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Interest without uptake: A mixed-methods analysis of methadone utilization in Kyrgyz prisons

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Název: Interest without uptake: A mixed-methods analysis of methadone utilization in Kyrgyz prisons
Autoři: Amanda R. Liberman, Daniel J. Bromberg, Taylor Litz, Ainura Kurmanalieva, Samy Galvez, Julia Rozanova, Lyu Azbel, Jaimie P. Meyer, Frederick L. Altice
Zdroj: PLoS One
PLoS ONE, Vol 17, Iss 10, p e0276723 (2022)
Informace o vydavateli: Public Library of Science (PLoS), 2022.
Rok vydání: 2022
Témata: Science, 03 medical and health sciences, Opioid-Related Disorders/drug therapy, 0302 clinical medicine, Opiate Substitution Treatment/methods, Opiate Substitution Treatment, Humans, Analgesics, Acquired Immunodeficiency Syndrome, Prisoners, Opioid-Related Disorders, 16. Peace & justice, 3. Good health, Analgesics, Opioid, Methadone/therapeutic use, Acquired Immunodeficiency Syndrome/drug therapy, Prisons, Medicine, Opioid/therapeutic use, 0305 other medical science, Methadone, Research Article
Popis: HIV incidence continues to increase in Eastern Europe and Central Asia (EECA), in large part due to non-sterile injection drug use, especially within prisons. Therefore, medication-assisted therapy with opioid agonists is an evidence-based HIV-prevention strategy. The Kyrgyz Republic offers methadone within its prison system, but uptake remains low. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a framework for identifying people who would potentially benefit from methadone, intervening to identify OUD as a problem and methadone as a potential solution, and providing referral to methadone treatment. Using an SBIRT framework, we screened for OUD in Kyrgyz prisons among people who were within six months of returning to the community (n = 1118). We enrolled 125 people with OUD in this study, 102 of whom were not already engaged in methadone treatment. We conducted a pre-release survey followed by a brief intervention (BI) to address barriers to methadone engagement. Follow-up surveys immediately after the intervention and at 1 month, 3 months, and 6 months after prison release assessed methadone attitudes and uptake. In-depth qualitative interviews with 12 participants explored factors influencing methadone utilization during and after incarceration. Nearly all participants indicated favorable attitudes toward methadone both before and after intervention in surveys; however, interest in initiating methadone treatment remained very low both before and after the BI. Qualitative findings identified five factors that negatively influence methadone uptake, despite expressed positive attitudes toward methadone: (1) interpersonal relationships, (2) interactions with the criminal justice system, (3) logistical concerns, (4) criminal subculture, and (5) health-related concerns.
Druh dokumentu: Article
Other literature type
Jazyk: English
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0276723
Přístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/36282864
https://doaj.org/article/21b4dabb209d40c7986abd426eaaf19f
Rights: CC BY
URL: http://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Přístupové číslo: edsair.doi.dedup.....6008adfa3e7e2a76771dd13b4e44764b
Databáze: OpenAIRE
Popis
Abstrakt:HIV incidence continues to increase in Eastern Europe and Central Asia (EECA), in large part due to non-sterile injection drug use, especially within prisons. Therefore, medication-assisted therapy with opioid agonists is an evidence-based HIV-prevention strategy. The Kyrgyz Republic offers methadone within its prison system, but uptake remains low. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a framework for identifying people who would potentially benefit from methadone, intervening to identify OUD as a problem and methadone as a potential solution, and providing referral to methadone treatment. Using an SBIRT framework, we screened for OUD in Kyrgyz prisons among people who were within six months of returning to the community (n = 1118). We enrolled 125 people with OUD in this study, 102 of whom were not already engaged in methadone treatment. We conducted a pre-release survey followed by a brief intervention (BI) to address barriers to methadone engagement. Follow-up surveys immediately after the intervention and at 1 month, 3 months, and 6 months after prison release assessed methadone attitudes and uptake. In-depth qualitative interviews with 12 participants explored factors influencing methadone utilization during and after incarceration. Nearly all participants indicated favorable attitudes toward methadone both before and after intervention in surveys; however, interest in initiating methadone treatment remained very low both before and after the BI. Qualitative findings identified five factors that negatively influence methadone uptake, despite expressed positive attitudes toward methadone: (1) interpersonal relationships, (2) interactions with the criminal justice system, (3) logistical concerns, (4) criminal subculture, and (5) health-related concerns.
ISSN:19326203
DOI:10.1371/journal.pone.0276723