# Assessing the impact of jail-initiated medication for opioid use disorder: A multisite analysis of the SOMATICS collaborative

## TL;DR

This study examined if starting opioid addiction treatment in jail reduces relapse six months later, but found no significant benefit compared to standard care.

## Contribution

The study combines three trials to evaluate jail-initiated MOUD and patient navigation for opioid use disorder.

## Key findings

- MOUD initiation in jail did not significantly reduce OUD diagnosis six months post-release compared to enhanced treatment-as-usual.
- Adding patient navigation to MOUD also did not significantly reduce OUD diagnosis rates.
- Results suggest the need to improve post-release treatment adherence for MOUD effectiveness.

## Abstract

The objective of this study was to estimate the associations of jail-initiated medication for opioid use disorder (MOUD) and patient navigation (PN) with opioid use disorder (OUD) at 6 months post-release. Three randomized trials (combined N = 330) were combined to assess whether MOUD (extended-release naltrexone or interim methadone) initiated prior to release from jail with or without PN would reduce the likelihood of a DSM-5 diagnosis of OUD 6 months post-release relative to enhanced treatment-as-usual (ETAU). Across the three studies, assignment to MOUD compared to ETAU was not associated with an OUD diagnosis at 6 months post-release (69% vs. 75%, respectively, OR = 0.67, 95% CI: 0.42 to 1.20). Similarly, PN compared to MOUD without PN was not associated with an OUD diagnosis (63% vs 77%, respectively, OR = 0.61, 95% CI: 0.27 to 1.53). Results underscore the need to further optimize the effectiveness of MOUD for patients initiating treatment in jail, beginning with an emphasis on post-release treatment adherence.