Dorgay, Coriann E. and Bromberg, Daniel J. and Doltu, Svetlana and Litz, Taylor and Galvez, Samy and Polonsky, Maxim and Dvoryak, Sergey and Altice, Frederick L. (2022) A pilot implementation study to scale-up methadone in incarcerated persons with opioid use disorder and retain them on treatment after release in Moldova. International Journal Of Drug Policy, 104. ISSN 0955-3959, DOI https://doi.org/10.1016/j.drugpo.2022.103683.
Full text not available from this repository.Abstract
Background: Eastern Europe and Central Asia have intertwined HIV and incarceration epidemics, concentrated in people who inject drugs . Moldova is one of the few countries in this region that offers methadone within prisons, but uptake and post-release retention remains suboptimal. Screening, brief intervention, and referral to treatment (SBIRT) procedures are a potential implementation strategy to address this problem. Methods: From June 1, 2017 to March 3, 2018, we conducted a 2-stage SBIRT strategy in nine prisons and four pre-trial detention facilities in Moldova among incarcerated persons with opioid use disorder (OUD; N = 121) and within 90 days of release. Survey results were analyzed to evaluate the effect of the SBIRT strategy on the uptake of and post-release retention on methadone maintenance treatment (MMT). Results: Among the 121 screened with OUD, 27 were on MMT at baseline within the prison and this number increased to 41 after the two-step SBIRT intervention, reflecting a 51.9% increase over baseline. Eleven (78.6%) of the 14 participants that newly started MMT did so only after completing both SBIRT sessions. The brief intervention did not significantly improve knowledge about methadone but did improve attitudes towards it. Among the 41 participants who received methadone during this trial, 40 (97.6%) were retained 6 months after release; the one participant not retained was on methadone at the time of the intervention and had planned to taper off. Conclusion: The SBIRT strategy significantly improved participant attitudes, but treatment initiation mostly occurred after completing both sessions, including soon after release, but remained low overall. Work within the Moldovan prison subculture to dispel negative myths and misinformation is needed to further scale-up OAT in Moldova.
| Item Type: | Article |
|---|---|
| Funders: | National Institute of Health and National Institute of Drug Abuse (Grant No. R01DA029910), National Institute of Health and National Institute of Drug Abuse (Grant No. R21DA047902), National Institute of Health and National Institute of Drug Abuse (Grant No. F31 DA054861), United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Institute of Mental Health (NIMH) (Grant No. T32 MH020031), Global Health Equity Scholars Program from the Fogarty International Center (Grant No. D43 TW010540) |
| Uncontrolled Keywords: | HIV; Incarceration; Moldova; Opioid agonist therapy; SBIRT; Methadone; Implementation science; HIV; Incarceration; Moldova; Opioid agonist therapy; SBIRT; Methadone; Implementation science |
| Subjects: | R Medicine |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 15 Oct 2023 02:17 |
| Last Modified: | 15 Oct 2023 02:17 |
| URI: | http://eprints.um.edu.my/id/eprint/42293 |
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