Date of Award

January 2020

Document Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Robert Heimer

Abstract

Background and Aims. Methadone treatment is underutilized in correctional facilities, despite high prevalence of opioid use disorder in criminal justice settings. In 2013 and 2014, two pilot programs were established by the Connecticut Department of Corrections in the New Haven and Bridgeport Correctional Centers to provide methadone for inmates who had been in medication-based treatment prior to incarceration. We sought to assess post-release outcomes (non-fatal overdose, fatal overdose, recidivism, and resumption of methadone in the community) associated with implementation of methadone treatment in these correctional centers.

Methods. This was a retrospective observational cohort study, linking datasets from the Connecticut Department of Correction (DOC), the Connecticut Office of the Chief Medical Examiner (OCME), and the Department of Mental Health and Addiction Services (DMHAS), and the Connecticut Department of Public Health (DPH). Per-subject profiles were generated and post-incarceration outcomes were analyzed on an individual basis. 1,564 male inmates at the New Haven and Bridgeport Correctional Centers were included in the analysis who arrived at the facilities between January 1, 2014 and November 30, 2018.

Results. Receiving methadone with incarcerated was associated with a significant decrease in non-fatal overdose (OR:0.55) and were significantly more likely to resume medication-based treatment in the community post-release (OR:2.55). There was not a significant difference in fatal overdoses and instances of reincarceration.

Conclusions. Continuation of methadone treatment during incarceration can significantly improve post-release outcomes of non-fatal overdose and contribute to greater reengagement with community providers. Expanding these treatment programs are a critical step in addressing opioid use disorder in the criminal justice system.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 11/27/2020

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