In a previously reported randomized controlled trial,
formerly opioid-dependent prisoners were more likely to enter community drug
abuse treatment when they were inducted in prison onto buprenorphine/naloxone
(hereafter called buprenorphine) than when they received counseling without
buprenorphine in prison (47.5% vs. 33.7%, p = 0.012) ( Gordon et al., 2014 ).
In this communication we report on the results of the induction schedule and
the adverse event profile seen in pre-release prisoners inducted onto buprenorphine.
This paper examines the dose induction procedure, a
comparison of the proposed versus actual doses given per week, and side effects
reported for 104 adult participants who were randomized to buprenorphine
treatment in prison. Self-reported side effects were analyzed using generalized
estimated equations to determine changes over time in side effects.
Study participants were inducted onto buprenorphine at a
rate faster than the induction schedule. Of the 104 (72 males, 32 females)
buprenorphine recipients, 64 (37 males, 27 females) remained on medication at
release from prison. Nine participants (8.6%) discontinued buprenorphine
because of unpleasant opioid side effects. There were no serious adverse events
reported during the in-prison phase of the study. Constipation was the most
frequent symptom reported (69 percent).
Our findings suggest that buprenorphine administered to
non-opioid-tolerant adults should be started at a lower, individualized dose
than customarily used for adults actively using opioids, and that
non-opioid-tolerant pre-release prisoners can be successfully inducted onto
therapeutic doses prior to release.
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