Abstract
BackgroundThere is little data on the impact of office-based buprenorphine therapy on criminal activity. The goal of this study was to determine the impact of primary care clinic-based buprenorphine maintenance therapy on rates of criminal charges and the factors associated with criminal charges in the 2 years after initiation of treatment.MethodsWe collected demographic and outcome data on 252 patients who were given at least one prescription for buprenorphine. We searched a public database of criminal charges and recorded criminal charges prior to and after enrollment. We compared the total number of criminal cases and drug cases 2 years before versus 2 years after initiation of treatment.ResultsThere was at least one criminal charge made against 38% of the subjects in the 2 years after initiation of treatment; these subjects were more likely to have used heroin, to have injected drugs, to have had any prior criminal charges, and recent criminal charges. There was no significant difference in the number of subjects with any criminal charge or a drug charge before and after initiation of treatment. Likewise, the mean number of all cases and drug cases was not significantly different between the two periods. However, among those who were opioid-negative for 6 or more months in the first year of treatment, there was a significant decline in criminal cases. On multivariable analysis, having recent criminal charges was significantly associated with criminal charges after initiation of treatment (adjusted odds ratio 3.92); subjects who were on opioid maintenance treatment prior to enrollment were significantly less likely to have subsequent criminal charges (adjusted odds ratio 0.52).ConclusionsAmong subjects with prior criminal charges, initiation of office-based buprenorphine treatment did not appear to have a significant impact on subsequent criminal charges.
Highlights
Substance dependence is a common medical problem and is associated with criminal activity [1,2]
A number of characteristics were associated with criminal charges after enrollment in buprenorphine maintenance therapy
All of the subjects with criminal charges in the two years after initiating treatment had prior criminal charges, compared to only 67.7% (p < 0.001) of those whom had no criminal charges after initiating treatment; these subjects were more likely to have had charges in the 2 years prior to initiation of treatment and had a significantly higher median number of prior cases
Summary
Substance dependence is a common medical problem and is associated with criminal activity [1,2]. Given the prevalence of substance use in the criminal justice population [13] and the current limited access to pharmacologic treatment for opioid dependence, there is a tremendous need for effective treatment; incarceration may be an opportunity to initiate treatment for opioid dependence and improve rates of recidivism [14,15]. There is little data on the impact of office-based buprenorphine therapy on criminal activity. The goal of this study was to determine the impact of primary care clinic-based buprenorphine maintenance therapy on rates of criminal charges and the factors associated with criminal charges in the 2 years after initiation of treatment
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