Tamburello Anthony, Martin Tracy L
Dr. Tamburello is Associate Director of Psychiatry, University Correctional Health Care, and Clinical Professor of Psychiatry, Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, NJ, USA. Dr. Martin is a staff psychiatrist, VA Pittsburgh Healthcare System, Washington, D.C., USA.
J Am Acad Psychiatry Law. 2024 Dec 12;52(4):441-448. doi: 10.29158/JAAPL.240071-24.
Opioid use disorder is common in incarcerated persons, and concern about the diversion of buprenorphine is a barrier to treatment. We conducted a retrospective chart review of incarcerated persons in the New Jersey Department of Corrections who received charges for misuse of medication, including buprenorphine, hypothesizing that the prescription of buprenorphine monoproduct, multiple tabs or films of buprenorphine, or higher doses of buprenorphine would be associated with more diversion incidents. Within the dosing range of 2 to 12 mg, there were more incidents of diversion of buprenorphine monoproduct (24.3%) compared with buprenorphine-naloxone (10.7%, = .004). More incidents of diversion were seen when multiple films or tabs of buprenorphine product were prescribed (21.7%, comparison 12.7%, = .01). This observation held when considering multiple buprenorphine-naloxone films, but not multiple buprenorphine tablets. No statistically significant association was found for institutional diversion charges related to higher doses of buprenorphine products. These results suggest that, within the dosing range of buprenorphine used in the New Jersey Department of Corrections, misuse charges were not associated with higher doses although were associated with prescribing buprenorphine monoproduct and multiple films of buprenorphine-naloxone.
阿片类药物使用障碍在被监禁人员中很常见，而对丁丙诺啡转移的担忧是治疗的一个障碍。我们对新泽西州惩教部中因滥用药物（包括丁丙诺啡）而被指控的被监禁人员进行了一项回顾性病历审查，假设丁丙诺啡单一产品、多片或多膜丁丙诺啡的处方，或更高剂量的丁丙诺啡与更多的转移事件相关。在2至12毫克的剂量范围内，丁丙诺啡单一产品的转移事件发生率（24.3%）高于丁丙诺啡 - 纳洛酮（10.7%，P = .004）。当开具多膜或多片丁丙诺啡产品时，转移事件更多见（21.7%，对比12.7%，P = .01）。在考虑多膜丁丙诺啡 - 纳洛酮时这一观察结果成立，但多片丁丙诺啡时则不然。未发现与更高剂量丁丙诺啡产品相关的机构转移指控有统计学显著关联。这些结果表明，在新泽西州惩教部使用的丁丙诺啡剂量范围内，滥用指控与更高剂量无关，尽管与开具丁丙诺啡单一产品和多膜丁丙诺啡 - 纳洛酮有关。
