Highlights
- Receipt of pharmacotherapy for opioid use disorder may differ by justice status.
- Prison-involved veterans had a lower rate of receipt of pharmacotherapy.
- Jail/court- and non-justice-involved veterans did not differ in rate of receipt.
- Rates of receipt varied widely within VHA facilities by justice status.
Background
Pharmacotherapy
– methadone, buprenorphine, or naltrexone – is an evidence-based treatment for
opioid use disorder, but little is known about receipt of these medications
among veterans involved in the justice system. The current study examines
receipt of pharmacotherapy for opioid use disorder among veterans with a
history of justice involvement at U.S. Veterans Health Administration (VHA)
facilities compared to veterans with no justice involvement.
Methods
Using
national VHA clinical and pharmacy records, we conducted a retrospective cohort
study of veterans with an opioid use disorder diagnosis in fiscal year 2012.
Using a mixed-effects logistic regression model, we examined receipt of
pharmacotherapy in the 1-year period following diagnosis as a function of
justice involvement, adjusting for patient and facility characteristics.
Results
The
1-year rate of receipt for pharmacotherapy for opioid use disorder was 27% for
prison-involved veterans, 34% for jail/court-involved veterans, and 33% for
veterans not justice-involved. Compared to veterans not justice-involved, those
prison-involved had 0.75 lower adjusted odds (95% confidence interval [CI]:
0.65–0.87) of receiving pharmacotherapy whereas jail/court-involved veterans
did not have significantly different adjusted odds.
Conclusions
Targeted
efforts to receipt of pharmacotherapy for opioid use disorder among veterans
exiting prison is needed as they have lower odds of receiving these
medications.
Purchase full article at: http://goo.gl/AhL9EN
By: Andrea
K. Finlay, Alex H.S. Harris, Joel Rosenthal, Jessica Blue-Howells, Sean Clark, Jim McGuire, Christine Timko, Susan M. Frayne, David Smelson, Elizabeth Oliva, Ingrid Binswanger
Affiliations
Center for Innovation to Implementation (Ci2i), VA Palo Alto
Health Care System, 795 Willow Road (152-MPD), Menlo Park, CA 94025, USA
Correspondence
Corresponding author at: 795 Willow Road (152-MPD), Menlo
Park, CA 94025, USA.
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