Table 1. Categorical matrix of systematic review findings.
| Authors | State | Sample size | Time of intervention | Setting | Study design | Type of opioid intervention | Comparator | SDH included | Outcomes |
|---|---|---|---|---|---|---|---|---|---|
| Brinkley-Rubinstein et al. (2018) | RI | 223 | During incarceration | Prison | RCTa | MMTb | Forced Methadone withdrawal |
For first appointment only − Transportation − Scheduling first MMT appointment − Financial assistance |
12-month follow-up, MMT − Heroin use less likely, prior 30 days (p = 0.0467)* − Injection drug use less likely, prior 30 days (p = 0.0033)** − Non-fatal overdose less likely (7% vs 18%, p = 0.039)* − Continuous engagement with MMT during 12 month follow-up period* (p = 0.0211)* |
| Christopher et al. (2018) | MA | 318 | During civil commitment | Inpatient Civil Commitment | Prospective cohort | Civil commitment | - | None |
Longer time to relapse positively associated with − Keeping appointment for medication treatment following commitment (p = 0.017)* |
| Fox et al. (2014) | NY | 135 | Post-release | Transitions Clinic | Retrospective cohort | BTc | - |
Offered for all clinic patients − Social work referral − Nutrition services − Medicaid enrollment − Health education − Care coordination by formerly incarcerated community health worker |
6-month outcomes − Fast median time from release to initial medical visit (10 days). − Low care retention for opioid dependence (33%). − Fewer buprenorphine-treated patients reduced opioid use (19%). − Specifically cites need for SDH intervention and SDH as conflicting health priority. |
| Fresquez-Chavez & Fogger (2015) | NM | 55 | During incarceration | Jail | Case report | Withdrawal management (clonidine) | - | None |
Withdrawal symptom scores (Subjective Opiate Withdrawal Scale) − Baseline to 1 hour post-treatment (p = .001)*** − Baseline to 4 hours post-treatment (p = .001)*** |
| Gordon et al. (2014) | MD | 211 | Pre-release and Post incarceration | Prison | RCT, 2x2 factorial | In-prison treatment condition 1: BT while incarcerated Post-release service setting 1: Opioid treatment program post-incarceration |
In-prison treatment condition 2: Counseling only while incarcerated Post-release service setting 2: Treatment at community health center post-incarceration |
− Addressing barriers to community treatment entry (not specified) − Employment − Housing Offered in weekly group sessions provided by the study’s addiction counselor |
In-prison treatment condition − Entering prison treatment more likely (99.0% v 80.4%, p = .006)** − Community treatment entry (47.5% v 33.7%, p = .012)* − Women more likely than men to complete prison treatment (85.7% v 52.7%, p<0.001).*** − 89.6% of all participants entered prison treatment − 40.6% of all participants entered community all treatment − 62.6% of all participants completed prison treatment |
| Gordon et al. (2015) | MD | 27 | Pre-release | Prison | Pilot | XR-NTXd | - | − None |
9-month follow-up − 77.8% of all participants completed prison injections − 66.7% of all participants received first community injection − 37% of all participants completed injection cycle − Completers less likely to use opioids any time during the study vs non completers (p = 0.003).** |
| Gordon et al. (2017) | MD | 211 | Pre-release and Post incarceration | Prison | RCT, 2x2 factorial | In-prison treatment condition 1: Buprenorphine treatment while incarcerated Post-release service setting 1: Opioid treatment program post-incarceration |
In-prison treatment condition 2: Counseling only while incarcerated Post-release service setting 2: Treatment at community health center post-incarceration |
− Barriers to community treatment entry (not specified) − Employment − Housing − Offered in weekly group sessions provided by the study’s addiction counselor |
12 month follow-up Follow-up to Gordon (2014) In-prison treatment condition − Higher mean number of days of community buprenorphine treatment v post-release medication initiation (p = .005)** − No significant difference in negative urine opioid results of participants who entered community treatment. (p >0.14) − No statistically significant effects for in-prison treatment condition for days of heroin use. (p >0.14) |
| Kobayashi et al. (2017) | RI | 107 | During incarceration | Prison | Pilot | Voluntary training, lay-person intranasal naloxone administration, opioid overdose prevention | - | − None |
1-month post-release follow-up − 1 fatal opioid overdose (of 103 participants) − 7 participants experienced non-fatal opioids − 3 of 7 opioids ODs reversed using study-provided naloxone |
| Lee et al. (2015) | NY | 34 | Post-release | Jail | Randomized effectiveness trial | XR-NTX + counseling and referral intervention | Counseling and referral only | − None |
4-week post-release outcomes − 15 of 17 participants initiated treatment − Rates of opioid relapse 4 weeks post-release lower among XR-NTX participants (p<0.004, OR = .08, CI = 1.4–8.5)** − More negative opioid urine samples in XR-NTX group (p<0.009, OR = 3.5, CI = 1.4–8.5)** − No significant difference in rates of overdose − No significant difference in participanion in other community drug treatment (19 v 12%) aSmall sample size aSeveral measures relied on self-report |
| Morse et al. (2017) | NY | 200 | Post-release | Transitions Clinic | Chart review | BT | - | SDOH included in the Transitions Clinic model, but not measured for this chart review. | − Thirty (70%) of the 38 women in sample with opioid use disorder received methadone or suboxone. |
| Prendergast, McCollister, & Warda (2017) | CA | 732 | During Incarceration | Jail | RCT | SBIRTe | Drug and alcohol, HIV risk information + program list of local providers | − None |
− No significant difference in change in opioid risk between SBIRT and control group (p = 0.13) − No significant difference in attending outpatient treatment, past 12 months (p = 0.49) − No significant difference for any primary or secondary outcomes between groups. |
| Rich et al. (2015) | RI | 223 | Intake | Prison | RCT | Continued MMT post-release | Methadone taper | Transportation, Scheduling − Financial assistance − With first methadone treatment appointment only |
1 month post-release follow-up − Of participants assigned to continued MMT post-release, 97% (n = 111) attended community methadone clinic vs. 71% (n = 77) of participants assigned to methadone taper (p<0.0001)*** − MMT participants twice as likely to return to community methadone clinic within 1 month post-release (Hazard risk = 2.04, 95% CI = 1.48–2.80) − N = 1 mortality (Continued MMT group), no significant difference − N = 1 non-fatal overdose in continued MMT group, n = 2 in methadone taper group (p = 0.423) |
| Vocci et al. (2015) | MD | 104 | During Incarceration | Prison | RCT | BT | No BT | − None |
10 weeks post-therapy initiation 62% of participants (n = 63) remained on BT at release from prison − 50% of participants completed 10 weeks of treatment (n = 60). − Suggest that buprenorphine administered to non-opioid-tolerant adults should be started at a lower, individualized dose than customarily used for adults actively using opioids. |
a RCT = randomized controlled trial
b MMT = methadone Maintenance Treatment
c BT = buprenorphine treatment
d XR-NTX = injectable extended-release naltrexone
e Screening, brief intervention, and referral to treatment
* p ≤ 0.05
** p ≤ 0.01
*** p ≤ 0.001