title: Rate of community methadone treatment reporting at jail reentry following a methadone increased dose quality improvement effort.
abstract: The Rikers Island Key Extended Entry Program (KEEP) has offered methadone treatment for opioid dependent inmates incarcerated in New York City's jails since 1986. In response to a trend toward low-dose methadone maintenance prescribing, a quality improvement (QI) protocol trained KEEP counselors, physicians, and pharmacists in the evidence base supporting moderate-to-high methadone maintenance doses in order to maximize therapeutic effects and rates of successful reporting to community methadone treatment programs (MTPs) post release. Discharge dose level and length of incarceration data were analyzed for 2 groups of KEEP patients discharged pre/post-QI. Among patients incarcerated for 21 or more days, the proportion of those on moderate-to-high doses of methadone increased significantly. Patients who reached a moderate-to-high methadone dose demonstrated higher rates of reporting to community MTP versus lower doses, both pre- and post-QI. Overall, a higher proportion of all patients reported to community MTP post-QI.
authors.affiliation: Prison Health Services, Inc., New York, New York, USA.
authors.forename: Andiea
authors.initials: A
authors.lastname: Harris
authors.forename: Daniel
authors.initials: D
authors.lastname: Selling
authors.forename: Charles
authors.initials: C
authors.lastname: Luther
authors.forename: Jason
authors.initials: J
authors.lastname: Hershberger
authors.forename: Joan
authors.initials: J
authors.lastname: Brittain
authors.forename: Samuel
authors.initials: S
authors.lastname: Dickman
authors.forename: Alvin
authors.initials: A
authors.lastname: Glick
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Lee
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use; D002047:Buprenorphine / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006556:Heroin Dependence / Q000188:drug therapy* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage* / Q000627:therapeutic use; D009519:New York City; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000534:rehabilitation; D010349:Patient Compliance; D011329:Prisoners; D058996:Quality Improvement
chemical_list: D000701:Analgesics, Opioid; D002047:Buprenorphine; D008691:Methadone