Correlates of Staff Acceptability of a Novel Telemedicine-Delivered Medications for Opioid Use Disorder Program in a Rural Detention Center

Abstract

Opioid use disorder and related overdose deaths immediately following the post-incarceration period represent a public health crisis in the US. Evidence-based medications are underutilized in jails and detention centers, and nearly non-existent in rural carceral settings. We have previously reported our efforts to address this gap through our established telemedicine-based medications for opioid use disorder (tele-MOUD) program for rural Maryland detention centers, which initiates prophylactic treatment with buprenorphine or naltrexone prior to the vulnerable post-discharge period. But staff acceptance and perceptions are critically important factors in the assurance of program validation. The current study used survey-based methods to capture tele-MOUD acceptability and perceived efficacy and stigma associated with MOUD in one detention center (N=28). Results demonstrated a statistically significant positive correlation between tele-MOUD acceptability and perceptions of MOUD efficacy and a statistically significant negative correlation between acceptability and stigmatizing notions of MOUD. Findings suggest the need for educational interventions to increase awareness of the evidence base demonstrating the efficacy and potency of tele-MOUD treatment. Future research investigating the potential moderating effects of training on staff acceptability of jail based tele-MOUD will support the implementation and sustainability of these lifesaving programs.

Keywords: Jail, Medications for Opioid Use Disorder (MOUD), Telemedicine, Stigma, Carceral Settings

JEL Classification: n/a