Methadone within prison and linkage to and retention in treatment upon community release for people with opioid use disorder in Kyrgyzstan: Evaluation of a national program.
Methadone within prison and linkage to and retention in treatment upon community release for people with opioid use disorder in Kyrgyzstan: Evaluation of a national program.
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DOI：
10.1016/j.drugpo.2021.103558
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发表时间：
2022-03
影响因子：
4.4
通讯作者：
Altice, Frederick L.
中科院分区：
文献类型：
--
作者：
Bachireddy, Chethan;Shrestha, Roman;Bromberg, Daniel J.;Azbel, Lyu;Kurmanalieva, Ainura;Wegman, Martin;Shumskaya, Natalya;Rozanova, Julia;Meyer, Jaimie P.;Altice, Frederick L.
HIV incidence in Eastern Europe and Central Asia (EECA) continues to increase, primarily among people who inject drugs (PWID) and people in prisons. In Kyrgyzstan, an estimated 35% of people in prison are PWID, and 10% have been diagnosed with HIV. In 2008, Kyrgyzstan became the first country in EECA to provide free and voluntary methadone in prisons. We examine the impact of this national program on methadone within prison as well as linkage to and retention in treatment upon release to the community. Administrative data from a national methadone registry with de-identified information were assessed retrospectively. We examined the delivery of methadone services, including the duration of treatment both within prison and after release, for all prisoners who were prescribed methadone in Kyrgyz prisons from 2008 to 2018. Reasons for discontinuing methadone, HIV status and methadone dose are also analyzed. Between 2008 and 2018, nine of Kyrgyzstan’s 16 prisons offered methadone, and 982 incarcerated people initiated methadone within prison. Prisoners prescribed methadone were mostly male (96.2%), in their mid-30s (mean=34.9 years), and had been incarcerated for a relatively long time (mean = 44.1 months); their mean treatment duration in prison was 12.5 months, and 31.6% had HIV. A subsample (N = 645; 65.7%) of these were released to the community. Of these 645 people, 356 (55.2%) were not taking methadone at the time of release, 128 (19.8%) were on methadone and continued it after release, and the remainder (N=161, 25.0%) were on methadone at the time of release, but subsequently discontinued it, most within the first 7 days after release Among those continuing methadone, 14.8% (N=19) remained on treatment ≥ 12 months. Independent correlates of linkage to methadone after release included positive HIV status (adjusted hazard ratio (aHR)=1.55; p = 0.033) receipt of methadone before their incarceration (aHR = 2.01; p = 0.039), and receipt of methadone at the time o release (aHR = 20.81; p < 0.001). This is the first evaluation of within-prison methadone treatment in EECA. Uptake of methadone within prison and retention in treatment after release were both low. Continuous maintenance of treatment throughout incarceration is an opportunity to optimize HIV prevention and link patients to methadone post-release.
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DOI：
10.1016/s1473-3099(18)30469-9
发表时间：
2018-12
期刊：
The Lancet. Infectious diseases
影响因子：
--
作者：
Stone J;Fraser H;Lim AG;Walker JG;Ward Z;MacGregor L;Trickey A;Abbott S;Strathdee SA;Abramovitz D;Maher L;Iversen J;Bruneau J;Zang G;Garfein RS;Yen YF;Azim T;Mehta SH;Milloy MJ;Hellard ME;Sacks-Davis R;Dietze PM;Aitken C;Aladashvili M;Tsertsvadze T;Mravčík V;Alary M;Roy E;Smyrnov P;Sazonova Y;Young AM;Havens JR;Hope VD;Desai M;Heinsbroek E;Hutchinson SJ;Palmateer NE;McAuley A;Platt L;Martin NK;Altice FL;Hickman M;Vickerman P
通讯作者：
Vickerman P
影响因子：
2.9
作者：
Rhodes, Tim;Azbel, Lyuba;Meyer, Jaimie
通讯作者：
Meyer, Jaimie
影响因子：
6
作者：
Polonsky, Maxim;Azbel, Lyuba;Altice, Frederick L.
通讯作者：
Altice, Frederick L.
DOI：
10.1007/s11524-018-0256-4
发表时间：
2018-08-01
影响因子：
6.6
作者：
Rozanova, Julia;Morozova, Olga;Altice, Frederick L.
通讯作者：
Altice, Frederick L.
DOI：
10.1016/j.drugpo.2021.103209
发表时间：
2021-08
期刊：
The International journal on drug policy
影响因子：
--
作者：
Liberman AR;Bromberg DJ;Azbel L;Rozanova J;Madden L;Meyer JP;Altice FL
通讯作者：
Altice FL