Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2019 Aug;114(8):1396-1404.
doi: 10.1111/add.14620. Epub 2019 May 2.

Criminal justice outcomes over 5 years after randomization to buprenorphine-naloxone or methadone treatment for opioid use disorder

Elizabeth A Evans  1 , Yuhui Zhu  2   3 , Caroline Yoo  2 , David Huang  2 , Yih-Ing Hser  2
Affiliations
Randomized Controlled Trial

Criminal justice outcomes over 5 years after randomization to buprenorphine-naloxone or methadone treatment for opioid use disorder

Elizabeth A Evans et al. Addiction. 2019 Aug.

Abstract

Aims: To compare long-term criminal justice outcomes among opioid-dependent individuals randomized to receive buprenorphine or methadone.

Design, setting and participants: A 5-year follow-up was conducted in 2011-14 of 303 opioid-dependent participants entering three opioid treatment programs in California, USA in 2006-09 and randomized to receive either buprenorphine/naloxone or methadone.

Intervention and comparator: Participants received buprenorphine/naloxone (BUP; n = 179) or methadone (MET; n = 124) for 24 weeks and then were tapered off their treatment over ≤ 8 weeks or referred for ongoing clinical treatment. Midway through the study, the randomization scheme was switched from 1 : 1 BUP : MET to 2 : 1 because of higher dropout in the BUP arm.

Measurements: Study outcomes included arrests and self-reported incarceration. Predictors included randomization condition (buprenorphine versus methadone), age, gender, race/ethnicity, use of cocaine, drug injection in the 30 days prior to baseline and study site. Treatment status (buprenorphine, methadone, none) during follow-up was included as a time-varying covariate.

Findings: There was no significant difference by randomization condition in the proportion arrested (buprenorphine: 55.3%, methadone: 54.0%) or incarcerated (40.9%, 47.3%) during follow-up. Among methadone-randomized individuals, arrest was less likely with methadone treatment (0.50, 0.35-0.72) during follow-up (relative to no treatment) and switching to buprenorphine had a lower likelihood of arrest than those receiving no treatment (0.39, 0.18-0.87). Among buprenorphine-randomized individuals, arrest was less likely with receipt of buprenorphine (0.49, 0.33-0.75) during follow-up and switching to methadone had a similar likelihood of arrest as methadone-randomized individuals receiving no treatment. Likelihood of arrest was also negatively associated with older age (0.98, 0.96-1.00); it was positively associated with Hispanic ethnicity (1.63, 1.04-2.56), cocaine use (2.00, 1.33-3.03), injection drug use (2.19, 1.26-3.83), and study site.

Conclusions: In a US sample of people treated for opioid use disorder, continued treatment with either buprenorphine or methadone was associated with a reduction in arrests relative to no treatment. Cocaine use, injection drug use, Hispanic ethnicity and younger age were associated with higher likelihood of arrest.

Keywords: Arrests; buprenorphine treatment; criminal justice outcomes; incarcerations; longitudinal; methadone treatment; opioid use disorder; pharmacotherapy.

PubMed Disclaimer

Conflict of interest statement

Declaration of Interest: Authors disclosing relevant financial interests, activities, relationships, and affiliations are:

All other authors report no financial or other possible conflicts of interest.

Figures

Figure 1a.
Figure 1a.. Proportion arrested per year over 5 years by randomization group (n=303)
At each time-point, the difference in arrests by randomization group is not statistically significant.
Figure 1b.
Figure 1b.. Number of arrests per year over 5 years by randomization group (n=303)
At each time-point, the difference in arrests by randomization group is not statistically significant.
See this image and copyright information in PMC

References

    1. Bruneau J, Ahamad K, Goyer MÈ, Poulin G, Selby P, Fischer B, et al. Wood E. Management of opioid use disorders: a national clinical practice guideline. CMAJ. 2018. March; 190(9): E247–E257. - PMC - PubMed
    1. U.S. Department of Health and Human Services (HHS), Office of the Surgeon General. Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington, DC: HHS, November 2016. - PubMed
    1. Hser YI, Evans E, Huang D, Weiss R, Saxon A, Carroll KM, et al., Ling W Long-term outcomes after randomization to buprenorphine/naloxone versus methadone in a multi-site trial. Addiction. 2016. April; 111(4): 695–705. - PMC - PubMed
    1. Hser YI, Saxon AJ, Huang D, Hasson A, Thomas C, Hillhouse M, et al., Ling W Treatment retention among patients randomized to buprenorphine/naloxone compared to methadone in a multi-site trial. Addiction. 2014. January; 109(1): 79–87. - PMC - PubMed
    1. Burns L, Gisev N, Larney S, Dobbins T, Gibson A, Kimber J, et al. Degenhardt L A longitudinal comparison of retention in buprenorphine and methadone treatment for opioid dependence in New South Wales, Australia. Addiction. 2015; 110(4): 646–655. - PubMed

Publication types