title: Community-based treatment for opioid dependent offenders: a pilot study.
abstract: BACKGROUND
  Primary care opioid substitution treatment (OST) has not been compared to program-based OST for community-supervised offenders.
  
  
  OBJECTIVE
  The purpose of this project was to compare primary care to specialist supervised OST for opioid dependent offenders in terms of substance use and HIV risk outcomes.
  
  
  METHODS
  This project randomly assigned 15 jail diversion participants to either: (i) primary care buprenorphine OST, (ii) specialist facility buprenorphine OST, or (iii) specialist facility methadone OST. Participation lasted 13.5 months (12-month active treatment plus a post-participation visit).
  
  
  RESULTS
  All subjects endorsed 0 days of opioid use in the previous 14 at follow-up. Specialty care reduced HIV risk (Risk Assessment Battery composite score) over 6 months (-.24 ± .17) compared to primary care (.02 ± .14; p = .032).
  
  
  CONCLUSIONS
  Findings support primary care OST feasibility for a community-supervised offender sample. Specialist care may facilitate improvements in secondary outcomes, such as HIV risk behaviors.
  
  
  CONCLUSIONS
  Further research is needed to clarify (i) the role of primary care in addicted offender management, and (ii) the matching of offenders, based upon history and co-morbidity, to care coordination conditions.
authors: Department of Family Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Wisconsin 53715, USA. randy.brown@fammed.wisc.edu
authors: Randy
authors: R
authors: Brown
authors: Michele
authors: M
authors: Gassman
authors: Scott
authors: S
authors: Hetzel
authors: Lisa
authors: L
authors: Berger
mesh_terms: D000328:Adult; D003416:Criminal Law / Q000379:methods; D057237:Criminals / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D009294:Narcotics / Q000627:therapeutic use; D058850:Opiate Substitution Treatment / Q000379:methods*; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D010865:Pilot Projects; D011320:Primary Health Care / Q000379:methods; D016320:Substance Abuse Treatment Centers / Q000379:methods
chemical_list: D009294:Narcotics; D008691:Methadone
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