Methadone and buprenorphine prescribing and referral practices in US prison systems: Results from a Nationwide Survey
Methadone and buprenorphine prescribing and referral practices in US prison systems: Results from a Nationwide Survey
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DOI：
10.1016/j.drugalcdep.2009.06.015
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发表时间：
2009-11-01
影响因子：
4.2
通讯作者：
Rich, Josiah D.
中科院分区：
文献类型：
--
作者：
Nunn, Amy;Zaller, Nickolas;Rich, Josiah D.
背景资料：超过50%的被监禁者有药物使用史，每年有超过20万名海洛因成瘾者通过美国的惩教设施。使用美沙酮或丁丙诺啡的阿片替代疗法（ORT）是治疗阿片类药物依赖的有效方法，可以减少囚犯的药物相关疾病和累犯。ORT的提供是一个经常被忽视的干预在correctional setting.Objective and methods：我们调查了50个州;华盛顿，哥伦比亚特区（DC）;和联邦惩教部的医疗主任或他们的设施的ORT处方政策和转介程序囚犯离开prison.Results：我们收到了来自全国52个监狱系统的51个答复。28个监狱系统（55%）在某些情况下向囚犯提供美沙酮。美沙酮的使用在各州之间差异很大：超过50%的提供美沙酮的惩教机构专门为孕妇或慢性疼痛管理提供美沙酮。七个州的监狱系统（14%）向一些囚犯提供丁丙诺啡。不提供口服体液补充疗法的最常见原因是，设施“更喜欢无毒品戒毒，而不是提供美沙酮或丁丙诺啡。“23个州的监狱系统（45%）为一些囚犯提供了释放后美沙酮维持方案的转诊服务，这一比例从2003年的8%有所增加; 15个州的监狱系统（29%）提供了社区丁丙诺啡提供者的转诊服务。尽管在监禁期间向囚犯提供口服体液补充疗法以及在释放后与口服体液补充疗法挂钩具有明显的社会、医疗和经济效益，全国许多监狱系统仍然不提供阿片类药物成瘾的药物治疗或在释放后转诊接受口服体液补充疗法。(C)2009爱思唯尔爱尔兰有限公司保留所有权利。
Background: More than 50% of incarcerated individuals have a history of substance use, and over 200,000 individuals with heroin addiction pass through American correctional facilities annually. Opiate replacement therapy (ORT) with methadone or buprenorphine is an effective treatment for opiate dependence and can reduce drug-related disease and recidivism for inmates. Provision of ORT is nevertheless a frequently neglected intervention in the correctional setting.Objective and methods: We surveyed the 50 state; Washington, District of Columbia (DC); and Federal Department of Corrections' medical directors or their equivalents about their facilities' ORT prescribing policies and referral programs for inmates leaving prison.Results: We received responses from 51 of 52 prison systems nationwide. Twenty-eight prison systems (55%) offer methadone to inmates in some situations. Methadone use varies widely across states: over 50% of correctional facilities that offer methadone do so exclusively for pregnant women or for chronic pain management. Seven states' prison systems (14%) offer buprenorphine to some inmates. The most common reason cited for not offering ORT was that facilities "prefer drug-free detoxification over providing methadone or buprenorphine." Twenty-three states' prison systems (45%) provide referrals for some inmates to methadone maintenance programs after release, which increased from 8% in 2003; 15 states' prison systems (29%) provide some referrals to community buprenorphine providers.Conclusion: Despite demonstrated social, medical, and economic benefits of providing ORT to inmates during incarceration and linkage to ORT upon release, many prison systems nationwide still do not offer pharmacological treatment for opiate addiction or referrals for ORT upon release. (C) 2009 Elsevier Ireland Ltd. All rights reserved.