Buprenorphine for probationers and parolees: Bridging the gap into treatment

摘要 这项拟议的为期五年的研究将评估行政管理的有效性 丁丙诺啡桥接疗法(BBT)对缓刑和假释犯治疗的比较 通常(TAU)，包括转诊到社区丁丙诺啡治疗计划。 项目实施将在吉尔福德大道进行，这是巴尔的摩市的主要进水口 社区监督(缓刑和假释)。建议的研究是一项平行的两组研究 160名男性和160名女性参加的随机对照试验 巴尔的摩的监管将在社区监管状态下随机分配 (缓刑或假释)和性别对两种治疗条件之一：(1)丁丙诺啡桥 治疗(BBT)：参与者将开始使用MedicaSafe丁丙诺啡药物治疗 丁丙诺啡在社区现场摄入后立即配发的装置 监督办公室，并继续这种治疗，直到他们过渡到社区 丁丙诺啡治疗；或(2)照常治疗(TAU)：参与者将被转介到 丁丙诺啡在社区的治疗。这两种情况都会收到有关服药过量的信息 预防。参与者将在基线以及服药后1、2、3、6和12个月进行评估 使用综合评估电池。主要目的：比较亲缘关系 BBT在以下方面对TAU的有效性：(A)非法阿片类药物尿液检测结果。次要目标： 检查BBT在以下方面优于TAU的程度：(B)接收天数 阿片类药物治疗；(C)使用非法阿片类药物的天数；(D)生活质量(一、身体健康；二. (E)艾滋病毒危险行为(一、性行为；二.针头使用或共用)；(F)罪犯 活动；(G)再次逮捕；和(H)再次监禁。这项拟议的研究意义重大，因为 许多患有OUD的缓刑/假释犯获得有效治疗的机会有限， 丁丙诺啡药物疗法。这项拟议的研究具有创新性，因为它将是第一项 在美国进行的评估临时丁丙诺啡社区疗效的试验 将监督办公室与转诊到社区治疗计划进行比较。公共卫生 影响将是广泛的，因为这种护理模式可以在许多领域扩大 在美国，刑事司法人口的犯罪率很高。

ABSTRACT This proposed five-year study will evaluate the effectiveness of the administration of buprenorphine bridge treatment (BBT) to probationers and parolees compared to treatment as usual (TAU), which consists of referral to a community buprenorphine treatment program. Project implementation will occur at Guilford Avenue, the primary intake unit for Baltimore City Community Supervision (Probation and Parole). The proposed study is a parallel two-group randomized controlled trial in which 160 men and 160 women with OUD on community supervision in Baltimore will be randomly assigned within community supervision status (probation or parole) and gender to one of two treatment conditions: (1) Buprenorphine Bridge Treatment (BBT): Participants will begin buprenorphine pharmacotherapy using the MedicaSafe buprenorphine dispensing device immediately after an on-site intake at a community supervision office and continue such treatment until they are transitioned to community buprenorphine treatment; or (2) Treatment as Usual (TAU): Participants will receive a referral to buprenorphine treatment in the community. Both conditions will receive information on overdose prevention. Participants will be assessed at baseline, and 1, 2, 3, 6, and 12 months post-intake using a comprehensive assessment battery. The Primary Aim: To compare the relative effectiveness of BBT to TAU in terms of: (a) illicit opioid urine test results. The Secondary Aim: To examine the extent to which BBT is superior to TAU in terms of: (b) number of days receiving opioid treatment; (c) number of days using illicit opioids; (d) quality of life (i. physical health; ii. mental health); (e) HIV risk behaviors (i. sexual behavior; ii. needle use or sharing); (f) criminal activity; (g) re-arrest; and (h) re-incarceration. The proposed study is significant because the large number of probationers/parolees with OUD have limited access to an efficacious treatment, buprenorphine pharmacotherapy. The proposed study is innovative because it would be the first trial in the US assessing the effectiveness of interim buprenorphine initiated at a community supervision office compared to referral to a community treatment program. The public health impact would be widespread, as this model of care could be scaled-up throughout many areas of the US with criminal justice populations with high rates of OUD.