Health and correctional staff acceptability of depot buprenorphine in NSW prisons

Sophia Little; Bethany White; Maja Moensted; Kerryn Butler; Mark Howard; Jillian Roberts; Adrian Dunlop

doi:10.1016/j.drugpo.2023.103978

Health and correctional staff acceptability of depot buprenorphine in NSW prisons

Int J Drug Policy. 2023 Apr:114:103978. doi: 10.1016/j.drugpo.2023.103978. Epub 2023 Mar 2.

Authors

Sophia Little¹, Bethany White², Maja Moensted³, Kerryn Butler⁴, Mark Howard⁵, Jillian Roberts⁶, Adrian Dunlop⁷

Affiliations

¹ Specialty of Addiction Medicine, University of Sydney, Sydney, Australia. Electronic address: sophia.little@sydney.edu.au.
² Edith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Drug Health Services, Sydney Local Health District, Sydney, Australia; Specialty of Addiction Medicine, University of Sydney, Sydney, Australia; Drug and Alcohol Clinical Research and Improvement Network, NSW, Australia.
³ Edith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Drug Health Services, Sydney Local Health District, Sydney, Australia; Specialty of Addiction Medicine, University of Sydney, Sydney, Australia.
⁴ Law and Justice Foundation, Sydney, Australia.
⁵ Corrections Research Evaluation and Statistics, Corrective Services NSW, Sydney, Australia.
⁶ Drug and Alcohol Clinical Research and Improvement Network, NSW, Australia; Drug and Alcohol, Justice Health and Forensic Mental Health Network, Matraville, Australia.
⁷ Drug and Alcohol Clinical Research and Improvement Network, NSW, Australia; Drug Health Services, Hunter New England Local Health District, Newcastle, Australia; School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.

PMID: 36870227
DOI: 10.1016/j.drugpo.2023.103978

Abstract

Background: Provision of opioid agonist treatment (OAT) in custodial settings is resource-intensive and may be associated with diversion, non-medical use, and violence. A clinical trial of a new OAT, depot buprenorphine (the UNLOC-T study), provided the opportunity to obtain health and correctional staff perspectives regarding this treatment prior to widespread roll-out.

Methods: Sixteen focus groups with 52 participants were conducted, including 44 health staff (nurses, nurse practitioners, doctors, and operational staff) and eight correctional staff.

Results: Key challenges to providing OAT identified as potentially being addressed by depot buprenorphine included 1) patient access, 2) OAT program capacity, 3) treatment administration procedures, 4) medication diversion and other safety issues and, 5) impact on other service delivery.

Conclusions: The introduction of depot buprenorphine into correctional settings was considered to have the potential to increase safety for patients, improve staff / patient relations and advance patient health outcomes via expanded treatment coverage and efficiencies gained through enhanced health service delivery. Support was almost universal from both correctional and health staff participating in this study. These findings build on emerging research regarding the positive impact of more flexible OAT programs and could be used to engage support for the implementation of depot buprenorphine from staff in other secure settings.

Keywords: Correctional centre; Depot buprenorphine; Implementation; Opioids treatment program; Staff acceptability.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Buprenorphine* / therapeutic use
Correctional Facilities Personnel
Humans
Opiate Substitution Treatment / methods
Opioid-Related Disorders* / drug therapy
Prisons

Substances

Buprenorphine