Impact of Jail-Based Methadone on Overdose, Recidivism, HIV and Health Outcomes, and Costs in New York City, 2011-2017

2011-2017 年纽约市监狱美沙酮对用药过量、累犯、艾滋病毒和健康结果及成本的影响

• 批准号: 10407967
• 负责人: JOSHUA D LEE
• 金额: $ 63.63万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-15 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10407967
• 关键词: AIDS/HIV problem; Admission activity; Adoption; Adult; Back; Buprenorphine; Caring; Clinical Trials; Collection; Communities; Community Health; Computerized Medical Record; Costs and Benefits; Criminal Justice; Crystallization; Data; Data Linkages; Data Set; Databases; Diagnosis; Drug Courts; Employment; Epidemic; Evaluation; Event; Fentanyl; Geographic Distribution; Goals; Government; Growth; HIV; HIV Seropositivity; Health; Health Care Costs; Health Services; Heroin; Homelessness; Imprisonment; Individual; Inpatients; Intervention; Island; Jail; Link; Medical; Methadone; Municipalities; Naltrexone; New York City; Opioid; Outcome; Outpatients; Overdose; Overdose reduction; Persons; Pharmaceutical Preparations; Population; Positioning Attribute; Prevalence; Prisoner; Prisons; Public Health; Public Policy; Published Comment; Research Personnel; Risk; Sampling; Services; Structural Models; Suboxone; System; Testing; Treatment outcome; Viral Load result; Woman; base; behavioral health; cost; economic outcome; experience; health care service utilization; health economics; improved; medication-assisted treatment; men; methadone treatment; mortality; opioid epidemic; opioid overdose; opioid use disorder; overdose death; overdose risk; parole; prevent; primary outcome; probation; programs; recidivism; response; service utilization; standard of care; treatment program

Project Abstract The growing prevalence of opioid use disorders (OUDs) in the community and in Criminal Justice Systems drives increasing rates of overdose mortality, poor health, and high costs. Persons incarcerated in local jails and prisons are particularly susceptible to increased risk of unintentional overdose, re-incarceration, and uncontrolled HIV. Methadone maintenance treatment is effective community treatment for OUD. However, the impact of methadone maintenance offered routinely in a large, high-volume, high-turnover municipal jail setting has not been studied. New York City, with a large jail methadone program, a jail electronic medical record, and a rich collection of regional health surveillance databases, presents a unique opportunity to estimate in-jail methadone treatment and associations with post-release overdose, re-incarceration, HIV control, and costs. This study analyses important opioid-related outcomes among NYC jail inmates admitted to and leaving NYC jails during 2011-2017, and compares individuals who: a) accessed the jail methadone maintenance treatment program and were released from jail on methadone maintenance, or, b) were diagnosed with an opioid use disorder but did not access methadone and were released from jail out- of-treatment (detox-only). Secondary, exploratory analysis will examine outcomes among, c) a smaller sample of buprenorphine maintained individuals. We will test the primary hypotheses that methadone maintenance exposure reduced the risk of fatal and non-fatal overdoses and jail recidivism, improved HIV control (among HIV-positive persons), and improved rates of appropriate health care utilization and lowered costs. This study proposes to link New York City jail electronic medical records with NYC-wide overdose, re-incarceration, HIV/AIDS, and related health and economic outcome data to better define the public health impact of methadone maintenance in NYC jails.

项目摘要 阿片类药物使用障碍（OUD）在社区和刑事司法中的日益普遍 系统导致过量死亡率增加，健康状况不佳和成本高。人 被关押在当地监狱和监狱的人特别容易受到意外伤害的风险增加。 吸毒过量，再次入狱，以及不受控制的艾滋病美沙酮维持治疗有效 社区治疗OUD。然而，美沙酮维持治疗的影响在一个 尚未对大型、高容量、高周转率的市级监狱进行研究。纽约市， 大型监狱美沙酮计划，监狱电子医疗记录，以及丰富的区域健康信息 监测数据库，提供了一个独特的机会，估计在监狱美沙酮治疗， 与释放后过量，重新监禁，艾滋病毒控制和成本的关联。 这项研究分析了纽约市监狱囚犯进出监狱的重要阿片类药物相关结果。 纽约监狱在2011-2017年期间，并比较了以下个人：a）访问监狱美沙酮 维持治疗计划，并从监狱释放美沙酮维持，或，B） 被诊断患有阿片类药物使用障碍，但没有获得美沙酮，并从监狱中释放出来- 治疗结束（仅排毒）。次要的探索性分析将检查以下结果：c）较小的 丁丙诺啡维持个体的样本。我们将检验美沙酮 维持暴露降低了致命和非致命过量和监狱累犯的风险， 艾滋病毒控制（在艾滋病毒阳性者中），提高适当保健利用率， 降低成本。这项研究建议将纽约市监狱的电子医疗记录与纽约市范围内的电子医疗记录联系起来， 过量用药、再次监禁、艾滋病毒/艾滋病以及相关的健康和经济结果数据，以更好地确定 纽约市监狱美沙酮维持对公共卫生的影响。

项目成果

Jail-based medication for opioid use disorder and patterns of reincarceration and acute care use after release: A sequence analysis.

用于治疗阿片类药物使用障碍的监狱药物以及出狱后的再监禁和急性护理使用模式：序列分析。

• DOI: 10.1016/j.josat.2023.209254
• 发表时间: 2024
• 期刊: Journal of substance use and addiction treatment
• 作者: Lim,Sungwoo;Cherian,Teena;Katyal,Monica;Goldfeld,KeithS;McDonald,Ryan;Wiewel,Ellen;Khan,Maria;Krawczyk,Noa;Braunstein,Sarah;Murphy,SeanM;Jalali,Ali;Jeng,PhilipJ;Rosner,Zachary;MacDonald,Ross;Lee,JoshuaD
• 通讯作者: Lee,JoshuaD

Association between jail-based methadone or buprenorphine treatment for opioid use disorder and overdose mortality after release from New York City jails 2011-17.

2011-17 年纽约市监狱释放后因阿片类药物使用障碍而进行的监狱美沙酮或丁丙诺啡治疗与服药过量死亡率之间的关联。

• DOI: 10.1111/add.16071
• 发表时间: 2023
• 期刊: Addiction (Abingdon, England)
• 作者: Lim,Sungwoo;Cherian,Teena;Katyal,Monica;Goldfeld,KeithS;McDonald,Ryan;Wiewel,Ellen;Khan,Maria;Krawczyk,Noa;Braunstein,Sarah;Murphy,SeanM;Jalali,Ali;Jeng,PhilipJ;MacDonald,Ross;Lee,JoshuaD
• 通讯作者: Lee,JoshuaD