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APHA Scientific Session and Event Listing

Linking opiate addicted ex-offenders to community methadone treatment: Comparing 12-month outcomes based on retention in treatment

Michelle McKenzie, MPH1, Portia Thurmond, BA1, Grace Macalino, PhD2, and Josiah Rich, MD, MPH3. (1) Infectious Disease/Immunology, The Miriam Hospital/Brown Medical School, 164 Summit Ave., CFAR Bldg., Providence, RI 02906, 401/793-4790, mmckenzie@lifespan.org, (2) Institute for Clinical Research and Health Policy Studies, NEMC, 750 Washington St., #63, Boston, MA 02111, (3) Medicine and Community Health, Brown Medical School, Miriam Hospital, 164 Summit Ave, Providence, RI 02906

BACKGROUND: Approximately 20% of the incarcerated individuals have a history of opiate addiction in the US. Methadone maintenance treatment (MMT) is highly effective treatment and release is opportune time for intervention because recently released inmates are at particularly high risk for drug relapse, overdose and disease transmission. We are implementing a 5-year, SAMHSA funded service initiative to link recently released ex-offenders to MMT.

METHODS: We recruit clients from the Rhode Island Department of Corrections, make logistical arrangements for methadone treatment entry upon release, and provide partial financial assistance for MMT for 24 weeks. Clients are followed for one year, with interviews at baseline, six and 12 months. Measures between clients in treatment and out of treatment at 12 months were compared using chi square test.

RESULTS: As of November 2005, we enrolled 321 clients, 122 completed all three interviews (84% follow-up), of which 47 (39%) remained in MMT. Regardless of treatment status clients at 12 months reported sustained reductions in drug use (heroin, other opiates, cocaine, benzodiazepines, polysubstances, and alcohol to intoxication) injection drug use, and more stable income and living arrangements as compared to baseline. Longer retention in MMT was significantly associated with heroin use, living situation, receiving SSI, overdose, incarceration and health as outlined the table.

CONCLUSIONS: Twelve month data suggests that retention in MMT decreases heroin use, thereby risk of overdose, is positively associated with living in own place and receiving SSI income (and Medicaid insurance), and is negatively associated with re-incarceration and reporting good health.

Learning Objectives:

Keywords: Methadone Maintenance, Incarceration

Presenting author's disclosure statement:

Not Answered

Issues in Treating Substance Abuse Poster Session

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA