Medication-assisted treatment for opioid use disorders in correctional settings: An ethics review |
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| Institution: | 1. Institute for the Medical Humanities, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, USA;2. Department of Mental Health Law and Policy, University of South Florida, 13301 Bruce B. Downs Boulevard, Tampa, FL 33612, USA;1. Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California at Los Angeles, Los Angeles, CA, USA;2. National Center for AIDS Prevention and Control, Chinese Center for Disease Control and Prevention, Beijing, China;1. Department of Marketing, College of Business at Iowa State University, 3250 Gerdin Building, Ames, IA 50011, United States;2. Department of Applied Economics and Management, Cornell Food and Brand Lab at Cornell University, 15 Warren Hall, Ithaca, NY 14853, United States;1. Department of Health Education and Promotion, East Carolina University, 2302 Carol Belk Building, MS 529, Greenville, NC 27858, USA;2. Department of Health Education and Promotion, East Carolina University, 2206 Carol Belk Building, MS 529, Greenville, NC 27858, USA;3. Department of Criminal Justice, East Carolina University, 239 Rivers Building, Greenville, NC 27858, USA;1. Onassis Cardiac Surgery Center, Athens, Greece;2. London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom;1. Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland;2. Independent Research Consultant, Liverpool, United Kingdom;3. Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland;4. Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland;5. National Institute for Health and Welfare, Helsinki, Finland;6. Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden;7. Helsinki Deaconess Institute, Helsinki, Finland;1. Department of Preventative Medicine, University of California, 550, 16th Street, San Francisco, CA 94143, United States;2. Department of Psychology, University of Dodoma, P.O. Box 259, Dodoma, Tanzania;3. Pangaea Global AIDS, 436, 14th Street, Suite 920, Oakland, CA 94612, United States;4. Department of Psychiatry, Muhimbili University of Health and Allied Sciences, P.O. Box 65293, Dar es Salaam, Tanzania;5. Behavioral and Urban Health Program, RTI International, 351, California St, Suite 500, San Francisco, CA 94104, United States;6. Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States;7. Department of Global Health, University of Washington, Seattle, WA, United States |
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| Abstract: | Opioid use disorders are a pressing health concern that disproportionately impacts the United States (U.S.) correctional population. Medication-assisted treatment (MAT) is an evidence-based standard of care for opioid use disorders. Despite its availability in the community, MAT and MAT medications (buprenorphine and methadone) are largely unavailable and/or inaccessible for the treatment of opioid use disorders in U.S. prisons and jails. Given that the ethical principles have served as justification for limiting access to MAT on “moral” grounds, this article examines the implications of current correctional policies through the ethical principles of: (1) beneficence/non-maleficence; (2) distributive justice (equivalence-of-care); and (3) autonomy (informed consent). Special attention is paid to the five components of informed consent (capacity, disclosure, understanding, voluntariness, and access), as this facet has been used most often to justify policies that limit access to MAT in the past. Findings highlight that these core ethical principles support the adoption of correctional policies that include MAT. Furthermore, our findings demonstrate that autonomy is maximized during the informed consent process when MAT is available as a treatment option. |
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| Keywords: | Prison Jail Ethics Medication-assisted treatment Opioid |
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