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Community-based treatment for opioid dependent offenders: a pilot study
Randy Brown1, Michele Gassman, Scott Hetzel
1Department of Family Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Wisconsin 53715, USA. randy.brown@fammed.wisc.edu
Primary care opioid substitution treatment (OST) is feasible for offenders, with specialist care showing greater reductions in HIV risk behaviors. Further research is needed to optimize offender care matching.
Area of Science:
- Addiction Medicine
- Criminal Justice Health
- Public Health
Background:
- Opioid substitution treatment (OST) in primary care has not been compared to program-based OST for community-supervised offenders.
- Understanding optimal OST delivery models for offenders is crucial for public health.
Purpose of the Study:
- To compare primary care OST with specialist-supervised OST for opioid-dependent offenders.
- To evaluate differences in substance use and HIV risk outcomes between treatment models.
Main Methods:
- Random assignment of 15 jail diversion participants to three groups: primary care buprenorphine OST, specialist buprenorphine OST, or specialist methadone OST.
- Treatment duration was 13.5 months, including 12 months of active treatment.
Main Results:
- All participants reported zero opioid use at follow-up.
- Specialist care significantly reduced HIV risk behaviors over 6 months compared to primary care (p=0.032).
Conclusions:
- Primary care OST is a feasible option for community-supervised offenders.
- Specialist care settings may offer additional benefits for reducing HIV risk behaviors in this population.
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