Stimulant use disorder diagnosis and opioid agonist treatment dispensation following release from prison: a cohort study
Abstract Background Concurrent opioid and stimulant use is on the rise in North America. This increasing trend of use has been observed in the general population, and among people released from prison in British Columbia (BC), who face an elevated risk of overdose post-release. Opioid agonist treatm...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | Substance Abuse Treatment, Prevention, and Policy |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13011-022-00504-z |
| _version_ | 1811186976865386496 |
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| author | Heather Palis Bin Zhao Pam Young Mo Korchinski Leigh Greiner Tonia Nicholls Amanda Slaunwhite |
| author_facet | Heather Palis Bin Zhao Pam Young Mo Korchinski Leigh Greiner Tonia Nicholls Amanda Slaunwhite |
| author_sort | Heather Palis |
| collection | DOAJ |
| description | Abstract Background Concurrent opioid and stimulant use is on the rise in North America. This increasing trend of use has been observed in the general population, and among people released from prison in British Columbia (BC), who face an elevated risk of overdose post-release. Opioid agonist treatment is an effective treatment for opioid use disorder and reduces risk of overdose mortality. In the context of rising concurrent stimulant use among people with opioid use disorder, this study aims to investigate the impact of stimulant use disorder on opioid agonist treatment dispensation following release from prison in BC. Methods Linked health and corrections records were retrieved for releases between January 1st 2015 and December 29th 2018 (N = 13,380). Hospital and primary-care administrative health records were used to identify opioid and stimulant use disorder and mental illness. Age, sex, and health region were derived from BC’s Client Roster. Incarceration data were retrieved from provincial prison records. Opioid agonist treatment data was retrieved from BC’s provincial drug dispensation database. A generalized estimating equation produced estimates for the relationship of stimulant use disorder and opioid agonist treatment dispensation within two days post-release. Results Cases of release among people with an opioid use disorder were identified (N = 13,380). Approximately 25% (N = 3,328) of releases ended in opioid agonist treatment dispensation within two days post-release. A statistically significant interaction of stimulant use disorder and mental illness was identified. Stratified odds ratios (ORs) found that in the presence of mental illness, stimulant use disorder was associated with lower odds of obtaining OAT [(OR) = 0.73, 95% confidence interval (CI) = 0.64–0.84)] while in the absence of mental illness, this relationship did not hold [OR = 0.89, 95% CI = 0.70–1.13]. Conclusions People with mental illness and stimulant use disorder diagnoses have a lower odds of being dispensed agonist treatment post-release compared to people with mental illness alone. There is a critical need to scale up and adapt opioid agonist treatment and ancillary harm reduction, and treatment services to reach people released from prison who have concurrent stimulant use disorder and mental illness diagnoses. |
| first_indexed | 2024-04-11T13:54:20Z |
| format | Article |
| id | doaj.art-dc40def2b2ac47608ebb507e2bf6e53e |
| institution | Directory Open Access Journal |
| issn | 1747-597X |
| language | English |
| last_indexed | 2024-04-11T13:54:20Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Substance Abuse Treatment, Prevention, and Policy |
| spelling | doaj.art-dc40def2b2ac47608ebb507e2bf6e53e2022-12-22T04:20:24ZengBMCSubstance Abuse Treatment, Prevention, and Policy1747-597X2022-11-0117111110.1186/s13011-022-00504-zStimulant use disorder diagnosis and opioid agonist treatment dispensation following release from prison: a cohort studyHeather Palis0Bin Zhao1Pam Young2Mo Korchinski3Leigh Greiner4Tonia Nicholls5Amanda Slaunwhite6BC Centre for Disease Control, University of British ColumbiaBC Centre for Disease Control, University of British ColumbiaUnlocking the Gates Services SocietyUnlocking the Gates Services SocietyBC CorrectionsDepartment of Psychiatry, University of British ColumbiaBC Centre for Disease Control, University of British ColumbiaAbstract Background Concurrent opioid and stimulant use is on the rise in North America. This increasing trend of use has been observed in the general population, and among people released from prison in British Columbia (BC), who face an elevated risk of overdose post-release. Opioid agonist treatment is an effective treatment for opioid use disorder and reduces risk of overdose mortality. In the context of rising concurrent stimulant use among people with opioid use disorder, this study aims to investigate the impact of stimulant use disorder on opioid agonist treatment dispensation following release from prison in BC. Methods Linked health and corrections records were retrieved for releases between January 1st 2015 and December 29th 2018 (N = 13,380). Hospital and primary-care administrative health records were used to identify opioid and stimulant use disorder and mental illness. Age, sex, and health region were derived from BC’s Client Roster. Incarceration data were retrieved from provincial prison records. Opioid agonist treatment data was retrieved from BC’s provincial drug dispensation database. A generalized estimating equation produced estimates for the relationship of stimulant use disorder and opioid agonist treatment dispensation within two days post-release. Results Cases of release among people with an opioid use disorder were identified (N = 13,380). Approximately 25% (N = 3,328) of releases ended in opioid agonist treatment dispensation within two days post-release. A statistically significant interaction of stimulant use disorder and mental illness was identified. Stratified odds ratios (ORs) found that in the presence of mental illness, stimulant use disorder was associated with lower odds of obtaining OAT [(OR) = 0.73, 95% confidence interval (CI) = 0.64–0.84)] while in the absence of mental illness, this relationship did not hold [OR = 0.89, 95% CI = 0.70–1.13]. Conclusions People with mental illness and stimulant use disorder diagnoses have a lower odds of being dispensed agonist treatment post-release compared to people with mental illness alone. There is a critical need to scale up and adapt opioid agonist treatment and ancillary harm reduction, and treatment services to reach people released from prison who have concurrent stimulant use disorder and mental illness diagnoses.https://doi.org/10.1186/s13011-022-00504-zStimulant use disorderOpioid use disorderOpioid agonist treatmentIncarcerationPrisonMental health |
| spellingShingle | Heather Palis Bin Zhao Pam Young Mo Korchinski Leigh Greiner Tonia Nicholls Amanda Slaunwhite Stimulant use disorder diagnosis and opioid agonist treatment dispensation following release from prison: a cohort study Substance Abuse Treatment, Prevention, and Policy Stimulant use disorder Opioid use disorder Opioid agonist treatment Incarceration Prison Mental health |
| title | Stimulant use disorder diagnosis and opioid agonist treatment dispensation following release from prison: a cohort study |
| title_full | Stimulant use disorder diagnosis and opioid agonist treatment dispensation following release from prison: a cohort study |
| title_fullStr | Stimulant use disorder diagnosis and opioid agonist treatment dispensation following release from prison: a cohort study |
| title_full_unstemmed | Stimulant use disorder diagnosis and opioid agonist treatment dispensation following release from prison: a cohort study |
| title_short | Stimulant use disorder diagnosis and opioid agonist treatment dispensation following release from prison: a cohort study |
| title_sort | stimulant use disorder diagnosis and opioid agonist treatment dispensation following release from prison a cohort study |
| topic | Stimulant use disorder Opioid use disorder Opioid agonist treatment Incarceration Prison Mental health |
| url | https://doi.org/10.1186/s13011-022-00504-z |
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