Medications for Opioid Use Disorder Among Incarcerated Individuals: a Review of the Literature and Focus on Patient Preference

Abstract

Opioid use disorder (OUD) is a common diagnosis among incarcerated people. Despite strong evidence for use in correctional facilities, medications for OUD (MOUD) are infrequently used, and when they are, continuity after release is low. Patient preferences regarding treatment in other chronic health conditions can impact outcomes and is an emerging focus in patient-centered research. We review the extent that patient preference is incorporated in MOUD effectiveness studies among incarcerated people and how patient perceptions of MOUD may impact treatment utilization using the Gelberg-Anderson framework for vulnerable populations. Of 27 studies of the effectiveness of MOUD among correctional populations, 1 incorporated preference for MOUD in the study design and 5 either noted preference before randomization or elicited perceptions regarding MOUD post hoc. Using the Gelberg-Anderson framework to categorize how patient preference influences MOUD treatment decisions and engagement, there are predisposing, enabling, and needs-based factors, which influence MOUD treatment, including beliefs about medications, social networks, social needs, and perceived MOUD and health needs. Few high-quality MOUD effectiveness studies based in jails and prisons have systematically studied patient preference or perspective. Future studies should explicate the role of patient preference in the effectiveness of MOUD treatment and on the impact on treatment engagement and retention during and after incarceration.