Long-Acting Injectable Buprenorphine in Prison: Insights From a Short-Answer Survey of People in the Criminal Justice System Commencing Long-Acting Injectable Buprenorphine During a Non-Randomised Clinical Trial.

INTRODUCTION

Long-acting injectable buprenorphine (LAIB) is increasingly used in the Criminal Justice System (CJS) for treating people with opioid use disorder; however, little is known about these patients' experiences. We aimed to understand the perspectives of participants commenced on LAIB in prison as a part of the Understanding NSW Long-Active Opioids in Custody-Treatment (UNLOC-T) study.

METHODS

Results of an open-ended survey administered by UNLOC-T researchers underwent analysis. Participants were adults, recruited November 2018-July 2019, with moderate-severe opioid use disorder and ≥ 6 months remaining on their sentence. We conducted a thematic analysis using a pragmatic, descriptive coding approach.

RESULTS

Sixty-seven participants were included, of which 82% were male. Five primary themes were identified that described participants' experiences and highlighted issues that can directly inform service delivery: medication effectiveness, social and relational considerations, dosing frequency, financial aspects, and health and wellbeing. There was considerable variation in participant perspectives within themes.

DISCUSSION AND

CONCLUSIONS

Perspectives on LAIB are diverse, suggesting a need to individualise treatment and ensure person-centered care. While LAIB offers benefits to warrant including it as a treatment option, challenges remain. Future research into LAIB in the CJS would allow for triangulation, as well as further exploration of ongoing acceptability in the post-release period. Our findings could help to improve the way LAIB is offered as a treatment option or delivered to people in the CJS. There are also lessons for prescribers in counselling and tailoring treatment, and broader policy considerations around access to treatment formulations and patient autonomy.