Haber Lawrence A, Berk Justin, Taub Julie, South Anna-Maria
Division of Hospital Medicine, Denver Health and Hospital Authority, Denver, CO, USA.
Department of Medicine, University of Colorado, Aurora, CO, USA.
J Gen Intern Med. 2025 May 29. doi: 10.1007/s11606-025-09635-y.
Opioid use disorder (OUD) affects millions in the USA, with a growing disparity among Black men, a patient population which also suffers higher rates of incarceration. Medications for opioid use disorder (MOUD), specifically buprenorphine and methadone, significantly reduce mortality, though remain underutilized particularly within the incarcerated population. Post-release opioid overdose is the leading cause of mortality among recently incarcerated individuals, so opportunities to offer life-saving treatment must be capitalized upon. Hospitalization offers an ideal time to start MOUD, yet those incarcerated face unique barriers to initiating and continuing such medication. Initiating MOUD can improve post-release opioid-related outcomes but requires a well-coordinated approach to treatment. Here, we review the importance of MOUD for the incarcerated population and how hospital-based clinicians can address patient-, provider-, and system-level obstacles to deliver equitable, evidence-based treatment for this population.
阿片类药物使用障碍（OUD）在美国影响着数百万人，黑人男性中的差距日益扩大，这一患者群体的监禁率也更高。用于阿片类药物使用障碍的药物（MOUD），特别是丁丙诺啡和美沙酮，可显著降低死亡率，但仍未得到充分利用，尤其是在被监禁人群中。出狱后阿片类药物过量是近期被监禁者死亡的主要原因，因此必须利用提供救命治疗的机会。住院提供了开始使用MOUD的理想时机，但被监禁者在开始和持续使用此类药物方面面临独特的障碍。启动MOUD可以改善出狱后与阿片类药物相关的结果，但需要一种协调良好的治疗方法。在这里，我们回顾了MOUD对被监禁人群的重要性，以及医院临床医生如何克服患者、提供者和系统层面的障碍，为这一人群提供公平的、基于证据的治疗。
