Buprenorphine for probationers and parolees: Bridging the gap into treatment

摘要 这项拟议的五年期研究将评估 丁丙诺啡过渡治疗（BBT）的缓刑犯和假释犯相比， 通常（TAU），包括转介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单元 社区监督（缓刑和假释）。这项研究是一个平行的两组 一项随机对照试验，160名男性和160名女性OUD患者在社区 巴尔的摩的监督将在社区监督状态下随机分配 （缓刑或假释）和性别的两个治疗条件之一：（1）丁丙诺啡桥 治疗（BBT）：受试者将使用MedicaSafe开始丁丙诺啡药物治疗 在社区现场摄入后立即使用丁丙诺啡分配装置 并继续这种治疗，直到他们过渡到社区 丁丙诺啡治疗;或（2）药物治疗（TAU）：受试者将被转诊至 丁丙诺啡的治疗这两种情况都将收到有关过量的信息 预防参与者将在基线和摄入后1、2、3、6和12个月进行评估 使用综合评估电池。主要目的：比较相对 BBT对TAU的有效性：（a）非法阿片类药物尿液检测结果。次要目的： 检查BBT在以下方面上级TAU的程度：（B）接收天数 类阿片治疗;（c）使用非法类阿片的天数;（d）生活质量（i.身体健康; ii. （e）艾滋病毒危险行为（即：性行为; ii.使用或共用针头）;（f）犯罪 （1）再次被捕;（2）再次入狱。这项研究意义重大，因为 一些患有OUD的缓刑犯/假释犯获得有效治疗的机会有限， 丁丙诺啡药物治疗。这项拟议的研究是创新的，因为它将是第一个 在美国进行的一项试验，评估在社区启动的临时丁丙诺啡的有效性 监督办公室相比，转介到社区治疗方案。公共卫生 影响将是广泛的，因为这种护理模式可以在许多地区推广 在美国，刑事司法人口的OUD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.