Prisoners with pre-incarceration heroin addiction histories rarely receive drug abuse treatment while incarcerated, or upon release. Re-addiction among such individuals typically occurs within one month of release, placing these individuals at disproportionately high risk for HIV and hepatitis B and C infections, overdose death, increased criminal activity, and re-incarceration. Research is clearly needed to evaluate the effectiveness of innovative drug treatment interventions spanning incarceration and the community. Based on substantial evidence of the effectiveness of opioid agonist treatment in the community, and the authors'considerable investigative experience with prison-initiated opioid agonist maintenance treatment of male inmates, a five-year study is proposed to examine the effectiveness of the administration of buprenorphine to previously-addicted inmates initiated in the institution and continued on release to the community. Moreover, the proposed study would be the first to examine the effectiveness of opioid agonist therapy for female (n=160) as well as male (n=160) pre-release inmates with pre-addiction heroin addiction histories. Finally, the proposed research will examine the extent to which the setting of post-release buprenorphine is provided [in an opioid agonist treatment program (OTP) vs. a community health center (CHC)]. Participants will be randomly assigned, within gender, to one of four treatment conditions: 1) buprenorphine and counseling in prison, with referral for continued treatment at an OTP upon release;2) buprenorphine and counseling in prison, with referral for continued treatment at a CHC upon release;3) counseling only in prison, with referral for buprenorphine and counseling at a OTP upon release;and 4) counseling only in prison, with referral for buprenorphine and counseling at a CHC upon release. Participants will be assessed at study entry and at 1, 3, 6, and 12 months following their release from prison. Outcome measures include: treatment entry and retention in the community, heroin use, cocaine use, HIV infection, HIV-risk behaviors, criminal activity, and employment. Relevance: While there have been substantial advances in the effectiveness of drug abuse treatment, only limited improvements have occurred in the provision of treatment services in non-research settings. Therefore, both researchers and practitioners have emphasized the need for rigorous research to examine the delivery of treatment services to heroin-dependent individuals in """"""""real-world"""""""" settings, including prisons and community health centers. The presently proposed clinical trial aims to bridge this gap by examining the extent to which opioid maintenance treatment initiated in prison for inmates with a history of opioid addiction and the type of post-release treatment setting to which they are referred has an impact on public health and public safety outcomes in pre-release prison inmates.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
3R01DA021579-04S1
Application #
8198488
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Hilton, Thomas
Project Start
2007-08-24
Project End
2012-07-31
Budget Start
2010-08-01
Budget End
2011-07-31
Support Year
4
Fiscal Year
2011
Total Cost
$146,022
Indirect Cost
Name
Friends Research Institute, Inc.
Department
Type
DUNS #
010095032
City
Baltimore
State
MD
Country
United States
Zip Code
21201
Gordon, Michael S; Kinlock, Timothy W; Schwartz, Robert P et al. (2017) A randomized clinical trial of buprenorphine for prisoners: Findings at 12-months post-release. Drug Alcohol Depend 172:34-42
Vocci, Frank J; Schwartz, Robert P; Wilson, Monique E et al. (2015) Buprenorphine dose induction in non-opioid-tolerant pre-release prisoners. Drug Alcohol Depend 156:133-138
Gordon, Michael S; Kinlock, Timothy W; Schwartz, Robert P et al. (2015) Buprenorphine Treatment for Probationers and Parolees. Subst Abus 36:217-25
Gordon, Michael S; Kinlock, Timothy W; Schwartz, Robert P et al. (2014) A randomized controlled trial of prison-initiated buprenorphine: prison outcomes and community treatment entry. Drug Alcohol Depend 142:33-40
Gordon, Michael S; Kinlock, Timothy W; Couvillion, Kathryn A et al. (2013) Gender Differences Among Prisoners With Pre-Incarceration Heroin Dependence Participating in a Randomized Clinical Trial of Buprenorphine Treatment. J Offender Rehabil 52:376-391
Gordon, Michael S; Kinlock, Timothy W; Schwartz, Robert P et al. (2013) The Severity, Frequency, and Variety of Crime in Heroin-Dependent Prisoners Enrolled in a Buprenorphine Clinical Trial. Prison J 93:390-410
Kinlock, Timothy W; Gordon, Michael S; Schwartz, Robert P et al. (2013) Individual Patient and Program Factors Related to Prison and Community Treatment Completion in Prison-Initiated Methadone Maintenance Treatment. J Offender Rehabil 52:509-528
Gordon, Michael S; Kinlock, Timothy W; Miller, Patrice M (2011) Medication-assisted treatment research with criminal justice populations: challenges of implementation. Behav Sci Law 29:829-45
Kinlock, Timothy W; Gordon, Michael S; Schwartz, Robert P et al. (2010) Developing and Implementing a New Prison-Based Buprenorphine Treatment Program. J Offender Rehabil 49:91-109