Health and correctional staff acceptability of depot buprenorphine in NSW prisons

• Published in: The International journal of drug policy 2023-04, Vol.114, p.103978-103978, Article 103978
• Main Authors: Little, Sophia, White, Bethany, Moensted, Maja, Butler, Kerryn, Howard, Mark, Roberts, Jillian, Dunlop, Adrian
• Format: Article
• Language: English
• Subjects: Buprenorphine - therapeutic use; Correctional centre; Correctional Facilities Personnel; Depot buprenorphine; Humans; Implementation; Opiate Substitution Treatment - methods; Opioid-Related Disorders - drug therapy; Opioids treatment program; Prisons; Staff acceptability
• ISSN: 0955-3959; 1873-4758
• DOI: 10.1016/j.drugpo.2023.103978

•Opioid treatment programs are limited in custodial settings due to significant barriers.•The majority of staff felt the introduction of depot buprenorphine would reduce these barriers.•Improvements included increased safety for patients and improved health outcomes.•Treatment coverage could increase using depot buprenorphine and improve service efficiency•Support was almost universal from both correctional and health staff participating in this study. Provision of opioid agonist treatment (OAT) in custodial settings is resource-intensive and may be associated with diversion, non-medical use, and violence. A clinical trial of a new OAT, depot buprenorphine (the UNLOC-T study), provided the opportunity to obtain health and correctional staff perspectives regarding this treatment prior to widespread roll-out. Sixteen focus groups with 52 participants were conducted, including 44 health staff (nurses, nurse practitioners, doctors, and operational staff) and eight correctional staff. Key challenges to providing OAT identified as potentially being addressed by depot buprenorphine included 1) patient access, 2) OAT program capacity, 3) treatment administration procedures, 4) medication diversion and other safety issues and, 5) impact on other service delivery. The introduction of depot buprenorphine into correctional settings was considered to have the potential to increase safety for patients, improve staff / patient relations and advance patient health outcomes via expanded treatment coverage and efficiencies gained through enhanced health service delivery. Support was almost universal from both correctional and health staff participating in this study. These findings build on emerging research regarding the positive impact of more flexible OAT programs and could be used to engage support for the implementation of depot buprenorphine from staff in other secure settings.