Testing XR:NTX vs XR:B (Sublocade) (035)

This study is conducting a large multisite trial to compare the effectiveness of extended-release buprenorphine (Sublocade, XR-B) to extended-release naltrexone (XR-NTX). The trial will enroll individuals prior to release from jail and randomize to either medication option. The first dose of medication will be administered prior to release, with an additional 24 weeks of treatment received in the community.

Participating jails are located in Connecticut, Delaware, New Hampshire, New Jersey and Oregon. The study will measure retention in treatment, and opioid and other substance use outcomes between the two medication conditions, as well as a sample of individuals who opt for other treatment options (“treatment as usual”).

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XR:NTX vs XR:B (Brixadi) (034)

This study is conducting a comparative effectiveness trial of extended-release naltrexone (XR-NTX) versus a new extended-release formulation of buprenorphine (Brixadi, XR-B) to treat opioid use disorder (OUD) among justice-involved individuals in ten Maryland county jails.

Participants will be randomly assigned to receive either XR-NTX or XR-B prior to release from jail, followed by six monthly injections while in the community. The goal of the study is to evaluate the effectiveness of the two medications, measure medication adherence, and gather data to inform broader scale-up of medications for opioid use disorder (MOUD) in jails and in the community.

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Evaluation of Massachusetts State-Mandated Pilot of MOUD in Jails (032)

A 2018 Massachusetts law (“Chapter 208”) established a 4-year pilot program to expand the use of all FDA-approved forms of medications for opioid use disorder (MOUD) at five county jails; two additional jails voluntarily joined this pilot. The law stipulates that MOUD be maintained in individuals who were already receiving it prior to detention; initiated prior to release from jail when appropriate; and continued in the community via facilitated linkages to local services after release. The Massachusetts Hub will conduct a longitudinal treatment outcome study of individuals in these jails to examine MOUD initiation, engagement and retention, as well as fatal and non-fatal overdose and recidivism. The study will also identify strategies associated with the successful implementation of MOUD and inform the development of future strategies to address opioid use disorder in jails nationwide.

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