Recidivism Rates Drop for Inmates With OUD Treated With Buprenorphine

In a recent study of 2 Massachusetts jails, risk of recidivism after leaving jail was found to be lower among those with opioid use disorder who were offered buprenorphine during their incarceration vs. those who were not.

Findings were published Tuesday by the journal Drug & Alcohol Dependence. The primary funder of the study was the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, through the Helping to End Addiction Long-term (HEAL) Initiative.

Researchers from the University of Massachusetts noted that previous studies have found that most correctional facilities that do offer medications for opioid use disorder (MOUD) are large, urban correctional facilities or part of a unified state system, and those that do typically only offer naltrexone. With most previous similar research projects examining post-release outcomes among inmates who have received methadone and naltrexone, few have looked at the impact of buprenorphine in county jails.

Data from 2 rural correctional facilities in Massachusetts were studied. Franklin County Sheriff’s Office (FCSO) began offering buprenorphine in February 2016. Nearby Hampshire County House of Corrections (HCHC), meanwhile, did not begin offering buprenorphine until May 2019. (A legislative mandate in 2019 caused 7 correctional facilities, including the 2 included in the study, to expand their OUD treatment options and related services.)

Based on the jails’ electronic medical records, the study looked at adult inmates diagnosed with opioid use disorder who exited one of the facilities between January 1, 2015, and April 30, 2019. During the period studied, 93.4% of the FCSO population received an MOUD while incarcerated. Most (86.2%) received buprenorphine. No individuals at HCHC, meanwhile, received an MOUD while incarcerated.

For the purposes of the study, recidivism was defined as any incarceration, arraignment, or probation violation occurring after release. Researchers found that fewer individuals in FCSO recidivated compared to HCHC (48.2% vs. 62.5%, respectively). FCSO also had about 11% to 18% fewer arraignments or re-incarcerations than HCHC. Researchers noted that analyses found no differences in violations of parole or probation, suggesting that the differences were not attributable to technical violations and variation in community correctional practices.

While past research examining outcomes of urban incarcerated individuals saw no differences in criminal activity between individuals treated with buprenorphine vs. a counseling-only comparison group 1 year after release, the prior studies focused on populations returning to large metropolitan areas.

“The current findings suggest that MOUD may have more substantial impact among persons leaving smaller jails who return to rural communities, although more research is needed,” the University of Massachusetts researchers concluded.

Reference

Evans EA, Wilson D, Friedmann PD. Recidivism and mortality after in-jail buprenorphine treatment for opioid use disorder. Drug and Alcohol Dependence. https://www.sciencedirect.com/science/article/abs/pii/S0376871621007493. Published January 18, 2022. Accessed January 18, 2022.