Evidence map›Paper›PMID 39393533›Full record

ArticleJournal of substance use and addiction treatment2025

"Yeah, this is not going to work for me"-The impact of federal policy restrictions on methadone continuation upon release from jail or prison.

Justin Berk, Cameron Miller, Michael-Evans James, Megan Martin, Josiah Rich, Eliana Kaplowitz, Lauren Brinkley-Rubinstein

Abstract read
In one paragraph

Article in Journal of substance use and addiction treatment, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Justin BerkAlpert Medical School at Brown University, Providence, RI 02905, United States. Electronic address: justin_berk@brown.edu.
Cameron MillerAlpert Medical School at Brown University, Providence, RI 02905, United States.
Michael-Evans JamesAlpert Medical School at Brown University, Providence, RI 02905, United States.
Megan MartinAlpert Medical School at Brown University, Providence, RI 02905, United States.
Josiah RichAlpert Medical School at Brown University, Providence, RI 02905, United States.
Eliana KaplowitzSilberman School of Social Worker at Hunter College, United States.
Lauren Brinkley-RubinsteinDuke University School of Medicine, Department of Population Health Sciences, United States.

Funding

Using Implementation Interventions and Peer Recovery Support to Improve Opioid Treatment Outcomes in Community SupervisionU01DA050442 · NIDA · BROWN UNIVERSITY · PI BRINKLEY-RUBINSTEIN, LAUREN, MARTIN, ROSEMARIE A · 2019 to 2024
$12.6M
Substance Abuse Intervention/Outcome Research TrainingT32DA016184 · NIDA · BROWN UNIVERSITY · PI Damaris J. Rohsenow, JENNIFER W. TIDEY · 2003 to 2026
$6.1M
The Lifespan/Brown Criminal Justice Research Program on Substance Use and HIVR25DA037190 · NIDA · MIRIAM HOSPITAL · PI CURT G BECKWITH · 2014 to 2026
$3.5M
Advancing Health Disparities Research in Aging: The Aging Research in Criminal Justice & Health (ARCH) NetworkR24AG065175 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI LISA C BARRY, BRIE A WILLIAMS · 2019 to 2026
$3.3M
Injectable Extended-Release Buprenorphine (XR-B) in a Correctional Setting: A Pilot Randomized Controlled TrialK23DA055695 · NIDA · RHODE ISLAND HOSPITAL · PI Justin Berk · 2022 to 2026
$1.0M
Evaluating the implementation and impact of a novel medication assisted treatment program in a unified jail and prison systemR21DA044443 · NIDA · MIRIAM HOSPITAL · PI RICH, JOSIAH D · 2017 to 2018
$663k
NIA NIH HHS R24 AG065175NIDA NIH HHS K23 DA055695NIDA NIH HHS R21 DA044443NIDA NIH HHS R25 DA037190NIDA NIH HHS T32 DA016184NIDA NIH HHS U01 DA050442
6 · The paper itself

Abstract

introductionIndividuals impacted by the criminal-legal system face increased risk of opioid overdose. Medications for opioid use disorder (MOUD) provide a life-saving intervention. Multiple barriers prevent access to MOUD, including federal policies regulating opioid treatment programs (OTPs). This study aims to identify how federal policy affects anticipated barriers to methadone treatment access at a high-risk time for opioid mortality: community re-entry after incarceration.

methodsThe study used standard qualitative methods to conduct 40 in-depth-interviews with incarcerated individuals enrolled in the Rhode Island Department of Corrections MOUD treatment program. Semi-structured interviews took place between June and August 2018 and focused on participants' experiences with MOUD and anticipated treatment barriers upon re-entry. A deductive coding framework incorporating the SAMHSA "8-point" criteria for take-home methadone as the a priori codebook and additional identified barriers informed further inductive analysis.

resultsFour themes emerged: (1) logistical hurdles such as transportation and clinic location impeded clinic access; (2) punitive measures within clinics, like dose reduction for rule infractions, discouraged treatment continuation; (3) the environment of methadone clinics often tempted return to use; (4) while the structured nature of methadone treatment provided accountability, it also posed challenges. Federal policies, particularly around daily dosing and "take-home" regulations, exacerbated barriers for those re-entering the community. State and clinic level policies, however, were also identified as direct or exacerbating barriers to treatment access.

conclusionSignificant hurdles persist for methadone access among individuals released from incarceration. Though the federal 8-point criteria have now been replaced with more flexible take-home policies, our findings highlight critical treatment barriers for individuals during the high-risk period of community re-entry. State and clinic level policies also exacerbate many of the barrier-driven themes identified in this analysis. Future work can explore how to best implement the identified benefits of a structured program without forcing the punitive measures that discourage treatment retention. Additional policy reform can help mitigate the effects of other social determinants of health (including transportation access). Ultimately, the many barriers to community methadone treatment retention also apply to individuals involved in the criminal legal system; they can be exacerbated at the federal, state, and clinic policy level.

Indexed as

Health Services AccessibilityMethadoneOpiate Substitution TreatmentOpioid-Related DisordersPrisonersAdultAnalgesics, OpioidFemaleHealth PolicyHumansJailsMaleMiddle AgedPrisonsQualitative ResearchRhode IslandAnalgesics, OpioidMethadoneAddictionCriminal justiceMethadoneOpioid use disorderQualitative

Identifiers

PMID39393533
PMCPMC11624052

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.