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RSAT Forum > Monthly Discussion > April 2015: Other Medications View modes: 
eeagle - 4/2/2015 9:36:31 AM
   
April 2015: Other Medications
I know some RSAT programs are providing opioid and alcohol dependent inmates with injected naltrexone before release, are any programs providing other medications for the entire period the person is incarcerated?

eeagle - 4/2/2015 9:37:32 AM
   
RE:April 2015: Other Medications
A number of prisons offer methadone maintenance to inmates already on methadone and especially for pregnant inmates.
There was a NIDA funded study that experimented with Suboxone for prisoners.  It is described in the following summary.

Gordon MS, Kinlock TW, Schwartz RP, Fitzgerald TT, O'Grady KE, & Vocci FJ (Sept. 2014). A randomized controlled trial of prison-initiated buprenorphine: prison outcomes and community treatment entry. Drug Alcohol Depend. 1;142:33-40.

Abstract

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.

~Andy Klein


eeagle - 4/2/2015 11:06:45 AM
   
RE:April 2015: Other Medications

It appears that the feds are cracking down on institutions and courts that stop addicts from continuing their prescribed medications after being jailed or placed on probation. Also these agencies face lawsuits if the removal subsequently results in fatal overdoses when abstinence only therapy doesn’t work.

 

Although medications, especially opioid replacement drugs like methadone and buprenorphine, cause correctional officials headaches in terms of diversion, well run correctional institutions have been providing inmates methadone for decades.

 

~Stephanie Lear


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