Opiate Replacement Therapy at Release from Incarceration

出狱后的阿片替代疗法

• 批准号: 7476683
• 负责人: JOSIAH D RICH
• 金额: $ 7.02万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-06-15 至 2010-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7476683
• 关键词: AIDS/HIV problem; Aftercare; Buprenorphine; Caring; Clinic; Communities; Counseling; Country; Crime; Data; Drug abuse; Drug usage; Effectiveness; Employment; Funding; Grant; HIV; Heroin; Homelessness; Housing; Imprisonment; Individual; Infection; Injection of therapeutic agent; Intervention; Interview; Jail; Letters; Link; Maintenance; Measures; Medical; Methadone; Minority; NIH Program Announcements; Naloxone; National Institute of Drug Abuse; Numbers; Occupations; Opiates; Overdose; Participant; Persons; Pharmaceutical Preparations; Population Study; Prisoner; Prisons; Provider; Purpose; Randomized Controlled Trials; Rate; Recording of previous events; Replacement Therapy; Research; Research Personnel; Resources; Rhode Island; Risk; Risk Behaviors; Risk Reduction Behavior; Seasons; Site; System; Target Populations; Time; Training Programs; United States; Upper arm; Week; Work; addiction; base; burden of illness; concept; criminal behavior; drug relapse; experience; follow-up; methadone clinic/center; payment; recidivism; reincarceration; response; social integration; transmission process; treatment program

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.

这项研究将评估在释放前启动阿片类药物替代治疗的有效性 因减少艾滋病毒危险行为而入狱。注射鸦片类药物的人感染艾滋病毒的风险增加 通过注射和性行为。相当大比例的阿片依赖者是 在吸毒期间被监禁，近800万人从惩教所获释 每年的布景都有上瘾的历史。少数族裔在惩教系统中的比例都过高。 并且承担着不成比例的更高的疾病负担。释放后的紧接期间 监禁是艾滋病毒和毒品复发的特别高风险时期。美沙酮是最广泛使用的 阿片替代疗法在美国，并已被证明可以降低艾滋病毒风险，药物使用，犯罪， 以及重新监禁。其他好处包括稳定就业、住房和增加联系。 与医疗服务提供者的关系。该国大多数监狱都不提供阿片类药物替代疗法，也不提供 出院后接受治疗。来自CSAT资助的连接鸦片依赖囚犯的项目的初步数据 出狱后用美沙酮治疗表明，这种方法是可行的 前景看好，但诊所就诊率低于预期。一项随机对照试验将确定 在释放前服用美沙酮是否比转介美沙酮更有效 出狱后的治疗方案。主要目标将是确定每一项措施的效果 研究ARM在减少艾滋病毒危险行为、减少再犯罪率和增加药物治疗就诊率方面的作用。 这项研究的人群将是曾多次与毒品有关的监禁和以前的 美沙酮治疗经验。如果这个项目能够证明使用归纳法 出狱前的美沙酮治疗是有效的，这可能是对 其他形式的鸦片替代疗法，如丁丙诺啡/纳洛酮，以减少艾滋病毒传播。