Feasibility and effectiveness of extended-release buprenorphine (XR-BUP) among correctional populations: a systematic review

Research output: Contribution to journalReview articleContributedpeer-review

Contributors

  • Cayley Russell - , University of Toronto, Ontario Node, Canadian Research Initiative in Substance Misuse (CRISM) (Author)
  • Tony P. George - , University of Toronto (Author)
  • Nitin Chopra - , University of Toronto (Author)
  • Bernard Le Foll - , University of Toronto, Ontario Node, Canadian Research Initiative in Substance Misuse (CRISM) (Author)
  • Flora I. Matheson - , University of Toronto (Author)
  • Jürgen Rehm - , Chair of Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Centre for Addiction and Mental Health (CAMH), University of Toronto, TUD Dresden University of Technology, University of Hamburg, Ontario Node, Canadian Research Initiative in Substance Misuse (CRISM) (Author)
  • Shannon Lange - , University of Toronto (Author)

Abstract

Background: Medications for opioid use disorder (MOUD) reduce risks for overdose among correctional populations. Among other barriers, daily dosing requirements hinder treatment continuity post-release. Extended-release buprenorphine (XR-BUP) may therefore be beneficial. However, limited evidence exists. Objectives: To conduct a systematic review examining the feasibility and effectiveness of XR-BUP among correctional populations. Methods: Searches were carried out in Pubmed, Embase, and PsychINFO in October 2023. Ten studies reporting on feasibility or effectiveness of XR-BUP were included, representing n = 819 total individuals (81.6% male). Data were extracted and narratively reported under the following main outcomes: 1) Feasibility; 2) Effectiveness; and 3) Barriers and Facilitators. Results: Studies were heterogeneous. Correctional populations were two times readier to try XR-BUP compared to non-correctional populations. XR-BUP was feasible and safe, with no diversion, overdoses, or deaths; several negative side effects were reported. Compared to other MOUD, XR-BUP significantly reduced drug use, resulted in similar or higher treatment retention rates, fewer re-incarcerations, and was cost-beneficial, with a lower overall monthly/yearly cost. Barriers to XR-BUP, such as side effects and a fear of needles, as well as facilitators, such as a lowered risk of opioid relapse, were also identified. Conclusion: XR-BUP appears to be a feasible and potentially effective alternative treatment option for correctional populations with OUD. XR-BUP may reduce community release-related risks, such as opioid use and overdose risk, as well as barriers to treatment retention. Efforts to expand access to and uptake of XR-BUP among correctional populations are warranted.

Details

Original languageEnglish
JournalAmerican Journal of Drug and Alcohol Abuse
Publication statusAccepted/In press - 2024
Peer-reviewedYes

Keywords

Sustainable Development Goals

Keywords

  • Addiction, buprenorphine, correctional populations, extended-release, medications for opioid use disorder (MOUD), opioid use disorder