- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00367302
Buprenorphine Maintenance for Opioid-Addicted Persons in Jail and Post-Release
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Background: Heroin and other opioid abuse continues as a significant problem among the criminal justice population. In 2002, the criminal justice system was the source of referral for 36% of all substance abuse treatment admissions, the largest source of referrals. Heroin use among offenders has serious health and social consequences. Injection, still the primary route of administration among heroin users, is strongly associated with the transmission of HIV, hepatitis C and other blood-borne diseases. During 1997, 20% to 26% of all people living with HIV in the United States, and 29% to 43% of all those infected with hepatitis C, passed through a correctional facility. The relationship between heroin use and criminal activity has been extensively documented. Although methadone maintenance has been the primary treatment for chronic opioid dependence since the 1970's, correctional systems in the U.S., with very few exceptions (primarily Rikers Island in New York City), have not provided institutional access to methadone maintenance. Regrettably, negative attitudes to methadone are prevalent among criminal justice professionals, the public, treatment providers and opioid-dependent offenders themselves; there is little prospect of that changing soon. Buprenorphine maintenance is a recently approved therapy that may be more acceptable than methadone to the criminal justice system and opioid-dependent offenders. With one minor exception, buprenorphine has never been systematically administered as an opioid replacement therapy in a correctional setting in the U.S.
Aims and Objectives:
- To determine the feasibility of providing buprenorphine maintenance to opioid-dependent offenders in a jail setting and of transitioning those patients to buprenorphine maintenance in the community after their release.
- To conduct a randomized clinical trial of buprenorphine maintenance (N=50) vs. methadone maintenance (N=50) initiated in the jail setting and continuing in the community.
- To determine the reasons that offenders fail to report for community buprenorphine or methadone treatment after release or drop out of community treatment.
Study Design: Consenting eligible inmates at Rikers Island in New York City will be randomly assigned to buprenorphine or methadone maintenance in jail and will be referred to a corresponding community treatment upon their release. Subjects will be followed-up at 3 months after release from jail.
Target Population: Opioid-dependent jail inmates sentenced to 10- 90 days.
Study Type
Enrollment (Actual)
Phase
- Phase 2
- Phase 1
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- opioid dependent patients who meet eligibility requirements for the KEEP program,
- patients serving sentences who will remain confined for at least 10 days but less than 90 days in the EMTC facility (all male) at Rikers,
- willingness to accept buprenorphine treatment,
- expected to reside in New York City after release
- 18-65 years of age
Exclusion Criteria:
- receiving methadone treatment in the community at sentencing and remanded to Rikers
- took non-prescribed 'street methadone' within last 3 days
- currently receiving more than 20mg/day methadone
- current psychotic symptoms (e.g., schizophrenia, schizoaffective disorder) requiring referral for mental health intervention, or current treatment with antipsychotic medication)
- HIV infection with T lymphocytes less than 200 per mm of blood and/or presence of a serious opportunistic infection requiring treatment, or receiving the HIV medication atazanavir.
- unable to complete English language interview
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: 1
Buprenorphine maintenance
|
maintenance
Other Names:
|
Active Comparator: 2
Methadone maintenance
|
maintenance
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Treatment completion in jail
Time Frame: Until release from jail
|
Until release from jail
|
Reporting to assigned treatment modality after release
Time Frame: Within 3 months after release from jail
|
Within 3 months after release from jail
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Intention to continue treatment after release
Time Frame: At release from jail
|
At release from jail
|
Re-incarceration
Time Frame: Within 3 months after release
|
Within 3 months after release
|
Frequency of illicit opioid use after release
Time Frame: Within 3 months after release
|
Within 3 months after release
|
Re-arrest
Time Frame: Within 3 months after release
|
Within 3 months after release
|
Severity of re-arrest charges
Time Frame: Within 3 months after release, if re-arrested
|
Within 3 months after release, if re-arrested
|
Satisfaction with opioid replacement treatment.
Time Frame: During jail and 3 months post-release
|
During jail and 3 months post-release
|
Opioid withdrawal symptoms and cravings
Time Frame: During jail and post-release
|
During jail and post-release
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Mental Disorders
- Chemically-Induced Disorders
- Substance-Related Disorders
- Narcotic-Related Disorders
- Compulsive Behavior
- Impulsive Behavior
- Opioid-Related Disorders
- Behavior, Addictive
- Physiological Effects of Drugs
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Analgesics, Opioid
- Narcotics
- Narcotic Antagonists
- Respiratory System Agents
- Antitussive Agents
- Buprenorphine
- Methadone
Other Study ID Numbers
- DA020583
- R21DA020583 (U.S. NIH Grant/Contract)
- 1R21DA020583 (U.S. NIH Grant/Contract)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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