Abstract：
BACKGROUND: Individuals with opioid use disorder (OUD) transitioning from jails or prisons to the community are at high risk of overdose-related death shortly after release. Buprenorphine, methadone, and extended-release naltrexone are FDA-approved medications for opioid use disorder (MOUD) to reduce overdose risk and increase treatment engagement. Despite the evidence, many correctional facilities in the United States do not provide MOUD to their incarcerated population. Albany County Jail and Rehabilitative Services Center (ACCRSC) is a jail in New York State that provides comprehensive MOUD and overdose prevention services to all incarcerated individuals with OUD.
METHODS: MOUD program participants\' data was collected during custody and after release to determine whether the program\'s primary goals of preventing overdose-related mortality and MOUD continuation after release were met. Other quality-of-life metrics were used for program improvements, such as program participants\' physical and mental well-being, postrelease housing, employment, access to mental health services, and re-incarceration.
RESULTS: This study included 375 unique individuals who received MOUD treatment at the jail between January 19, 2019, and the end of December 2020, with 56.2 % continuing their treatment and 43.7 % initiating MOUD during custody. Among those who initiated MOUD at ACCRSC, 93.3 % were enrolled in buprenorphine. We identified eight program participant deaths after release within a year after incarceration. The average time between release and death was 233 days, with the shortest time between release and death being 107 days. We found that over half (53.6 %) of program participants using buprenorphine picked up their prescriptions after exiting ACCRSC. Among those who did not, nearly 16 % were unable to do so because they were transferred to another jail or prison that did not provide MOUD care. Overall, nearly 80 % of program participants who were transferred to another correctional facility could not continue their medication.
CONCLUSIONS: MOUD in correctional settings appears to reduce overdose deaths immediately after release. Administering buprenorphine and other types of MOUD in a jail setting has shown relatively high retention for people to fill their first prescription of buprenorphine outside the jail. To ensure high MOUD retention among incarcerated populations, all correctional facilities must provide MOUD care.
METHODS: MOUD program participants\' data was collected during custody and after release to determine whether the program\'s primary goals of preventing overdose-related mortality and MOUD continuation after release were met. Other quality-of-life metrics were used for program improvements, such as program participants\' physical and mental well-being, postrelease housing, employment, access to mental health services, and re-incarceration.
RESULTS: This study included 375 unique individuals who received MOUD treatment at the jail between January 19, 2019, and the end of December 2020, with 56.2 % continuing their treatment and 43.7 % initiating MOUD during custody. Among those who initiated MOUD at ACCRSC, 93.3 % were enrolled in buprenorphine. We identified eight program participant deaths after release within a year after incarceration. The average time between release and death was 233 days, with the shortest time between release and death being 107 days. We found that over half (53.6 %) of program participants using buprenorphine picked up their prescriptions after exiting ACCRSC. Among those who did not, nearly 16 % were unable to do so because they were transferred to another jail or prison that did not provide MOUD care. Overall, nearly 80 % of program participants who were transferred to another correctional facility could not continue their medication.
CONCLUSIONS: MOUD in correctional settings appears to reduce overdose deaths immediately after release. Administering buprenorphine and other types of MOUD in a jail setting has shown relatively high retention for people to fill their first prescription of buprenorphine outside the jail. To ensure high MOUD retention among incarcerated populations, all correctional facilities must provide MOUD care.
摘要：
背景：从监狱或监狱过渡到社区的阿片类药物使用障碍（OUD）患者在释放后不久就面临过量相关死亡的高风险。丁丙诺啡,美沙酮,和缓释纳曲酮是FDA批准的用于阿片类药物使用障碍(MOUD)的药物,可降低药物过量风险并增加治疗参与度.尽管有证据,美国的许多惩教设施不向被监禁的人口提供MOUD。奥尔巴尼县监狱和康复服务中心（ACCRSC）是纽约州的一所监狱，为所有被监禁的OUD患者提供全面的MOUD和过量预防服务。
方法：MOUD计划参与者在监护期间和释放后收集数据，以确定该计划预防过量相关死亡率和释放后MOUD延续的主要目标是否达到。其他生活质量指标用于计划改进，如项目参与者的身心健康，租赁后住房，employment,获得精神卫生服务，和重新监禁。
结果：这项研究包括375名在2019年1月19日至2020年12月底期间在监狱接受MOUD治疗的独特个体，其中56.2％继续治疗，43.7％在拘留期间开始MOUD。在ACCRSC发起MOUD的人中，93.3％的患者被纳入丁丙诺啡。我们确定了8名计划参与者在监禁后一年内获释后死亡。释放和死亡之间的平均时间为233天，释放和死亡之间最短的时间是107天。我们发现，超过一半（53.6％）的使用丁丙诺啡的计划参与者在退出ACCRSC后服用了处方。在那些没有的人中，将近16％的人无法这样做，因为他们被转移到另一个监狱或不提供MOUD护理的监狱。总的来说,近80%被转移到另一所惩教机构的计划参与者无法继续服药.
结论：矫正设置中的MOUD似乎可以减少释放后立即过量死亡。在监狱环境中管理丁丙诺啡和其他类型的MOUD对于人们在监狱外填写丁丙诺啡的第一个处方显示出相对较高的保留率。为了确保在被监禁人群中保持较高的MOUD保留率，所有惩教设施必须提供MOUD护理。
方法：MOUD计划参与者在监护期间和释放后收集数据，以确定该计划预防过量相关死亡率和释放后MOUD延续的主要目标是否达到。其他生活质量指标用于计划改进，如项目参与者的身心健康，租赁后住房，employment,获得精神卫生服务，和重新监禁。
结果：这项研究包括375名在2019年1月19日至2020年12月底期间在监狱接受MOUD治疗的独特个体，其中56.2％继续治疗，43.7％在拘留期间开始MOUD。在ACCRSC发起MOUD的人中，93.3％的患者被纳入丁丙诺啡。我们确定了8名计划参与者在监禁后一年内获释后死亡。释放和死亡之间的平均时间为233天，释放和死亡之间最短的时间是107天。我们发现，超过一半（53.6％）的使用丁丙诺啡的计划参与者在退出ACCRSC后服用了处方。在那些没有的人中，将近16％的人无法这样做，因为他们被转移到另一个监狱或不提供MOUD护理的监狱。总的来说,近80%被转移到另一所惩教机构的计划参与者无法继续服药.
结论：矫正设置中的MOUD似乎可以减少释放后立即过量死亡。在监狱环境中管理丁丙诺啡和其他类型的MOUD对于人们在监狱外填写丁丙诺啡的第一个处方显示出相对较高的保留率。为了确保在被监禁人群中保持较高的MOUD保留率，所有惩教设施必须提供MOUD护理。
