Buprenorphine and methadone maintenance in jail and post-release

A randomized clinical trial

Stephen Magura, Joshua Lee, Jason Hershberger, Herman Joseph, Lisa Marsch, Carol Shropshire, Andrew Rosenblum

Research output: Contribution to journalArticle

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% vs. 14%, p < .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% vs. 44%, p < .001). Buprenorphine patients were also less likely than methadone patients to withdraw voluntarily from medication while in jail (3% vs. 16%, p < .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.

Original languageEnglish (US)
Pages (from-to)222-230
Number of pages9
JournalDrug and Alcohol Dependence
Volume99
Issue number1-3
DOIs
StatePublished - Jan 1 2009

Fingerprint

Prisons
Buprenorphine
Methadone
Randomized Controlled Trials
Opioid Analgesics
Therapeutics
Crime
Heroin
Standard of Care
Islands
Recurrence

Keywords

  • Buprenorphine treatment
  • Jail
  • Methadone treatment
  • Prisoners
  • Substance abuse treatment

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

Cite this

Magura, S., Lee, J., Hershberger, J., Joseph, H., Marsch, L., Shropshire, C., & Rosenblum, A. (2009). Buprenorphine and methadone maintenance in jail and post-release: A randomized clinical trial. Drug and Alcohol Dependence, 99(1-3), 222-230. https://doi.org/10.1016/j.drugalcdep.2008.08.006

Buprenorphine and methadone maintenance in jail and post-release : A randomized clinical trial. / Magura, Stephen; Lee, Joshua; Hershberger, Jason; Joseph, Herman; Marsch, Lisa; Shropshire, Carol; Rosenblum, Andrew.

In: Drug and Alcohol Dependence, Vol. 99, No. 1-3, 01.01.2009, p. 222-230.

Research output: Contribution to journalArticle

Magura, S, Lee, J, Hershberger, J, Joseph, H, Marsch, L, Shropshire, C & Rosenblum, A 2009, 'Buprenorphine and methadone maintenance in jail and post-release: A randomized clinical trial', Drug and Alcohol Dependence, vol. 99, no. 1-3, pp. 222-230. https://doi.org/10.1016/j.drugalcdep.2008.08.006
Magura, Stephen ; Lee, Joshua ; Hershberger, Jason ; Joseph, Herman ; Marsch, Lisa ; Shropshire, Carol ; Rosenblum, Andrew. / Buprenorphine and methadone maintenance in jail and post-release : A randomized clinical trial. In: Drug and Alcohol Dependence. 2009 ; Vol. 99, No. 1-3. pp. 222-230.
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