TY - JOUR T1 - Perceptions of extended-release naltrexone, methadone, and buprenorphine treatments following release from jail. AU - Velasquez,Melissa, AU - Flannery,Mara, AU - Badolato,Ryan, AU - Vittitow,Alexandria, AU - McDonald,Ryan D, AU - Tofighi,Babak, AU - Garment,Ann R, AU - Giftos,Jonathan, AU - Lee,Joshua D, Y1 - 2019/10/01/ PY - 2019/02/15/received PY - 2019/09/11/accepted PY - 2019/10/2/entrez PY - 2019/10/2/pubmed PY - 2020/5/19/medline KW - Extended-release naltrexone KW - Incarceration KW - Opioid use disorder KW - Reentry SP - 37 EP - 37 JF - Addiction science & clinical practice JO - Addict Sci Clin Pract VL - 14 IS - 1 N2 - BACKGROUND: Few studies have documented patient attitudes and experiences with extended-release naltrexone (XR-NTX) opioid relapse prevention in criminal justice settings. This study assessed barriers and facilitators of jail-to-community reentry among adults with opioid use disorder (OUD) treated with XR-NTX, buprenorphine, methadone, and no medications. METHODS: This qualitative study conducted individual interviews with a purposeful and convenience sample of adults with OUD who were recently released from NYC jails. XR-NTX, no medication, and methadone participants were concurrently enrolled in a large randomized controlled trial evaluating XR-NTX vs. a no medication Enhanced Treatment As Usual (ETAU) condition, or enrolled in a non-randomized quasi-experimental methadone maintenance cohort. Buprenorphine participants were referred from NYC jails to a public hospital office-based buprenorphine program and not enrolled in the parent trial. Interviews were audio recorded, transcribed, independently coded by two researchers, and analyzed per a grounded theory approach adapted to the Social Cognitive Theory framework. The research team reviewed transcripts and coding to reach consensus on emergent themes. RESULTS: N = 33 adults with OUD (28 male, 5 female) completed a single individual interview. Purposeful sampling recruited persons leaving jail on XR-NTX (n = 11), no active medication treatment (n = 9), methadone (n = 9), and buprenorphine (n = 4). Emergent themes were: (1) general satisfaction with XR-NTX's long-acting antagonist effects and control of cravings; (2) "testing" XR-NTX's blockade with heroin upon reentry was common; (3) early discontinuation of XR-NTX treatment was most common among persons with high self-efficacy and/or heavy exposure to drug use environments and peers; (4) similar satisfaction regarding effects of methadone and buprenorphine maintenance among retained-in-treatment individuals, alongside general dissatisfaction with daily observed dosing requirements and misinformation and stigmas regarding methadone adverse effects; (5) unstable housing, economic insecurity, and exposure to actively using peers were attributed to early termination of treatment and relapse; (6) individual motivation and willpower as central to long-term opioid abstinence and reentry success. CONCLUSIONS: In the context of more familiar agonist maintenance treatments, XR-NTX relapse prevention during jail-to-community reentry was viewed as a helpful and unique intervention though with important limitations. Commonly described barriers to treatment retention and heroin abstinence included homelessness, economic insecurity, and drug-using peers. Trial registration ClinicalTrials.gov, NCT01999946 (XOR), Registered 03 December 2013, https://clinicaltrials.gov/ct2/show/NCT01999946 . SN - 1940-0640 UR - https://www.unboundmedicine.com/medline/citation/31570100/Perceptions_of_extended_release_naltrexone_methadone_and_buprenorphine_treatments_following_release_from_jail_ DB - PRIME DP - Unbound Medicine ER -