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ABSTRACT
Primary care is understudied as a reentry drug and alcohol treatment setting. This study compared treatment retention and opioid misuse among opioid-dependent adults seeking buprenorphine/naloxone maintenance in an urban primary care clinic following release from jail versus community referrals. Postrelease patients were either (a) induced to buprenorphine in-jail as part of a clinical trial, or (b) seeking buprenorphine induction post release. From 2007 to 2008, N = 142 patients were new to primary care buprenorphine: n = 32 postrelease; n = 110 induced after community referral and without recent incarceration. Jail-released patients were more likely African American or Hispanic and uninsured. Treatment retention rates for postrelease (37%) versus community (30%) referrals were similar at 48 weeks. Rates of opioid positive urines and self-reported opioid misuse were also similar between groups. Postrelease patients in primary care buprenorphine treatment had equal treatment retention and rates of opioid abstinence versus community-referred patients.
Acknowledgments
This work was supported by a grant from the New York City Department of Health and Mental Hygiene and the New York City Health and Hospitals Corporation and NIDA R21-DA020583. Some medications used in this study were donated by Reckitt Benkiser Inc. The authors declare they have no conflict of interests. Drs. Lee and Gourevitch receive extramural grants from Cephalon and Alkermes Inc. supporting studies of alcohol treatment.
The authors wish to thank Andrew B. Wallach, MD, and Valerie Perel, MD, Bellevue Hospital Center staff, Jason Hershberger, MD, and the NYC Department of Health and Mental Hygiene, and Ms. Nadina Santana-Correa for their support of this study.
