163756 Supportive re-entry: Who seeks linkage to community methadone treatment upon release from incarceration?

Tuesday, November 6, 2007

Michelle McKenzie, MPH , Infectious Disease/Immunology, The Miriam Hospital/Brown Medical School, Providence, RI
Portia Thurmond, MPH , Infectious Disease/Immunology, The Miriam Hospital, Providence, RI
Bradley Anderson, PhD , General Internal Medicine-Research, Rhode Island Hospital, Providence, RI
Grace Macalino, PhD , Arthur Ashe Institute for Urban Health, Brooklyn, NY
Josiah Rich, MD, MPH , Medicine and Community Health, Brown Medical School, Providence, RI
BACKGROUND: More than 20% of the incarcerated individuals have a history of opiate addiction in the US. Methadone maintenance treatment (MMT) is highly effective treatment. Re-entry is a particularly high risk time for drug relapse, overdose and disease transmission, therefore opportune for public health intervention. We are implementing a SAMHSA funded service initiative to link recently released ex-offenders to MMT.

METHODS: Recruitment occurs at the Rhode Island Department of Corrections. Opiate addicted inmates self-refer to the program and through discharge planning staff. We make logistical arrangements for methadone treatment entry upon release, and provide partial financial assistance for MMT for 24 weeks. Intake occurs post-release at initiation of community methadone treatment. Clients are followed for one year, with interviews at baseline, six and 12 months.

RESULTS: As of September 2006, we enrolled 381 clients. Table 1 outlines the characteristics of project enrollees. Clients have a long history of heroin addiction, are primarily unstably housed and unemployed and report high rates of current heroin, cocaine and poly substance use, injecting and sharing; and mental health concerns. Many clients report a history of methadone treatment. Sixty-two percent of inmates screened at Rhode Island Department of Corrections enter community methadone treatment.

CONCLUSIONS: Recently released inmates who enter community methadone clinic are very high risk individuals, struggling with an unstable social environment. Provision of drug treatment at this high risk time may provide one element of stability. Future work will focus on meeting the needs of the 38% who do not enter treatment.

Learning Objectives:
1. Describe characteristics of a program linking recently released ex-offenders to community methadone treatment. 2.Identify re-entry challenges for opiate addicted ex-offenders. 3. Discuss the pros and cons of the intervention and future steps for improving access to opioid treatment.

Keywords: Methadone Maintenance, Incarceration

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.