A call to action: Contingency management to improve post-release treatment engagement among people with opioid use disorder who are incarcerated.

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ID: 277776
2023
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Abstract
People with opioid use disorder (OUD) are overrepresented in US correctional facilities and experience disproportionately high risk for illicit opioid use and overdose after release. A growing number of correctional facilities offer medication for OUD (MOUD), which is effective in reducing these risks. However, a recent evaluation found that <50% of those prescribed MOUD during incarceration continued MOUD within 30 days after release, demonstrating a need to improve post-release continuity of care. We describe available evidence on contingency management (CM), an intervention wherein patients receive incentives contingent on behavior change, to achieve this goal. A prior systematic review reported strong evidence in support of CM for increasing treatment adherence in MOUD programs, but the trials reviewed did not include incarcerated participants. Research on CM to increase treatment adherence among participants in the criminal justice system is limited with mixed findings. However, in comparison to the trials that supported CM's efficacy in the community, CM trials in the criminal justice system provided smaller rewards with greater delays in the delivery of rewards to patients, which likely contributed to null findings. Indeed, a prior meta-analysis demonstrates a dose-response relationship between the magnitude and immediacy of reward and CM effectiveness. Thus, CM involving larger and more immediately delivered rewards are likely necessary to improve MOUD adherence during the critical period following release from incarceration. Future research on the effectiveness and implementation of CM to improve MOUD retention after release from incarceration is warranted.
Reference Key
klemperer2023apreventive Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Klemperer, Elias M;Evans, Elizabeth A;Rawson, Richard;
Journal Preventive medicine
Year 2023
DOI
10.1016/j.ypmed.2023.107647
URL
Keywords
incarceration reentry opioid use disorder medication assisted treatment contingency management financial incentives criminal justice continuation of care medication for opioid use disorder

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