Adults with problematic opioid use released from jail: Mutual help groups and medication support contribute to a greater likelihood of opioid abstinence.

Abstract

Although medications for opioid use disorder (MOUD) improve outcomes for persons with opioid use disorder (OUD), it is unclear whether augmentation with mutual help groups (MHGs), such as 12-Step programs, enhances abstinence following jail release. This study examined how MHG and MOUD together affect abstinence in persons with problematic opioid use in the 6 months post-incarceration. We subset to 328 adult participants who completed baseline, 3- and 6-month follow-ups. All screened positive for problematic opioid use upon discharge from jail, primarily in Chicago. Participants reported days of MHG and MOUD participation and days abstinent from illicit opioids. Both supports could be accessed in any combination. Beta-binomial models estimated the effects of MHG and MOUD participation at 3 months on abstinent days at 3 and 6 months, adjusting for relevant baseline factors. At 3 months, each day of MHG participation was associated with + 0.4 days of opioid abstinence. MOUD days showed a similar effect (+0.3 abstinent days). At 6 months, 3-month MHG and MOUD days continued to predict greater abstinence to a smaller degree (+0.3 and +0.1 days, respectively). Together, MHGs were associated with greater abstinence only among individuals receiving low levels of MOUD at 3-months. No MHG×MOUD interaction was observed at 6-months. Our findings highlight the benefits of incorporating MHGs and MOUD to support abstinence from illicit opioids while extending prior work to a predominately Black, post-incarceration sample. Further research should examine factors influencing the combined effects of MHG and MOUD participation.