re-incarceration.
CONCLUSION
Participants had different goals for post-release buprenorphine treatment continuation, but their prior experiences suggested that social structural issues would complicate these plans. Incarceration can intensify marginalization, which when combined with heightened legal supervision, reinforced cycles of release, relapse, and re-incarceration. Participants valued buprenorphine treatment, but other structural and policy changes will be necessary to reduce incarceration-related inequities in opioid overdose mortality.
Identifiants
pubmed: 33810909
pii: S0376-8716(21)00024-7
doi: 10.1016/j.drugalcdep.2021.108529
pmc: PMC10044474
mid: NIHMS1878645
pii:
doi:
Substances chimiques
Buprenorphine
40D3SCR4GZ
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
108529Subventions
Organisme : NIAID NIH HHS
ID : P30 AI124414
Pays : United States
Organisme : NIDA NIH HHS
ID : R01 DA044878
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002556
Pays : United States
Informations de copyright
Copyright © 2021 Elsevier B.V. All rights reserved.
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