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Prospective study of retention in opioid agonist treatment and contact with emergency healthcare following release from prisons in Victoria, Australia

BACKGROUND: People recently released from prison engage with emergency healthcare at greater rates than the general population. While retention in opioid agonist treatment (OAT) is associated with substantial reductions in the risk of opioid-related mortality postrelease, it is unknown how OAT affec...

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Autores principales: Curtis, Michael, Wilkinson, Anna L, Dietze, Paul, Stewart, Ashleigh Cara, Kinner, Stuart A, Cossar, Reece David, Nehme, Emily, Aitken, Campbell, Walker, Shelley, Butler, Tony, Winter, Rebecca J, Smith, Karen, Stoove, Mark
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10176422/
https://www.ncbi.nlm.nih.gov/pubmed/36759173
http://dx.doi.org/10.1136/emermed-2022-212755
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author Curtis, Michael
Wilkinson, Anna L
Dietze, Paul
Stewart, Ashleigh Cara
Kinner, Stuart A
Cossar, Reece David
Nehme, Emily
Aitken, Campbell
Walker, Shelley
Butler, Tony
Winter, Rebecca J
Smith, Karen
Stoove, Mark
author_facet Curtis, Michael
Wilkinson, Anna L
Dietze, Paul
Stewart, Ashleigh Cara
Kinner, Stuart A
Cossar, Reece David
Nehme, Emily
Aitken, Campbell
Walker, Shelley
Butler, Tony
Winter, Rebecca J
Smith, Karen
Stoove, Mark
author_sort Curtis, Michael
collection PubMed
description BACKGROUND: People recently released from prison engage with emergency healthcare at greater rates than the general population. While retention in opioid agonist treatment (OAT) is associated with substantial reductions in the risk of opioid-related mortality postrelease, it is unknown how OAT affects contact with emergency healthcare. In a cohort of men who injected drugs regularly prior to imprisonment, we described rates of contact with ambulance services and EDs, and their associations with use of OAT, in the 3 months after release from prison. METHODS: Self-report data from a prospective observational cohort of men who regularly injected drugs before a period of sentenced imprisonment, recruited between September 2014 and May 2016, were linked to state-wide ambulance and ED records over a 3-month postrelease period in Victoria, Australia. We used generalised linear models to estimate associations between OAT use (none/interrupted/retained) and contact with ambulance and EDs postrelease, adjusted for other covariates. RESULTS: Among 265 participants, we observed 77 ambulance contacts and 123 ED contacts over a median of 98 days of observation (IQR 87–125 days). Participants who were retained in OAT between prison release and scheduled 3-month postrelease follow-up interviews had lower rates of contact with ambulance (adjusted incidence rate ratio (AIRR) 0.33, 95% CI 0.14 to 0.76) and ED (AIRR 0.43, 95% CI 0.22 to 0.83), compared with participants with no OAT use postrelease. Participants with interrupted OAT use did not differ from those with no OAT use in rates of contact with ambulance or ED. CONCLUSION: We found lower rates of contact with emergency healthcare after release among people retained in OAT, but not among people reporting interrupted OAT use, underscoring the benefits of postrelease OAT retention. Strategies to improve accessibility and support OAT retention after leaving prison are important for men who inject drugs.
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spelling pubmed-101764222023-05-13 Prospective study of retention in opioid agonist treatment and contact with emergency healthcare following release from prisons in Victoria, Australia Curtis, Michael Wilkinson, Anna L Dietze, Paul Stewart, Ashleigh Cara Kinner, Stuart A Cossar, Reece David Nehme, Emily Aitken, Campbell Walker, Shelley Butler, Tony Winter, Rebecca J Smith, Karen Stoove, Mark Emerg Med J Original Research BACKGROUND: People recently released from prison engage with emergency healthcare at greater rates than the general population. While retention in opioid agonist treatment (OAT) is associated with substantial reductions in the risk of opioid-related mortality postrelease, it is unknown how OAT affects contact with emergency healthcare. In a cohort of men who injected drugs regularly prior to imprisonment, we described rates of contact with ambulance services and EDs, and their associations with use of OAT, in the 3 months after release from prison. METHODS: Self-report data from a prospective observational cohort of men who regularly injected drugs before a period of sentenced imprisonment, recruited between September 2014 and May 2016, were linked to state-wide ambulance and ED records over a 3-month postrelease period in Victoria, Australia. We used generalised linear models to estimate associations between OAT use (none/interrupted/retained) and contact with ambulance and EDs postrelease, adjusted for other covariates. RESULTS: Among 265 participants, we observed 77 ambulance contacts and 123 ED contacts over a median of 98 days of observation (IQR 87–125 days). Participants who were retained in OAT between prison release and scheduled 3-month postrelease follow-up interviews had lower rates of contact with ambulance (adjusted incidence rate ratio (AIRR) 0.33, 95% CI 0.14 to 0.76) and ED (AIRR 0.43, 95% CI 0.22 to 0.83), compared with participants with no OAT use postrelease. Participants with interrupted OAT use did not differ from those with no OAT use in rates of contact with ambulance or ED. CONCLUSION: We found lower rates of contact with emergency healthcare after release among people retained in OAT, but not among people reporting interrupted OAT use, underscoring the benefits of postrelease OAT retention. Strategies to improve accessibility and support OAT retention after leaving prison are important for men who inject drugs. BMJ Publishing Group 2023-05 2023-02-09 /pmc/articles/PMC10176422/ /pubmed/36759173 http://dx.doi.org/10.1136/emermed-2022-212755 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Research
Curtis, Michael
Wilkinson, Anna L
Dietze, Paul
Stewart, Ashleigh Cara
Kinner, Stuart A
Cossar, Reece David
Nehme, Emily
Aitken, Campbell
Walker, Shelley
Butler, Tony
Winter, Rebecca J
Smith, Karen
Stoove, Mark
Prospective study of retention in opioid agonist treatment and contact with emergency healthcare following release from prisons in Victoria, Australia
title Prospective study of retention in opioid agonist treatment and contact with emergency healthcare following release from prisons in Victoria, Australia
title_full Prospective study of retention in opioid agonist treatment and contact with emergency healthcare following release from prisons in Victoria, Australia
title_fullStr Prospective study of retention in opioid agonist treatment and contact with emergency healthcare following release from prisons in Victoria, Australia
title_full_unstemmed Prospective study of retention in opioid agonist treatment and contact with emergency healthcare following release from prisons in Victoria, Australia
title_short Prospective study of retention in opioid agonist treatment and contact with emergency healthcare following release from prisons in Victoria, Australia
title_sort prospective study of retention in opioid agonist treatment and contact with emergency healthcare following release from prisons in victoria, australia
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10176422/
https://www.ncbi.nlm.nih.gov/pubmed/36759173
http://dx.doi.org/10.1136/emermed-2022-212755
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