Criminal Charges Prior to and After Enrollment in Opioid Agonist Treatment: A Comparison of Methadone Maintenance and Office-based Buprenorphine

Darius A. Rastegar, Sarah Sharfstein Kawasaki, Van L King, Elizabeth E. Harris, Robert K. Brooner

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Entry into methadone maintenance is associated with a reduction in criminal activity; less is known about the effects of office-based buprenorphine. Objective: To compare criminal charges before and after enrollment in methadone maintenance or office-based buprenorphine. Methods: Subjects were opioid-dependent adults who initiated either methadone maintenance (n = 252) or office-based buprenorphine (n = 252) between 2003 and 2007. Medical records were reviewed to gather demographic data and a state-maintained web-based database to collect data on criminal charges. Overall charges and drug charges in the 2 years prior to and after treatment enrollment were compared. Multivariable analysis was used to examine risk factors for charges after treatment enrollment. Results: In the 2 years after enrolling in treatment, subjects receiving methadone had a significant decline in the proportion of subjects with any charges (49.6% vs. 32.5%, p <.001) or drug charges (25.0% vs. 17.5%, p =.015), as well as the mean number of cases (0.97 vs. 0.63, p =.002) and drug cases (0.38 vs. 0.23, p =.008), while those who initiated buprenorphine did not have significant changes in any of these measures. On multivariable analysis, the strongest predictor of criminal charges in the 2 years after treatment enrollment was prior charges (adjusted odds ratio 3.35, 95% confidence interval, 2.24–5.01). Conclusions: Enrollment in office-based buprenorphine treatment did not appear to have the same beneficial effect on subsequent criminal charges as methadone maintenance. If this observation is replicated in other settings, it may have implications for matching individuals to these treatment options.

Original languageEnglish (US)
Pages (from-to)803-811
Number of pages9
JournalSubstance Use and Misuse
Volume51
Issue number7
DOIs
StatePublished - Jun 6 2016
Externally publishedYes

Fingerprint

charge
Buprenorphine
Methadone
Opioid Analgesics
drug
Pharmaceutical Preparations
confidence
Medical Records
Odds Ratio
Demography
Databases
Confidence Intervals

Keywords

  • buprenorphine
  • Crime
  • methadone
  • opioid agonist treatment
  • opioid-related disorders

ASJC Scopus subject areas

  • Health(social science)
  • Medicine (miscellaneous)
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

Cite this

Criminal Charges Prior to and After Enrollment in Opioid Agonist Treatment : A Comparison of Methadone Maintenance and Office-based Buprenorphine. / Rastegar, Darius A.; Sharfstein Kawasaki, Sarah; King, Van L; Harris, Elizabeth E.; Brooner, Robert K.

In: Substance Use and Misuse, Vol. 51, No. 7, 06.06.2016, p. 803-811.

Research output: Contribution to journalArticle

Rastegar, Darius A. ; Sharfstein Kawasaki, Sarah ; King, Van L ; Harris, Elizabeth E. ; Brooner, Robert K. / Criminal Charges Prior to and After Enrollment in Opioid Agonist Treatment : A Comparison of Methadone Maintenance and Office-based Buprenorphine. In: Substance Use and Misuse. 2016 ; Vol. 51, No. 7. pp. 803-811.
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abstract = "Background: Entry into methadone maintenance is associated with a reduction in criminal activity; less is known about the effects of office-based buprenorphine. Objective: To compare criminal charges before and after enrollment in methadone maintenance or office-based buprenorphine. Methods: Subjects were opioid-dependent adults who initiated either methadone maintenance (n = 252) or office-based buprenorphine (n = 252) between 2003 and 2007. Medical records were reviewed to gather demographic data and a state-maintained web-based database to collect data on criminal charges. Overall charges and drug charges in the 2 years prior to and after treatment enrollment were compared. Multivariable analysis was used to examine risk factors for charges after treatment enrollment. Results: In the 2 years after enrolling in treatment, subjects receiving methadone had a significant decline in the proportion of subjects with any charges (49.6{\%} vs. 32.5{\%}, p <.001) or drug charges (25.0{\%} vs. 17.5{\%}, p =.015), as well as the mean number of cases (0.97 vs. 0.63, p =.002) and drug cases (0.38 vs. 0.23, p =.008), while those who initiated buprenorphine did not have significant changes in any of these measures. On multivariable analysis, the strongest predictor of criminal charges in the 2 years after treatment enrollment was prior charges (adjusted odds ratio 3.35, 95{\%} confidence interval, 2.24–5.01). Conclusions: Enrollment in office-based buprenorphine treatment did not appear to have the same beneficial effect on subsequent criminal charges as methadone maintenance. If this observation is replicated in other settings, it may have implications for matching individuals to these treatment options.",
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