Effectiveness of Medication Assisted Treatment for Opioid Use in Prison and Jail Settings: A Meta- Analysis and Systematic Review

Authors
Kelly E. Moore
Walter Roberts
Holly H. Reid
Kathryn M.Z. Smith
Lindsay M.S. Oberleitner
Sherry A. McKee
Peer-Reviewed Article
April 2019
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Headline

Medication-assisted treatment (MAT) in correctional settings improves substance use treatment engagement and reduces illicit opioid use post-release.    

Context

Individuals in correctional settings with opioid use disorder experience elevated risk for fatal overdoses after release, due to decreased tolerance and the increased presence of fentanyl in the street drug supply. Studies have substantiated that MAT, such as buprenorphine, methadone, and naltrexone, reduces opioid withdrawal symptoms/cravings, reduces illicit drug use, and improves treatment adherence. However, correctional facilities rarely utilize MAT. This meta-analysis and systematic review examine the effectiveness of the administration of MAT in prison and jail settings.

Findings

The authors examined evidence on the effectiveness of MAT in correctional facilities as it relates to post-release outcomes across 24 randomized control trials and quasi-experimental studies. The authors found that methadone treatment during incarceration was associated with increased treatment engagement following release, as well as decreased illicit drug use. The authors also found buprenorphine and naltrexone treatment had similar or better outcomes compared to methadone. The authors did not find a significant association between MAT initiation during incarceration and lower reincarnation rates.

Takeaways

The findings of this systemic review can assist policymakers and correctional health care providers seeking to improve transitional health care outcomes for people with opioid use disorder in prisons and jails.

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