A meta-analysis on the effects of incarceration-based opioid substitution treatment

Med Sci Law. 2023 Jan;63(1):53-60. doi: 10.1177/00258024221118971. Epub 2022 Aug 8.

Abstract

Objective: Opioid substitution treatment (OST) is a common treatment for individuals who use opioids; however, empirical evidence on the effects of OST during incarceration is scarce. Our aim was to conduct a meta-analysis on the effects of incarceration-based OST on substance use, treatment engagement post-release and re-incarceration. Method: We searched for studies on individuals who were incarcerated and treated with OST, compared to a comparison group. Studies were only included if they reported data post-release. Results: N = 15 studies met the inclusion criteria. We found less opioid use, less other drug use, higher treatment engagement post-release and less re-incarceration among treated individuals compared to the comparison group. Moderator analyses showed some influence of length of follow-up period and study quality. Conclusions: Incarceration-based OST reduces drug use, re-incarceration and leads to higher treatment engagement after release. More research is needed on the effects of incarceration-based OST on secondary outcomes (e.g. health and social integration) and on factors that moderate these effects.

Keywords: Opioid use disorder; incarcerated populations; meta-analysis; opioid substitution treatment; treatment of incarcerated individuals.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Analgesics, Opioid / therapeutic use
  • Humans
  • Opiate Substitution Treatment
  • Opioid-Related Disorders* / drug therapy
  • Prisoners*

Substances

  • Analgesics, Opioid