Does incarceration influence patients’ goals for opioid use disorder treatment? A qualitative study of buprenorphine treatment in jail

William Vail, Elissa Faro, Dana Watnick, Jonathan Giftos, Aaron D. Fox

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Correctional facilities increasingly offer medications for opioid use disorder (OUD), including buprenorphine. Nevertheless, retention in treatment post-incarceration is suboptimal and overdose mortality remains high. Our objectives were to understand how incarcerated patients viewed buprenorphine treatment and identify modifiable factors that influenced treatment continuation post-release. Methods: We conducted semi-structured interviews with 22 men receiving buprenorphine treatment in an urban jail. Interviews were audio recorded, professionally transcribed, and analyzed using a grounded-theory approach. Team members constructed preliminary case memos from transcripts, and then interactively discussed themes within respective memos. We established participant ‘typologies’ by consensus. Results: Distinct typologies emerged based on participants’ post-release treatment goals: (1) those who viewed buprenorphine treatment as a cure for OUD; (2) those who thought buprenorphine would help manage opioid-related problems; and (3) those who did not desire OUD treatment. Participants also described common social structural barriers to treatment continuation and community re-integration. Participants reported that post-release housing instability, unemployment, and negative interactions with parole contributed to opioid use relapse and re-incarceration. Conclusion: Participants had different goals for post-release buprenorphine treatment continuation, but their prior experiences suggested that social structural issues would complicate these plans. Incarceration can intensify marginalization, which when combined with heightened legal supervision, reinforced cycles of release, relapse, and re-incarceration. Participants valued buprenorphine treatment, but other structural and policy changes will be necessary to reduce incarceration-related inequities in opioid overdose mortality.

Original languageEnglish (US)
Article number108529
JournalDrug and Alcohol Dependence
Volume222
DOIs
StatePublished - May 1 2021

Keywords

  • Attitudes toward substance use treatment
  • Buprenorphine treatment
  • Jail
  • Post-incarceration

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

Fingerprint

Dive into the research topics of 'Does incarceration influence patients’ goals for opioid use disorder treatment? A qualitative study of buprenorphine treatment in jail'. Together they form a unique fingerprint.

Cite this