Gordon Michael S, Kinlock Timothy W, Schwartz Robert P, O'Grady Kevin E, Fitzgerald Terrence T, Vocci Frank J
Friends Research Institute, Inc., 1040 Park Avenue, Suite 103, Baltimore, MD 21201, United States.
University of Baltimore, School of Criminal Justice, 10 W. Preston Street, Baltimore, MD 21201, United States.
Drug Alcohol Depend. 2017 Mar 1;172:34-42. doi: 10.1016/j.drugalcdep.2016.11.037. Epub 2017 Jan 11.
This study examined whether starting buprenorphine treatment prior to prison and after release from prison would be associated with better drug treatment outcomes and whether males and females responded differently to the combination of in-prison treatment and post-release service setting.
Study design was a 2 (In-Prison Treatment: Condition: Buprenorphine Treatment: vs. Counseling Only)×2 [Post-Release Service Setting Condition: Opioid Treatment: Program (OTP) vs. Community Health Center (CHC)]×2 (Gender) factorial design. The trial was conducted between September 2008 and July 2012. Follow-up assessments were completed in 2014. Participants were recruited from two Baltimore pre-release prisons (one for men and one for women). Adult pre-release prisoners who were heroin-dependent during the year prior to incarceration were eligible. Post-release assessments were conducted at 1, 3, 6, and 12-month following prison release.
Participants (N=211) in the in-prison treatment condition effect had a higher mean number of days of community buprenorphine treatment compared to the condition in which participants initiated medication after release (P=0.005). However, there were no statistically significant hypothesized effects for the in-prison treatment condition in terms of: days of heroin use and crime, and opioid and cocaine positive urine screening test results (all Ps>0.14) and no statistically significant hypothesized gender effects (all Ps>0.18).
Although initiating buprenorphine treatment in prison compared to after-release was associated with more days receiving buprenorphine treatment in the designated community treatment program during the 12-months post-release assessment, it was not associated with superior outcomes in terms of heroin and cocaine use and criminal behavior.
本研究探讨了在入狱前和出狱后开始丁丙诺啡治疗是否会带来更好的药物治疗效果，以及男性和女性对狱中治疗与出狱后服务环境相结合的反应是否存在差异。
研究设计为2（狱中治疗：条件：丁丙诺啡治疗与仅咨询）×2[出狱后服务环境条件：阿片类药物治疗项目（OTP）与社区卫生中心（CHC）]×2（性别）析因设计。试验于2008年9月至2012年7月进行。随访评估于2014年完成。参与者从巴尔的摩的两所提前释放监狱（一所男性监狱和一所女性监狱）招募。在入狱前一年依赖海洛因的成年提前释放囚犯符合条件。出狱后的评估在出狱后的1、3、6和12个月进行。
与出狱后开始用药的情况相比，处于狱中治疗条件下的参与者（N = 211）在社区接受丁丙诺啡治疗的平均天数更多（P = 0.005）。然而，在以下方面，狱中治疗条件没有统计学上显著的假设效应：海洛因使用天数和犯罪情况、阿片类药物和可卡因尿液筛查阳性结果（所有P>0.14），也没有统计学上显著的假设性别效应（所有P>0.18）。
尽管在入狱时开始丁丙诺啡治疗与出狱后开始治疗相比，在出狱后12个月的指定社区治疗项目中接受丁丙诺啡治疗的天数更多，但在海洛因和可卡因使用以及犯罪行为方面，它并没有带来更好的结果。
