Factors of Interest in Extended-Release Buprenorphine: Comparisons Between Incarcerated and Non-Incarcerated Patients with Opioid Use Disorder

Abstract

Mathieu Chappuy,1– 3 Fadi Meroueh,4 Benoit Trojak,5,6 Jérôme Bachellier,7 Patrick Bendimerad,8 Margaux Kosim,9,10 Peter Hjelmström,11 Philippe Nubukpo,12,13 Georges Brousse,14,15 Benjamin Rolland1,2,16 1Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier, Bron, 69500, France; 2Service d’Addictologie, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France; 3CSAPA, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France; 4UCSA, CHU Lapeyronie, Montpellier, France; 5Service Hospitalo-Universitaire d’Addictologie, CHU de Dijon, Dijon, France; 6INSERM U1093, UFR Staps, Université de Bourgogne Franche Comté, Dijon, France; 7Service Universitaire d’Addictologie de Tours, CHU Bretonneau, Tours, France; 8Service d’Addictologie, Groupe Hospitalier de La Rochelle-Ré-Aunis, La Rochelle, France; 9Consultations de Médecine-Alcoologie PASS, Groupe Hospitalier Pitié Salpêtrière, Paris, France; 10Camurus SAS, Paris, France; 11Camurus AB, Ideon Science Park, Lund, Sweden; 12Service d’Addictologie, Centre Hospitalier Esquirol, Limoges, France; 13INSERM UMR 1094, Université de Limoges, Limoges, France; 14Service de Psychiatrie B et d’Addictologie, CHU de Clermont-Ferrand, Clermont-Ferrand, France; 15Équipe d’Accueil 7280, Université Clermont Auvergne, Clermont-Ferrand, France; 16INSERM U1028, CNRS UMR 5292, CRNL, Université de Lyon, UCBL1, Bron, FranceCorrespondence: Benjamin RollandService Universitaire d’Addictologie, CH Le Vinatier, Pôle MOPHA, 95 Bd Pinel, Bron, 69500, FranceTel [phone]Fax [phone]Email [email protected]: Extended-release buprenorphine (XR-BUP) covers a range of formulations of buprenorphine-based treatments for opioid use disorder (OUD) that release the medication over a period of one week, one month, or six months. OUD is particularly prevalent among incarcerated populations, and previous findings have shown that incarcerated subjects were not less interested in XR-BUP than non-incarcerated subjects. However, no study has ever investigated whether the factors of interest in XR-BUP were similar in incarcerated and non-incarcerated populations.Patients and Methods: We carried out post-hoc analyses using data from the “AMBRE” survey, which was conducted among 366 individuals with OUD, that were recruited in 68 French addiction settings, including six prison medical centers. The reasons for interest in XR-BUP were compared between incarcerated and non-incarcerated interviewees, using logistic regressions models, which provided raw and adjusted odds ratios (aORs) and 95% confidence intervals (95% CI). Adjustment variables were gender, age category, level of education, and type of current medication for OUD, respectively.Results: Data from 317 participants (ie, 221 non-incarcerated, and 96 incarcerated individuals) were included in the analyses. Adjusted comparisons found that “no longer taking a daily treatment” (aOR= 2.91; 95% CI= 1.21– 6.98) and “having a more discreet medication” (aOR= 1.76; 95% CI= 1.01– 3.10) were reasons that appealed more to incarcerated participants than to non-incarcerated ones. On the other hand, the potential reduction of withdrawal symptoms (aOR= 0.54; 95% CI= 0.29– 0.99) or the risk of misuse (aOR= 0.56; 95% CI= 0.34– 0.94) associated with XR-BUP treatment were considered more important by non-incarcerated individuals than by incarcerated ones.Conclusion: Incarcerated interviewees were interested in XR-BUP for different reasons than those outside prison. In particular, incarcerated patients were more interested in practicability and discretion features, and less in improving recovery or reducing misuse than non-incarcerated patients.Keywords: prison, opioid use disorder, buprenorphine, preferences

Keywords

• prison
• opioid use disorder
• buprenorphine
• preferences