This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
Every day, about 115 Americans die from an opioid overdose. Opioid use disorders, including the use of prescription opioids and heroin, are especially common among people entering jails and prisons. Many correctional facilities offer substance use education and counseling. But few use medicines approved to treat opioid addiction, which can help prevent relapse and overdose death after people leave jail.
Naltrexone is a medicine that blocks opioid effects, reduces opioid craving, and prevents relapse and overdose deaths. Because it is not a controlled substance and people can’t abuse it, health clinics in jails and prisons often make it part of treatment. People can take it as a tablet or as an injection that blocks opioid effects for a month.
The research team wants to study whether taking naltrexone as an injection can help people with opioid use disorder avoid using opioids after they leave jail. They also want to see if people who get this treatment before leaving jail are more likely to attend counseling and avoid going back to jail than people who get the medicine after they leave.
Who can this research help?
Results from this study can help correctional facility administrators and health staff as they are considering how best to treat prisoners with opioid use disorder.
What is the research team doing?
The research team is working with the Philadelphia Prison System to recruit 200 inmates who have opioid use disorder. All the prisoners taking part in the study have been through detoxification and are likely to leave jail soon. The research team helps them to get healthcare coverage, such as Medicaid. Half of the prisoners, selected by chance, receive injected naltrexone before they leave jail. The other half get referrals to a local drug treatment program to get the treatment after they leave jail. All can get three more monthly doses of naltrexone from the community program after they leave jail. If they decide to stop taking naltrexone, they can get any of the other treatments for opioid use disorder that are available from local programs. All study participants can also get counseling.
The research team is
- Collecting weekly urine samples for drug testing
- Asking detailed questions about opioid and other substance use, treatments received, and side effects
- Reviewing prison system records to see if people in the study go back to jail during the study period
- Checking with family members or close friends for information about people who miss appointments
- Checking the national death index for overdose deaths
Prison officials and addiction treatment program directors are working with the research team to plan and conduct the study.