Impact of long-acting depot buprenorphine post-release from custody– Early findings from the Release Study

Background. People with opioid use disorder are at elevated risk of overdose following release from custody. Opioid agonist treatment (OAT; methadone and buprenorphine) is protective against overdose among other benefits but is resource intensive to administer safely in custodial settings. Modified-release depot buprenorphine (depot-BPN) has been shown to be safe with low risk of diversion in correctional settings and is becoming the preferred OAT formulation in this context. However, it is unknown whether depot-BPN will be as effective as methadone during the high-risk post-release period.

Methods. The Release Study is a 12-month mixed-methods project comprising multiple arms, including a cross-sectional post-release telephone survey of people who received OAT in custody. Data collection is currently ongoing; early findings will be presented. The primary endpoint is retention in OAT while secondary outcomes include substance use post-release, return to custody and psychosocial support. 

Results. Between November 2022- November 2023, 331 men (80%) and women (20%) aged ≥18 were recruited from nine NSW prisons. Their mean age was 36.6 (SD8.5; range 20-64) and 46% identified as Aboriginal or Torres Strait Islander. Follow-up is ongoing but to-date, 70% of eligible participants had been surveyed a median 94 days (IQR 87-126) post-release; 20% had been reincarcerated and completed the survey in custody.

Conclusion. As depot-BPN is being increasingly prescribed in custodial settings world-wide, it is important and timely to understand if retention in treatment post-release is comparable to existing OAT and examine the effectiveness and acceptability of this treatment during the post-release period.