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Optimizing the impact of medications for opioid use disorder at release from prison and jail settings: A microsimulation modeling study.

Publication ,  Journal Article
Macmadu, A; Adams, JW; Bessey, SE; Brinkley-Rubinstein, L; Martin, RA; Clarke, JG; Green, TC; Rich, JD; Marshall, BDL
Published in: Int J Drug Policy
May 2021

BACKGROUND: We examined the impact of expanded access to medications for opioid use disorder (MOUD) in a unified prison and jail system on post-release, opioid-related overdose mortality. METHODS: We developed a microsimulation model to simulate a population of 55,000 persons at risk of opioid-related overdose mortality in Rhode Island. The effect of an extended-release (XR) naltrexone only intervention and the effect of providing access to all three MOUD (i.e., methadone, buprenorphine, and XR-naltrexone) at release from incarceration on cumulative overdose death over eight years (2017-2024) were compared to the standard of care (i.e., limited access to MOUD). RESULTS: In the standard of care scenario, the model predicted 2385 opioid-related overdose deaths between 2017 and 2024. An XR-naltrexone intervention averted 103 deaths (4.3% reduction), and access to all three MOUD averted 139 deaths (5.8% reduction). Among those with prior year incarceration, an XR-naltrexone only intervention and access to all three MOUD reduced overdose deaths by 22.8% and 31.6%, respectively. CONCLUSIONS: Expanded access to MOUD in prison and jail settings can reduce overdose mortality in a general, at-risk population. However, the real-world impact of this approach will vary by levels of incarceration, treatment enrollment, and post-release retention.

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Published In

Int J Drug Policy

DOI

EISSN

1873-4758

Publication Date

May 2021

Volume

91

Start / End Page

102841

Location

Netherlands

Related Subject Headings

  • Substance Abuse
  • Rhode Island
  • Prisons
  • Opioid-Related Disorders
  • Jails
  • Humans
  • Buprenorphine
  • 4407 Policy and administration
  • 4206 Public health
  • 17 Psychology and Cognitive Sciences
 

Citation

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Macmadu, A., Adams, J. W., Bessey, S. E., Brinkley-Rubinstein, L., Martin, R. A., Clarke, J. G., … Marshall, B. D. L. (2021). Optimizing the impact of medications for opioid use disorder at release from prison and jail settings: A microsimulation modeling study. Int J Drug Policy, 91, 102841. https://doi.org/10.1016/j.drugpo.2020.102841
Macmadu, Alexandria, Joëlla W. Adams, S. E. Bessey, Lauren Brinkley-Rubinstein, Rosemarie A. Martin, Jennifer G. Clarke, Traci C. Green, Josiah D. Rich, and Brandon D. L. Marshall. “Optimizing the impact of medications for opioid use disorder at release from prison and jail settings: A microsimulation modeling study.Int J Drug Policy 91 (May 2021): 102841. https://doi.org/10.1016/j.drugpo.2020.102841.
Macmadu A, Adams JW, Bessey SE, Brinkley-Rubinstein L, Martin RA, Clarke JG, et al. Optimizing the impact of medications for opioid use disorder at release from prison and jail settings: A microsimulation modeling study. Int J Drug Policy. 2021 May;91:102841.
Macmadu, Alexandria, et al. “Optimizing the impact of medications for opioid use disorder at release from prison and jail settings: A microsimulation modeling study.Int J Drug Policy, vol. 91, May 2021, p. 102841. Pubmed, doi:10.1016/j.drugpo.2020.102841.
Macmadu A, Adams JW, Bessey SE, Brinkley-Rubinstein L, Martin RA, Clarke JG, Green TC, Rich JD, Marshall BDL. Optimizing the impact of medications for opioid use disorder at release from prison and jail settings: A microsimulation modeling study. Int J Drug Policy. 2021 May;91:102841.
Journal cover image

Published In

Int J Drug Policy

DOI

EISSN

1873-4758

Publication Date

May 2021

Volume

91

Start / End Page

102841

Location

Netherlands

Related Subject Headings

  • Substance Abuse
  • Rhode Island
  • Prisons
  • Opioid-Related Disorders
  • Jails
  • Humans
  • Buprenorphine
  • 4407 Policy and administration
  • 4206 Public health
  • 17 Psychology and Cognitive Sciences