Prescription opioid abuse in prison settings: A systematic review of prevalence, practice and treatment responses

Bi-Mohammed, Zanib; Wright, Nat; Hearty, Philippa; King, Nigel; Gavin, Helen

doi:10.1016/j.drugalcdep.2016.11.032

Cited by 37 publications

(36 citation statements)

References 30 publications

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“…By contrast, they seemed more attracted by practicability aspects, for example by no longer having to take their OAT every day, or receiving a more discreet treatment. As buprenorphine diversion and misuse are widespread in prison [14], drug-related tra c can be an important source of bullying and violence in these settings [21]. Consequently, the subjects with OUD that receive a sublingual formulation of buprenorphine in prison can be more exposed to harassment and extortion than those receiving a depot or implant form.…”

Section: Discussionmentioning

confidence: 99%

“…The reasons are multiple and rely on a lack of resources and appropriate services, as well as on frequent negative representations among penitentiary and medical teams in prison, including stigma, uncertainty of the effectiveness of OATs, and apprehensions on safety issues, such as overdose, diversion, or misuse of OAT [13]. Barriers may also come from the prisoners' milieu, as OAT diversion is important in prison [14], which can lead to bullying and racket, and thus refrain inmates with OUD from seeking treatment [15].…”

Section: Introductionmentioning

confidence: 99%

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Readiness to try extended-released buprenorphine and related factors of interest: comparison between incarcerated and non-incarcerated subjects with opioid use disorder.

Chappuy¹,

Meroueh²,

Trojak³

et al. 2020

Preprint

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Background: Extended-release buprenorphine (XR-BUP) are new pharmaceutical products that offer a one-week-, one-month- or six-months-long buprenorphine treatment for subjects with opioid use disorder (OUD). OUD is frequent in incarcerated populations, and XR-BUP has been suggested to be an interesting treatment option in prison. However, some opioid users have deemed that XR-BUP could constitute a threat to the individual freedom of occasionally using drugs, and was also at risk to be coercively used in some situations. It was thus needed to explore whether incarcerated people with OUD were ready to try XR-BUP formulations, and which reasons could warrant their possible interest or apprehension.Methods: This is a secondary analysis of a survey performed between 12/02/2018 and 05/31/2019 among 366 patients with OUD. Participants were recruited in 68 addiction French settings, among which six were prison medical centers. Bivariable and multivariable comparisons between incarcerated and non-incarcerated interviewees with respect to their readiness to try XR-BUP and the reasons of interest in this new option. Odds ratios and their 95% confidence intervals (aORs; 95%CI) were adjusted for gender, age category, level of education, and type of opioid agonist treatment.Results: The data of 317 participants were included in the analyses. While 108 (48.9%) of the 221 non-incarcerated interviewees declared being ready to try XR-BUP, they were 63.5% (61 out of 96) among those incarcerated (p =0.016). Adjusted comparisons found that incarcerated were significantly less attracted by the potential of XR-BUP to reduce withdrawal symptoms (aOR= 0.54; 95%CI= 0.29 – 0.99), and to reduce misuse of buprenorphine (aOR= 0.56; 95%CI= 0.34 – 0.94), but more attracted by receiving a constantly efficacious treatment for a week or month (aOR= 2.91; 95%CI= 1.21 – 6.98), and have a more discreet treatment (aOR= 1.76; 95%CI= 1.01 – 3.10).Conclusions: Relative to non-incarcerated subjects with OUD, those in prison were readier to try XR-BUP and they seemed more attracted by practicability and discretion features.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Readiness to try extended-released buprenorphine and related factors of interest: comparison between incarcerated and non-incarcerated subjects with opioid use disorder.

Chappuy¹,

Meroueh²,

Trojak³

et al. 2020

Preprint

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“…Despite the rise, the overall rate of illicit BUP use among the IV drug using community is rare, with the majority of users reporting use of BUP to manage withdrawal symptoms as opposed to seeking an euphoric effect [42]. Conversely, BUP use in incarcerated individuals is common, with individuals inhaling or insufflating BUP in order to obtain a long-lasting high [43].…”

Section: Toxicitymentioning

confidence: 99%

Pharmacologic Treatment of Opioid Use Disorder: a Review of Pharmacotherapy, Adjuncts, and Toxicity

et al. 2018

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Opioid use disorder continues to be a significant source of morbidity and mortality in the USA and the world. Pharmacologic treatment with methadone and buprenorphine has been shown to be effective at retaining people in treatment programs, decreasing illicit opioid use, decreasing rates of hepatitis B, and reducing all cause and overdose mortality. Unfortunately, barriers exist in accessing these lifesaving medications: users wishing to start buprenorphine therapy require a waivered provider to prescribe the medication, while some states have no methadone clinics. As such, users looking to wean themselves from opioids or treat their opioid dependence will turn to alternative agents. These agents include using prescription medications, like clonidine or gabapentin, off-label, or over the counter drugs, like loperamide, in supratherapeutic doses. This review provides information on the pharmacology and the toxic effects of pharmacologic agents that are used to treat opioid use disorder. The xenobiotics reviewed in depth include buprenorphine, clonidine, kratom, loperamide, and methadone, with additional information provided on lofexidine, akuamma seeds, kava, and gabapentin.

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“…As a result of these findings, it has become clear that there is a necessity to find less abusable forms of the medication in question. 21 Methadone, for example is usually prescribed in the form of an oral suspension; it can also be produced in an injectable form, which is more commonly used when a patient is hospitalised and unable to take it for themselves. If methadone was prescribed in prisons in an injectable form, it would make it impossible for the drug to be concealed for use at a later date, or transferred to another inmate.…”

Section: Prescription Drugs In Prisonsmentioning

confidence: 99%

From prescription to addiction: a study of prescription drug abuse

O'Hagan¹,

Burns²

2019

FRCIJ

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General practitioners are dispensing an increasing number of painkillers to their patients at a time when drug abuse is rife in Britain's prisons and addiction to prescription drugs is in the headlines due to the fall from grace of a high-profile celebrity. This study seeks to investigate how widespread the abuse of prescription drugs has become and what possible solutions there may be. It will examine which drugs are most widely abused and the role of prescription drugs as a more easily obtainable source of illicit highs in the prison population. It will consider what action needs to be taken as a result. The study indicates that pregabalin and gabapentin are drugs most widely abused within the prison population and that drugs are being dispensed with too little consideration of their addictive properties. It is concluded that further research into this area is required with consideration of possible changes to the law in relation to which drugs are controlled, but acknowledges the difficulties due to the medicinal benefits and large numbers of NHS patients currently reliant on these drugs, and underfunding of alternative services such as cognitive behavioural therapy (CBT) and psychotherapy.

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Prescription opioid abuse in prison settings: A systematic review of prevalence, practice and treatment responses

Cited by 37 publications

References 30 publications

Readiness to try extended-released buprenorphine and related factors of interest: comparison between incarcerated and non-incarcerated subjects with opioid use disorder.

Readiness to try extended-released buprenorphine and related factors of interest: comparison between incarcerated and non-incarcerated subjects with opioid use disorder.

Pharmacologic Treatment of Opioid Use Disorder: a Review of Pharmacotherapy, Adjuncts, and Toxicity

From prescription to addiction: a study of prescription drug abuse

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