Russell Cayley, George Tony P, Chopra Nitin, Le Foll Bernard, Matheson Flora I, Rehm Jürgen, Lange Shannon
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
Ontario Node, Canadian Research Initiative in Substance Misuse (CRISM), Toronto, ON, Canada.
Am J Drug Alcohol Abuse. 2024 Sep 2;50(5):567-586. doi: 10.1080/00952990.2024.2360984. Epub 2024 Jun 28.
Medications for opioid use disorder (MOUD) reduce risks for overdose among correctional populations. Among other barriers, daily dosing requirements hinder treatment continuity post-release. Extended-release buprenorphine (XR-BUP) may therefore be beneficial. However, limited evidence exists. To conduct a systematic review examining the feasibility and effectiveness of XR-BUP among correctional populations. Searches were carried out in Pubmed, Embase, and PsychINFO in October 2023. Ten studies reporting on feasibility or effectiveness of XR-BUP were included, representing = 819 total individuals (81.6% male). Data were extracted and narratively reported under the following main outcomes: 1) Feasibility; 2) Effectiveness; and 3) Barriers and Facilitators. Studies were heterogeneous. Correctional populations were two times readier to try XR-BUP compared to non-correctional populations. XR-BUP was feasible and safe, with no diversion, overdoses, or deaths; several negative side effects were reported. Compared to other MOUD, XR-BUP significantly reduced drug use, resulted in similar or higher treatment retention rates, fewer re-incarcerations, and was cost-beneficial, with a lower overall monthly/yearly cost. Barriers to XR-BUP, such as side effects and a fear of needles, as well as facilitators, such as a lowered risk of opioid relapse, were also identified. XR-BUP appears to be a feasible and potentially effective alternative treatment option for correctional populations with OUD. XR-BUP may reduce community release-related risks, such as opioid use and overdose risk, as well as barriers to treatment retention. Efforts to expand access to and uptake of XR-BUP among correctional populations are warranted.
用于阿片类物质使用障碍（MOUD）的药物可降低惩教人群的过量用药风险。在其他障碍中，每日给药要求阻碍了释放后的治疗连续性。因此，长效丁丙诺啡（XR - BUP）可能有益。然而，相关证据有限。为了进行一项系统评价，考察XR - BUP在惩教人群中的可行性和有效性。2023年10月在PubMed、Embase和PsychINFO中进行了检索。纳入了10项报告XR - BUP可行性或有效性的研究，共涉及819人（81.6%为男性）。数据在以下主要结果下进行提取并叙述性报告：1）可行性；2）有效性；3）障碍与促进因素。各研究存在异质性。与非惩教人群相比，惩教人群尝试XR - BUP的意愿高出两倍。XR - BUP是可行且安全的，没有药物转移、过量用药或死亡情况报告；但报告了一些负面副作用。与其他MOUD相比，XR - BUP显著减少了药物使用，治疗保留率相似或更高，再次入狱情况更少，且具有成本效益，每月/每年总体成本更低。还确定了XR - BUP的障碍，如副作用和对针头的恐惧，以及促进因素，如阿片类物质复发风险降低。XR - BUP似乎是患有阿片类物质使用障碍的惩教人群一种可行且可能有效的替代治疗选择。XR - BUP可能会降低与社区释放相关的风险，如阿片类物质使用和过量用药风险，以及治疗保留的障碍。有必要努力扩大惩教人群中XR - BUP的可及性和使用率。
