TY - JOUR
T1 - Does incarceration influence patients’ goals for opioid use disorder treatment? A qualitative study of buprenorphine treatment in jail
AU - Vail, William
AU - Faro, Elissa
AU - Watnick, Dana
AU - Giftos, Jonathan
AU - Fox, Aaron D.
N1 - Funding Information:
The project described was supported in part by the National Center for Advancing Translational Sciences (NCATS), components of the National Institutes of Health (NIH), through CTSA grant number UL1TR002556-01. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. Dr. Fox was supported by R01 DA044878.This work was also supported by the Einstein-Rockefeller-CUNY Center for AIDS Research (P30-AI124414) which is supported by the following NIH Co-Funding and Participating Institutes and Centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH, NIA, FIC, NIMHD, NIGMS and NIDDK.
Publisher Copyright:
© 2021 Elsevier B.V.
PY - 2021/5/1
Y1 - 2021/5/1
N2 - 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.
AB - 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.
KW - Attitudes toward substance use treatment
KW - Buprenorphine treatment
KW - Jail
KW - Post-incarceration
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U2 - 10.1016/j.drugalcdep.2021.108529
DO - 10.1016/j.drugalcdep.2021.108529
M3 - Article
C2 - 33810909
AN - SCOPUS:85103566816
SN - 0376-8716
VL - 222
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
M1 - 108529
ER -
