This study will evaluate the effectiveness of initiating opiate replacement therapy prior to release from incarceration on reducing HIV risk behaviors. Individuals who inject opiates are at increased risk for HIV through both injection and sexual practices. A substantial proportion of opiate-dependent persons are incarcerated while addicted and a majority of the nearly 8 million individuals released from a correctional setting each year have a history of addiction. Minorities are both over represented in the corrections system and carry a disproportionately higher burden of disease. The period immediately after release from incarceration is a particularly high-risk time for HIV and drug relapse. Methadone is the most widely used opiate replacement therapy in the United States and has been shown to decrease HIV risk, drug use, crime, and reincarceration. Other benefits include the stabilization of employment, housing, and increased contact with medical care providers. Most prisons in the country do not offer opiate replacement therapy or refer to treatment upon release. Preliminary data from our CSAT-funded project linking opiate-dependent prisoners with methadone treatment after release from incarceration reveal that this approach is feasible and promising, but with lower-than-expected clinic attendance rates. A randomized, controlled trial will determine whether initiating methadone prior to release is a more effective strategythan referral to methadone treatment programs on release from incarceration. The primary aims will be to determine the effects of each study arm on reducing HIV risk behaviors, reducing recidivism, and increasing drug treatment attendance. The population of this study will be prisoners with multiple prior drug-related incarcerations and previous experience with methadone treatment. If this project is able to demonstrate that the use of induction of methadone treatment prior to release from incarceration is effective, this may be a """"""""proof of concept"""""""" for other forms of opiate replacement therapy, such as buprenorphine/naloxone, to reduce HIV transmission.
| Zaller, Nickolas; McKenzie, Michelle; Friedmann, Peter D et al. (2013) Initiation of buprenorphine during incarceration and retention in treatment upon release. J Subst Abuse Treat 45:222-6 |
| Rich, Josiah D; DiClemente, Ralph; Levy, Judith et al. (2013) Correctional facilities as partners in reducing HIV disparities. J Acquir Immune Defic Syndr 63 Suppl 1:S49-53 |
| McKenzie, Michelle; Zaller, Nickolas; Dickman, Samuel L et al. (2012) A randomized trial of methadone initiation prior to release from incarceration. Subst Abus 33:19-29 |
| (2011) Corrigendum. Drug Alcohol Depend 113:252 |
| Rich, Josiah D; McKenzie, Michelle; Dickman, Samuel et al. (2011) An Adverse Reaction to Buprenorphine/Naloxone Induction in Prison: A Case Report. Addict Disord Their Treat 10:199-200 |
| Bazazi, Alexander R; Yokell, Michael; Fu, Jeannia J et al. (2011) Illicit use of buprenorphine/naloxone among injecting and noninjecting opioid users. J Addict Med 5:175-80 |
| Rich, Josiah D; Wohl, David A; Beckwith, Curt G et al. (2011) HIV-related research in correctional populations: now is the time. Curr HIV/AIDS Rep 8:288-96 |
| Yokell, Michael A; Green, Traci C; Bowman, Sarah et al. (2011) Opioid overdose prevention and naloxone distribution in Rhode Island. Med Health R I 94:240-2 |
| Nunn, Amy; Zaller, Nickolas; Dickman, Samuel et al. (2010) Improving access to opiate addiction treatment for prisoners. Addiction 105:1312-3 |
| Beckwith, Curt G; Zaller, Nickolas D; Fu, Jeannia J et al. (2010) Opportunities to diagnose, treat, and prevent HIV in the criminal justice system. J Acquir Immune Defic Syndr 55 Suppl 1:S49-55 |
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