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Buprenorphine or Methadone Adherence = Fewer Arrests, Lower Incarceration for Opioid Use Disorder

START Study Startles Researchers

Researchers at the University of Massachusetts Amherst report that people with opioid use disorder taking approved medication for the condition were less likely to be arrested and incarcerated than those who were not taking medication.

Published in Addiction, the researchers found that, over a period of five years, people with opioid use disorder taking either buprenorphine or methadone were less likely to be arrested and incarcerated than those who were not taking medication.

To date, there has been little investigation into the impact on social outcomes of treating opioid use disorder. The study authors concentrated their efforts on examining criminal justice outcomes and whether providing either buprenorphine or methadone was related to the likelihood of arrest or incarceration over time.

Their study indicates that ongoing treatment with medications for people with opioid use disorder has social benefits, including fewer arrests, convictions, and incarcerations, and other advantages. The findings, say the researchers, warrant further study and suggest that providing these medications in jails and upon release would likely reduce recidivism and save lives.

The researchers analyzed data from the large, multisite, randomized START (Starting Treatment with Agonist Replacement Therapy) trial, conducted from 2006 to 2009, and from public criminal justice records from the California Department of Justice. START compared the effects of buprenorphine and methadone on liver health in 1,269 opioid-dependent people in five states.

Those who stayed on buprenorphine or methadone, or switched from one to the other, were less likely to be arrested or jailed than study participants who were no longer taking either medication. Certain characteristics such as younger age, cocaine use, injection-drug use, and Hispanic ethnicity made arrest and incarceration more likely.

The authors comment that their findings emphasize “the need for public health efforts to prevent or mitigate criminal justice consequences that may disproportionately impact certain groups with opioid use disorder over others."

Fewer than 10% of people with opioid use disorder ever receive the evidence-based medications that are considered the most effective, medications which usually need to be taken long-term for the greatest benefit.

Source: University of Massachusetts Amherst, April 8, 2019

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