# Experiences of People Who Discontinue Long‐Acting Injectable Buprenorphine Treatment Recently Released From Prison in New South Wales, Australia

## TL;DR

This study explores why people recently released from prison in Australia stop using long-acting buprenorphine treatment, highlighting issues like misinformation and lack of support.

## Contribution

The study identifies psychosocial and informational factors affecting retention in long-acting buprenorphine treatment post-prison release.

## Key findings

- Misinformation and lack of treatment education contribute to discontinuation of long-acting buprenorphine.
- Limited transition supports for housing, mental health, and substance use impact treatment retention.
- Patient education and psychosocial supports are crucial for treatment continuation.

## Abstract

Among other benefits, opioid agonist treatment (OAT; methadone and buprenorphine) is protective against overdose for people with opioid use disorder following release from custody. Long‐acting injectable buprenorphine (LAIB) is safe with an apparent low risk of diversion relative to other OAT formulations in correctional settings and may become a preferred OAT formulation in this setting. Factors that influence retention in LAIB post‐release are unknown.

People receiving LAIB in nine New South Wales prisons were consented to participate in a survey designed to explore treatment experiences post‐release. Participants who reported ceasing LAIB within 12 weeks of release were invited to complete an in‐depth interview using a semi‐structured guide via phone or secure videoconference in the community, or in custody if reincarcerated. Interviews were transcribed verbatim, and data analysed using iterative categorisation and thematic analysis.

A total of 31 participants who ceased LAIB within 12 weeks following release from custody were interviewed. Mean age was 34 years (SD 9), 24 were male and 16 identified as Aboriginal People. Key themes regarding treatment cessation were misinformation and lack of treatment education, limited transition supports for housing, mental health and illicit substance use, and changing treatment benefits between the custody and community contexts including illicit substance preferences and side effects.

Numerous personal experiences and psychosocial factors impacted participant motivations and capacity to continue LAIB post‐release. Understanding and addressing these factors is necessary to support treatment retention and increase community‐based program acceptability and continuation in this population.

Misinformation about long‐acting opioid treatment impacts retention.Factors impacting retention in long‐acting opioid treatment were comparable to other pharmacotherapies.Treatment motivation may change post‐release, impacted by illicit substance access.Patient education and psychosocial supports are important for long‐acting opioid treatment continuation.

Misinformation about long‐acting opioid treatment impacts retention.

Factors impacting retention in long‐acting opioid treatment were comparable to other pharmacotherapies.

Treatment motivation may change post‐release, impacted by illicit substance access.

Patient education and psychosocial supports are important for long‐acting opioid treatment continuation.