Medication for opioid use disorder treatment continuity post-release from jail: A qualitative study with community-based treatment providers

Stopka, Thomas J.; Rottapel, Rebecca; Ferguson, Warren J.; Pivovarova, Ekaterina; Toro-Mejias, Lizbeth Del; Friedmann, Peter D.; Evans, Elizabeth

doi:10.1016/j.drugpo.2022.103803

Cited by 22 publications

(11 citation statements)

References 61 publications

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“…Stigma as a barrier to care was referenced both directly and indirectly by participants. Many reported reentry challenges mapped onto those prevalent in literature that speaks to structural inequities in community reentry (Doyle et al, 2022 ; Harding et al, 2019 ; Stopka et al, 2022 ).…”

Section: Resultsmentioning

confidence: 99%

“…counseling and medication for opioid use disorder [MOUD]), both while incarcerated and post-release (Harding et al, 2019 ; Hlavka et al, 2015 ; Visher et al, 2017 ). Unfortunately, speaking to the far reach of the criminal legal system’s structural inequities, barriers to released individuals accessing each of these necessities under typical release circumstances have been long-documented (Doyle et al, 2022 ; Harding et al, 2019 ; Stopka et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

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Returning home during the pandemic: a thematic analysis describing experiences of people with substance use disorders released early from New Jersey prisons during COVID-19

et al. 2023

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Background & aims The COVID-19 pandemic created intersecting health risks for incarcerated people with a history of substance use disorder (SUD). To reduce exposure to COVID-19 in prison, several US states enacted decarceration legislation. New Jersey enacted the Public Health Emergency Credit Act (PHECA), granting early release to thousands of incarcerated persons meeting eligibility criteria. This study undertook to explore how large scale decarceration during the pandemic impacted the reentry process for released individuals with SUDs. Methods Twenty seven participants involved in PHECA releases – 21 persons released from NJ carceral facilities with past/present SUDs (14 with opioid use disorder, 7 with other SUDs) and 6 reentry service providers acting as key informants – completed phone interviews on PHECA experiences from February–June 2021. Cross-case thematic analysis of transcripts identified common themes and divergent perspectives. Results Respondents described challenges consistent with long-documented reentry difficulties including housing and food insecurity, difficulty accessing community services, insufficient employment opportunities, and limited access to transportation. Challenges that were pertinent to mass release during a pandemic included limited access to communication technology and community providers and community providers exceeding enrollment capacity. Despite reentry difficulties, respondents identified many areas where prisons and reentry service providers adapted to meet novel challenges presented by mass decarceration during the COVID-19 pandemic. Facilitators made available by prison and reentry provider staff included providing released persons with cell phones, transportation assistance at transit hubs, prescription support for medications for opioid use disorder, and pre-release assistance with ID and benefits through NJ’s Joint Comprehensive Assessment Plan. Conclusions Formerly incarcerated people with SUDs experienced reentry challenges during PHECA releases similar to those that occur during ordinary circumstances. Despite barriers faced during typical releases and novel challenges unique to mass release during a pandemic, providers made adaptations to support released persons' successful reentry. Recommendations are made based on areas of need identified in interviews, including reentry service provision facilitating housing and food security, employment, medical services, technology fluency, and transportation. In anticipation of future large scale releases, providers will benefit from planning ahead and adapting to address temporary increases in resource demands.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Returning home during the pandemic: a thematic analysis describing experiences of people with substance use disorders released early from New Jersey prisons during COVID-19

et al. 2023

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“…For example, in interviews with jail staff, one study’s respondents stressed the importance of facilitating MOUD post release [ 29 ]. Likewise, in interviews with medical and administrative staff at MOUD programs serving jail-referred individuals, respondents noted the need for more structured care coordination for jail-to-community-based MOUD treatment [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

“Just fighting for my life to stay alive”: a qualitative investigation of barriers and facilitators to community re-entry among people with opioid use disorder and incarceration histories

Hoffman

Thompson

Gaeta

et al. 2023

Addict Sci Clin Pract

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Background During the period of community re-entry immediately following release from jail or prison, individuals with opioid use disorder (OUD) face structural barriers to successful re-entry and high risk of overdose. Few published studies investigate experiences in the immediate period (i.e., first 24 h) of re-entry among people with OUD. Aim To understand the barriers and facilitators to treatment and reintegration of people with OUD during the initial transition from carceral settings back into the community. Methods From January–December 2017, we conducted 42 semi-structured qualitative interviews with patients with a history of incarceration who were receiving methadone at a not-for-profit, low-barrier opioid treatment program. Interviews probed participants’ community re-entry experiences immediately following incarceration. Interviews were transcribed and analyzed using a Thematic Analysis approach. Results The main themes described the experiences during the 24 h following release, reacclimating and navigating re-entry barriers, and re-entry preparedness and planning. Participants noted the initial 24 h to be a period of risk for returning to substance use or an opportunity to engage with OUD treatment as well as a tenuous period where many lacked basic resources such as shelter or money. When discussing the subsequent re-entry period, participants noted social challenges and persistent barriers to stable housing and employment. Participants overall described feeling unprepared for release and suggested improvements including formal transition programs, improved education, and support to combat the risk of overdose and return to substance use after incarceration. Conclusions In this study that qualitatively examines the experiences of people with incarceration histories and OUD enrolled in methadone treatment, we found that participants faced many barriers to community re-entry, particularly surrounding basic resources and treatment engagement. Participants reported feeling unprepared for release but made concrete suggestions for interventions that might improve the barriers they encountered. Future work should examine the incorporation of these perspectives of people with lived experience into the development of transition programs or re-entry classes.

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“…16,17 MOUD use while incarcerated is also shaped by factors such as anticipation of transfer to a carceral system that does not offer MOUD or expected release into a community that has limited or no access to MOUD. 16,18,19 At the individual level, incarcerated women may be more likely than men to receive MOUD, for example, due to policies that prioritize provision of MOUD to pregnant women, 9 while a significant proportion of incarcerated women have co-occurring mental illnesses and do not receive treatment. 20 Recent literature suggests that Black and Hispanic individuals are less likely to enter carceral facilities with a MOUD prescription and are more likely to be inducted on buprenorphine while incarcerated, compared with White individuals.…”

mentioning

confidence: 99%

“…In addition, individuals with a short length of jail stay may go untreated with MOUD, for example, due to policies that direct treatment only for sentenced individuals, and preclude treatment of pretrial individuals, or due to logistical challenges that mean individuals enter and exit jail quickly before MOUD can be initiated 16,17 . MOUD use while incarcerated is also shaped by factors such as anticipation of transfer to a carceral system that does not offer MOUD or expected release into a community that has limited or no access to MOUD 16,18,19 …”

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confidence: 99%

Correlates and Patterns in Use of Medications to Treat Opioid Use Disorder in Jail

2023

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Objectives: Little is known about the correlates of use of medications to treat opioid use disorder (MOUD, ie, buprenorphine, methadone, naltrexone) offered in jails. We evaluated the implementation and outcomes of a MOUD program offered by 2 of the first jails nationwide to provide access to such care. Methods: We examined use of MOUD among adults with opioid use disorder (n = 347) incarcerated by 2 rural jails in Massachusetts (2018Massachusetts ( -2021. We examined MOUD transitions from intake to during incarceration. Using logistic regression, we examined factors associated with in-jail use of MOUD. Results: At jail entry, 48.7% of individuals with opioid use disorder were being treated with MOUD. During incarceration, 65.1% received MOUD, attributable to a 9.2% increase in use of methadone (from 15.9% to 25.1%) and a 10.1% increase in use of buprenorphine (from 28.5% to 38.6%). During incarceration, 32.3% of individuals were continued on the same MOUD from the community, 25.4% were started, 8.9% stopped, and 7.5% switched type. A total of 25.9% entered jail not on any MOUD and were not started on it. Use of MOUD during incarceration was positively associated with having received MOUD in the community (odds ratio, 12.2; 95% confidence interval, 5.8-25.5) and incarceration at site 1 compared with site 2 (OR, 24.6; 95% CI, 10.9-54.4). Conclusions: Expanded access to MOUD in jails can engage an at-risk population with treatment. Understanding factors related to this population's use of MOUD may aid efforts to optimize care during incarceration and after community re-entry.

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Medication for opioid use disorder treatment continuity post-release from jail: A qualitative study with community-based treatment providers

Cited by 22 publications

References 61 publications

Returning home during the pandemic: a thematic analysis describing experiences of people with substance use disorders released early from New Jersey prisons during COVID-19

Returning home during the pandemic: a thematic analysis describing experiences of people with substance use disorders released early from New Jersey prisons during COVID-19

“Just fighting for my life to stay alive”: a qualitative investigation of barriers and facilitators to community re-entry among people with opioid use disorder and incarceration histories

Correlates and Patterns in Use of Medications to Treat Opioid Use Disorder in Jail

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