Injectable pharmacotherapy for opioid use disorders (IPOD)

Area of Science:

• Correctional health
• Addiction medicine
• Pharmacotherapy

Background:

• Opioid use disorder (OUD) is prevalent among offenders, yet pharmacotherapy is underutilized in correctional settings.
• Extended-release naltrexone (XR-NTX) is a potential treatment for OUD in this population.
• Patient navigation may enhance treatment adherence and outcomes.

Purpose of the Study:

• To assess the clinical utility, effectiveness, and cost of XR-NTX for jail inmates with OUD.
• To evaluate the impact of adding patient navigation to XR-NTX treatment.
• To examine the reduction in opioid use, criminal behavior, and disease risk.

Main Methods:

• A 4-year trial randomizing opioid-dependent inmates to XR-NTX alone, XR-NTX plus patient navigation, or enhanced treatment-as-usual.
• First XR-NTX injection administered pre-release, followed by a 6-month medication phase.
• Data collection at 1, 3, 6, and 12 months post-release.

Main Results:

• The primary outcome is the diagnosis of OUD at 1 year post-randomization.
• Anticipated findings include reduced opioid use, criminal behavior, and injection-related disease risk.
• The study will provide insights into the effectiveness and cost-implications of XR-NTX in a high-risk population.

Conclusions:

• Providing XR-NTX prior to release may significantly benefit incarcerated individuals with OUD.
• XR-NTX, particularly with patient navigation, could be a valuable tool in reducing recidivism and improving health outcomes.
• Further research is needed to confirm the long-term effectiveness and cost-effectiveness.