title: A randomized controlled trial of prison-initiated buprenorphine: prison outcomes and community treatment entry.
abstract: BACKGROUND
  Buprenorphine is a promising treatment for heroin addiction. However, little is known regarding its provision to pre-release prisoners with heroin dependence histories who were not opioid-tolerant, the relative effectiveness of the post-release setting in which it is provided, and gender differences in treatment outcome in this population.
  
  
  METHODS
  This is the first randomized clinical trial of prison-initiated buprenorphine provided to male and female inmates in the US who were previously heroin-dependent prior to incarceration. A total of 211 participants with 3-9 months remaining in prison were randomized to one of four conditions formed by crossing In-Prison Treatment Condition (received buprenorphine vs. counseling only) and Post-release Service Setting (at an opioid treatment center vs. a community health center). Outcome measures were: entered prison treatment; completed prison treatment; and entered community treatment 10 days post-release.
  
  
  RESULTS
  There was a significant main effect (p=.006) for entering prison treatment favoring the In-Prison buprenorphine Treatment Condition (99.0% vs. 80.4%). Regarding completing prison treatment, the only significant effect was Gender, with women significantly (p<.001) more likely to complete than men (85.7% vs. 52.7%). There was a significant main effect (p=.012) for community treatment entry, favoring the In-Prison buprenorphine Treatment Condition (47.5% vs. 33.7%).
  
  
  CONCLUSIONS
  Buprenorphine appears feasible and acceptable to prisoners who were not opioid-tolerant and can facilitate community treatment entry. However, concerns remain with in-prison treatment termination due to attempted diversion of medication.
authors: Friends Research Institute, Inc., 1040 Park Avenue, Suite 103, Baltimore, MD 21201, USA; Stevenson University, Department of Criminal Justice, 1525 Greenspring Valley Road, Stevenson, MD 21153, USA. Electronic address: mgordon@friendsresearch.org.
authors: Michael S
authors: MS
authors: Gordon
authors: Friends Research Institute, Inc., 1040 Park Avenue, Suite 103, Baltimore, MD 21201, USA; University of Baltimore, School of Criminal Justice, College of Public Affairs, 1420 N Charles Street, Baltimore, MD 21201, USA.
authors: Timothy W
authors: TW
authors: Kinlock
authors: Friends Research Institute, Inc., 1040 Park Avenue, Suite 103, Baltimore, MD 21201, USA; University of Maryland School of Medicine, Department of Psychiatry, 110 South Paca St., Baltimore, MD 21201, USA.
authors: Robert P
authors: RP
authors: Schwartz
authors: Glenwood Life Counseling Center, 516 Glenwood Avenue, Baltimore, MD 21212, USA.
authors: Terrence T
authors: TT
authors: Fitzgerald
authors: University of Maryland, 8082 Baltimore Avenue, College Park, MD 20740, USA.
authors: Kevin E
authors: KE
authors: O'Grady
authors: Friends Research Institute, Inc., 1040 Park Avenue, Suite 103, Baltimore, MD 21201, USA.
authors: Frank J
authors: FJ
authors: Vocci
mesh_terms: D000328:Adult; D002047:Buprenorphine / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003376:Counseling; D005260:Female; D006556:Heroin Dependence / Q000188:drug therapy* / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use; D011329:Prisoners; D011330:Prisons; D016896:Treatment Outcome
chemical_list: D009294:Narcotics; D002047:Buprenorphine
keywords: Buprenorphine; Correctional settings; Heroin; Opioid dependence; Opioid use disorder; Prison