163781 Assisting opiate addicted offenders upon re-entry: 12 month outcomes for a methadone linkage program

Tuesday, November 6, 2007

Michelle McKenzie, MPH , Infectious Disease/Immunology, The Miriam Hospital/Brown Medical School, Providence, RI
Bradley Anderson, PhD , General Internal Medicine-Research, Rhode Island Hospital, Providence, RI
Portia Thurmond, MPH , Infectious Disease/Immunology, The Miriam 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: Twenty-three percent of state prisoners in the US have a history of opiate addiction. Methadone maintenance treatment (MMT) has been shown to be an effective treatment strategy to decrease drug use, HIV risk behaviors and criminal activity. Opiate addicted offenders re-entering the community are disproportionately affected by risk factors leading to relapse, overdose, blood-borne disease and recidivism. We are implementing a SAMHSA funded service initiative to link offenders entering the community to MMT.

METHODS: Project staff screen potential clients at the Rhode Island Department of Corrections. We make logistical arrangements for entering MMT upon release, provide partial financial assistance for MMT for 24 weeks, and social service referrals. Clients are followed for one year. Data are collected at baseline, six, and twelve months. Baseline occurs after initiation in community MMT.

RESULTS: As of September 2006 we enrolled 381 clients and completed 232 12-month interviews (87% follow-up). At six months 55% were enrolled in MMT and at 12 months 44% were enrolled in MMT. The proportion of participants reporting injecting in the past 30 days, sharing, heroin use and other drug use significantly decreased at 12 months. The proportion of participants reporting being employed and receiving pension significantly increased at 12 months.

CONCLUSIONS: Number of enrollees, length of stay in treatment, decreased risk behaviors suggest that linkage to MMT post release is feasible and beneficial. Future work will be a randomized trial of the program to demonstrate efficacy and initiating methadone during incarceration to facilitate treatment entry post release.

Learning Objectives:
1. Describe the characterististics of a methadone linkage program for offenders re-entering the community. 2. Identify the variables in which the program had the greatest impact at the 12-month follow-up. 3. Discuss the challenges of opiate addicted ex-offenders in securing housing, employment, health care, and minimizing HIV/hep risks in the time shortly after release from incarceration.

Keywords: Incarceration, Methadone Maintenance

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.