Comparative study between prison- and community-based treatment satisfaction for opioid use disorder in Lebanon

• Published in: International journal of prisoner health 2019-06, Vol.15 (2), p.138-152
• Main Authors: Khalaf, Dany, Hayek, Maryse, Bakhos, Jules-Joel, Abou-Mrad, Fadi
• Format: Article
• Language: English
• Subjects: Adult; Buprenorphine; Buprenorphine - therapeutic use; Communities; Community-based programs; Community-based treatment; Comparative studies; Cooperation; Correctional institutions; Cross-Sectional Studies; Diagnostic and Statistical Manual; Diagnostic systems; Drug addiction; Ethics; Humans; Imprisonment; Lebanon; Male; Marital status; Mental disorders; Methadone; Narcotics; Opiate Substitution Treatment - methods; Opioid-Related Disorders - drug therapy; Opioids; Patient satisfaction; Patient Satisfaction - statistics & numerical data; Pilot Projects; Prisoners; Prisoners - psychology; Prisons; Prisons - standards; Public health; Quality of life; Questionnaires; Substance abuse treatment; Substance use disorder; Young Adult
• ISSN: 1744-9200; 1744-9219
• DOI: 10.1108/IJPH-12-2017-0064

Purpose Opioid substitution treatment (OST), such as Buprenorphine, has become a well-established evidence-based approach for the treatment of inmates with opioid use disorder (OUD) in most of the developed world. However, its application in Lebanon remains mainly as a community-based intervention. The purpose of this paper is to highlight the need of its implementation within the Lebanese correctional system. Design/methodology/approach The work is a pilot cross-sectional study that compares two groups: 30 male adult prisoners with OUD convictions receiving symptomatic treatment and 30 male adult community patients with OUD receiving Buprenorphine. The objective was to measure the difference in the patients’ general perception and satisfaction of the treatments available. OUD was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders 5th Edition criteria and the level of satisfaction was measured by “Treatment Perceptions Questionnaire (TPQ).” Findings The prison group reported significantly lower satisfaction when compared to the community group (total TPQ mean scores: M=34.73, SD =4.12 and M=16.67, SD =4.78, respectively, with t (56.76) =15.68, p=0.000). Furthermore, age, marital status, education level and elapsed time in treatment had no significant interactions with the total TPQ score. Originality/value The major principles of the ethics of care and evidence-based safe practices will be proposed for the introduction of Buprenorphine to Lebanese prisons. This work provides an opportunity for the expansion of the Lebanese OST program and consequently other countries in the region could benefit from this experience.