Buprenorphine/naloxone treatment at the time of community reentry from an incarcerated setting

Background: Buprenorphine/naloxone has been shown to decrease drug use, criminal activity, recidivism, and HIV risk behavior. Methods: This was a single arm pilot study. We enrolled individuals at the Rhode Island Department of Corrections (RIDOC) who screened positive for opioid dependence. Initially, study participants were enrolled pre-release and referred to community treatment post release. The last 1.5 months of study enrollment, participants initiated treatment during incarceration and then linked to community treatment post release. Participants were followed for one year, with assessments at 1, 6 and 12 months. We assessed community treatment entry, length of treatment, and HIV risk factors using descriptive analyses. Results: Between October 2009 and February 2010, we enrolled 44 participants – 32 were referred to community treatment post release and 12 initiated treatment while still incarcerated. Participant demographics included 37 men (84%), 30 White (68%), 13 Latino (30%). Eleven of 12 participants (92%) who started treatment pre-release linked to community care (1 participant could not tolerate medication). 25 of 32 (78%) participants who were referred to treatment post-release linked to community care. At 6 months, (n=36; 11 pre-release initiation and 26 referrals) none of the participants who initiated treatment pre-release reported opiate or injection drug use in the prior 30 days. 6 (23%) participants who were referred to treatment post release reported opiate use and 7 (27%) reported injection drug use. Conclusions: Results of this pilot indicate that buprenorphine/naloxone treatment at the time of release is feasible and may reduce HIV risks for this vulnerable population.