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Table 1 Initial modifications to protocol based on focus groups

From: Adaptation of a standard extended-release naltrexone (XR-NTX) protocol for rural re-entering offenders with OUD

 

DOC Protocol

XR-NTX Pilot Adaptations For Research Study

Patient identification

Participant in DOC Substance Abuse Program (SAP), modified therapeutic community during incarceration

Individuals in jail preparing for release; screening protocols to identify transition to supervision in target county and release dates (including court dates and pleas)

Patient eligibility

Only state inmates in state-funded jail and prison SAP programs with OUD who meet eligibility criteria

All individuals (regardless of classification) in one target rural county jail with an OUD transitioning to community supervision in the same county who meet eligibility criteria

OUD and physical dependence determination

Assessment of OUD through state data collection system, includes DSM criteria; negative urine drug screen

Additional tools were included in screening and assessment including DSM5 checklist assessment for OUD, negative opioid urine screen, and Clinical Opioid Withdrawal Scale (COWS) total score indicating no withdrawal

Oral naltrexone dosing, First XR-NTX administration and other ancillary services during incarceration

XR-NTX administered by corrections health care and any ancillary services provided through SAP (during incarceration) after taking 50 mg oral naltrexone once daily for 3 days

XR-NTX administered by one community clinic partner in the jail; session includes counseling and case management. XR-NTX injection given two hours after tolerating single dose of oral naltrexone 12.5 mg

On-going XR-NTX administrations in the community

Referrals made to community providers based on re-entry plan

Second XR-NTX administration scheduled at the clinic [comparison condition] or at the P&P office [experimental condition] (coordinated with report days) based on random assignment

Patient documentation

Medical evaluation results (including laboratory results) and XR-NTX administration notes included in individuals’ medical record at the facility

Medical evaluation results, XR-NTX administration notes, counseling and case management notes recorded on paper forms in the jail and transferred to electronic medical record upon return to the clinic