The benefits and implementation challenges of the first state-wide comprehensive medication for addictions program in a unified jail and prison setting

Brinkley‐Rubinstein, Lauren; Peterson, Meghan; Clarke, Jennifer G.; Macmadu, Alexandra; Truong, Ashley; Pognon, Kimberly; Parker, Morgan; Marshall, Brandon D.L.; Green, Traci; Martin, Rosemarie A.; Stein, L. A. R.; Rich, Josiah D.

doi:10.1016/j.drugalcdep.2019.06.016

Cited by 29 publications

(20 citation statements)

References 31 publications

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“…A key strategy to address the opioid epidemic among correctional populations is increased access to medications to treat OUD (MOUD, i.e., buprenorphine, methadone, naltrexone) (Brinkley-Rubinstein et al, 2017;Malta et al, 2019). MOUD program implementation inside correctional institutions requires significant organizational changes (Brinkley-Rubinstein et al, 2019;Grella et al, 2020;Mace et al, 2019). The Franklin County Sheriff's Office (FCSO) in Greenfield, Massachusetts, was among the first jails nationwide to offer buprenorphine and methadone, in addition to naltrexone, to treat residents with OUD.…”

Section: Treating Opioid Use Disorder In Criminal Justice Settingsmentioning

confidence: 99%

COVID-19 and treating incarcerated populations for opioid use disorder

Donelan

Hayes

Potee

et al. 2021

Journal of Substance Abuse Treatment

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The Franklin County Sheriff's Office (FCSO), in Greenfield, Massachusetts, is among the first jails nationwide to provide correctional populations with access to all three medications to treat. opioid use disorder (MOUD, i.e., buprenorphine, methadone, naltrexone). In response to the COVID-19 pandemic, FCSO quickly implemented comprehensive mitigation policies and adapted MOUD programming. Two major challenges for implementation of the MOUD program were the mandated rapid release of nonviolent pretrial individuals, many of whom were being treated with MOUD and released too quickly to conduct continuity of care planning; and establishing how to deliver physically distanced MOUD services in jail. FCSO implemented and adapted a hub-and-spoke MOUD model, developed telehealth capacity, and experimented with take-home MOUD at release to facilitate continuity-of-care as individuals re-entered the community. Experiences underscore how COVID-19 accelerated the uptake and diffusion of technology-infused OUD treatment and other innovations in criminal justice settings. Looking forward, to address both opioid use disorder and COVID-19, jails and prisons need to develop capacity to implement mitigation strategies, including universal and rapid COVID-19 testing of staff and incarcerated individuals, and be resourced to provide evidence-based addiction treatment. FCSO quickly pivoted and adapted MOUD programming because of its history of applying public health approaches to address the opioid epidemic. Utilizing public health strategies can enable prisons and jails to mitigate the harms of the co-occurring epidemics of OUD and COVID-19, both of which disproportionately affect criminal justice populations, for persons who are incarcerated and the communities to which they return.

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Section: Treating Opioid Use Disorder In Criminal Justice Settingsmentioning

confidence: 99%

COVID-19 and treating incarcerated populations for opioid use disorder

Donelan

Hayes

Potee

et al. 2021

Journal of Substance Abuse Treatment

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“…Notably, in our study the majority of incarcerated people that we interviewed did not recall being offered HCV testing. The early days of incarceration can be particularly challenging as people deal with withdrawal symptoms from substances, emotional struggles/fear with incarceration itself, and adjust to the setting [ 33 ]. Offering exit testing could be a useful strategy to optimize uptake, though there are challenges to delivering results prior to re-entry into the community.…”

Section: Discussionmentioning

confidence: 99%

“…Lived experience should inform discussions about the best way to communicate preventative healthcare strategies with incarcerated people often who have low health literacy and may lack trust in clinicians working in the jail. Involving people who are incarcerated in discussions about their care is a critical step towards developing HIV/HCV care strategies that work for them [ 24 , 25 , 31 , 33 ]. Engaging people who are incarcerated in the development of programs for them has been shown to improve effectiveness in programs for transgender detainees [ 36 ] and STI testing for women who are incarcerated [ 37 ], as well as understanding perceptions of coercion in mental health courts [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

“I’m not gonna be able to do anything about it, then what’s the point?”: A broad group of stakeholders identify barriers and facilitators to HCV testing in a Massachusetts jail

et al. 2021

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Background Despite national guidelines promoting hepatitis C virus (HCV) testing in prisons, there is substantial heterogeneity on the implementation of HCV testing in jails. We sought to better understand barriers and opportunities for HCV testing by interviewing a broad group of stakeholders involved in HCV testing and treatment policies and procedures in Massachusetts jails. Methods We conducted semi-structured interviews with people incarcerated in Middlesex County Jail (North Billerica, MA), clinicians working in jail and community settings, corrections administrators, and representatives from public health, government, and industry between November 2018—April 2019. Results 51/120 (42%) of people agreed to be interviewed including 21 incarcerated men (mean age 32 [IQR 25, 39], 60% non-White). Themes that emerged from these interviews included gaps in knowledge about HCV testing and treatment opportunities in jail, the impact of captivity and transience, and interest in improving linkage to HCV care after release. Many stakeholders discussed stigma around HCV infection as a factor in reluctance to provide HCV testing or treatment in the jail setting. Some stakeholders expressed that stigma often led decisionmakers to estimate a lower “worth” of incarcerated individuals living with HCV and therefore to decide against paying for HCV testing.”. Conclusion All stakeholders agreed that HCV in the jail setting is a public health issue that needs to be addressed. Exploring stakeholders’ many ideas about how HCV testing and treatment can be approached is the first step in developing feasible and acceptable strategies.

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“…The opioid substitution program as a gold standard treatment reduces injection, use of co-injection equipment, and the risk of infectious diseases. By prescribing low-threshold methadone upon entry into the prison in the screening unit, withdrawal symptoms were also minimized (43)(44)(45). Several studies similarly showed that the implementation of the opioid substitution program reduced illicit drug use, and hence, the tension of PWUDs and drug-related crimes (44).…”

Section: Discussionmentioning

confidence: 99%

Substance Use and The Necessity for Harm Reduction Programs in Prisons: A Qualitative Study in Central Prison of Sanandaj, Iran

Zafarghandi

Eshrati

Arezoomandan

et al. 2021

Int J High Risk Behav Addict

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Background: For decades, harm reduction programs for addiction have been started in Iranian prisons. The programs comprise methadone maintenance treatment, antiretroviral treatment, and other harm reduction programs implemented as a triangular clinic. Despite the lack of funding to provide mental health services, particularly for substance use and harm reduction in prisons of low- and middle-income countries, Iran provides well-developed services. Objectives: The study investigated the implementation and achievements of harm reduction programs in Sanandaj prison located in the center of Kurdistan Province, west of Iran. Methods: This was a qualitative cross-sectional study. We used various information sources such as a checklist and group discussions. The participants were chosen by the purposive sample method and included prison authorities and harm reduction service providers and recipients. The data were analyzed by content analysis. Results: The harm reduction programs included opioid substitution therapy, providing information and education, voluntary counseling and testing for blood-borne diseases, providing condoms, hepatitis C virus screening, and antiretroviral treatment. Following the implementation of the program, a significant decrease in violence, self-injury, illegal drug use and shared syringes, HIV-positive new comers, and no necessity for the needle and syringe program when starting methadone treatment was reported. Conclusions: Commitment to a strict ban on the entering of drugs to the prison is a reason for the use of high-risk methods of drug use and behaviors such as injection, self-injury, or violence. Sharing syringes and needles is a major cause of the transmission of HIV and hepatitis viruses among drug users. Harm reduction programs, especially methadone maintenance treatment and antiretroviral treatment, have reduced a large proportion of drug-related harms in prisons. Scaling up the programs and their extension to post-release treatment will greatly reduce the country's health costs.

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The benefits and implementation challenges of the first state-wide comprehensive medication for addictions program in a unified jail and prison setting

Cited by 29 publications

References 31 publications

COVID-19 and treating incarcerated populations for opioid use disorder

COVID-19 and treating incarcerated populations for opioid use disorder

“I’m not gonna be able to do anything about it, then what’s the point?”: A broad group of stakeholders identify barriers and facilitators to HCV testing in a Massachusetts jail

Substance Use and The Necessity for Harm Reduction Programs in Prisons: A Qualitative Study in Central Prison of Sanandaj, Iran

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