ArticleThe International journal on drug policy2024
Higher methadone dose at time of release from prison predicts linkage to maintenance treatment for people with HIV and opioid use disorder transitioning to the community in Malaysia.
Article in The International journal on drug policy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
What it found
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Interventions to reduce harms related to drug use among people who experience incarceration: systematic review and meta-analysis.The Lancet. Public health · 2024Pooled it
- Prescribing methadone in prison predicts linkage to HIV care after release from prison: A randomized and patient preference trial.The International journal on drug policy · 2025Trial
- Exploring multi-level barriers and human-centered solutions to expand methadone for HIV prevention among people who inject drugs in Kyrgyzstan.Journal of substance use and addiction treatment · 2026Article
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Authors and funding
8 authors.
Funding
Abstract
backgroundIncarcerated people with HIV and opioid-dependence often experience poor post-release outcomes in the absence of methadone maintenance treatment (MMT). In a prospective trial, we assessed the impact of methadone dose achieved within prison on linkage to MMT after release.
methodsFrom 2010 to 2014, men with HIV (N = 212) and opioid dependence before incarceration were enrolled in MMT within 6 months of release from Malaysia's largest prison and followed for 12-months post-release. As a prospective trial, allocation to MMT was at random and later by preference design (predictive nonetheless). MMT dosing was individually targeted to minimally achieve 80 mg/day. Time-to-event analyses were conducted to model linkage to MMT after release.
findingsOf the 212 participants allocated to MMT, 98 (46 %) were prescribed higher dosages (≥80 mg/day) before release. Linkage to MMT after release occurred in 77 (36 %) participants and significantly higher for those prescribed higher dosages (46% vs 28 %; p = 0.011). Factors associated with higher MMT dosages were being married, on antiretroviral therapy, longer incarceration periods, having higher levels of depression, and methadone preference compared to randomization. After controlling for other variables, being prescribed higher methadone dosage (aHR: 2.53, 95 %CI: 1.42-4.49) was the only independent predictor of linkage to methadone after release.
interpretationHigher doses of methadone prescribed before release increased the likelihood of linkage to MMT after release. Methadone dosing should be introduced into international guidelines for treatment of opioid use disorder in prisons and further post-release benefits should be explored.
fundingNational Institute of Drug Abuse (NIDA).
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