Implementing a Jail-Based Buprenorphine Program in a Small Appalachian Facility: Insights From CFIR and ERIC.

Area of Science:

• Public Health
• Implementation Science
• Addiction Medicine

Background:

• Opioid use disorder (OUD) is common in jails, with high overdose risk post-release.
• Buprenorphine is effective for OUD but underutilized in U.S. jails, especially in the South.
• Justice-involved populations face significant barriers to evidence-based treatment.

Purpose of the Study:

• To evaluate clinical outcomes of a jail-based buprenorphine program in Appalachia.
• To identify implementation barriers and facilitators for this model.
• To assess the feasibility of telehealth-assisted OUD treatment in resource-constrained jail settings.

Main Methods:

• Mixed-methods approach combining quantitative retention data and qualitative staff interviews.
• Utilized the Consolidated Framework for Implementation Research (CFIR) and Expert Recommendations for Implementing Change (ERIC).
• Program involved telehealth prescribing and post-release navigation services.

Main Results:

• Strong patient retention rates, comparable to community-based benchmarks.
• Identified barriers: staff skepticism, stigma, limited capacity, role ambiguity.
• Facilitators included: ongoing education, leadership support, inter-agency collaboration.

Conclusions:

• Jail-based buprenorphine programs are feasible in resource-limited Southern settings.
• Telehealth and navigation models can improve treatment access for justice-involved individuals.
• Addressing implementation barriers is crucial for program sustainability and expansion.