{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T01:00:56Z","timestamp":1788915656141,"version":"build-2803163510"},"reference-count":46,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,9,19]],"date-time":"2023-09-19T00:00:00Z","timestamp":1695081600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1109009 [project grant]"],"award-info":[{"award-number":["APP1109009 [project grant]"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Connections is a voluntary health program that facilitates access to opioid agonist treatment (OAT) and social services for people with opioid use exiting prison. This study aimed to measure the effectiveness of Connections in reducing recidivism and improving health outcomes for people with a history of opioid use on leaving prison.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort study with quasi\u2010random allocation to the program.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Public adult prisons in New South Wales, Australia, 2008\u20132015.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Adults released from custody with a history of opioid use. Of 5549 eligible releasees, 3973 were allocated to Connections and 1576 to treatment\u2010as\u2010usual.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Outcomes were return\u2010to\u2010custody, all\u2010cause mortality, and OAT participation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Regression analyses on an intention\u2010to\u2010treat basis, and adjusting for baseline propensity scores, comparing patients allocated to Connections versus treatment\u2010as\u2010usual showed no difference in rates of return\u2010to\u2010custody within 2\u2009years (hazard ratio [HR]: 1.01; 95% confidence interval [CI]: 0.92 \u20131.12). Patients allocated to the Connections program were more likely to access OAT (odds ratio [OR]: 1.21; 95% CI: 1.06\u20131.39) and had lower mortality within 28\u2009days of release (0.25% vs. 0.66%; HR: 0.38; 95% CI: 0.14\u20131.03). Differences in mortality did not persist beyond 28\u2009days. Subgroup analyses showed that allocation to Connections was associated with higher risk of return\u2010to\u2010custody within 28\u2009days for Aboriginal and\/or Torres Strait Islander (Indigenous) and female releasees.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The Connections program for people with opioid use exiting prison did not reduce the likelihood of return\u2010to\u2010custody but did facilitate opioid agonist treatment participation on release from prison.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.16339","type":"journal-article","created":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T05:32:46Z","timestamp":1695187966000},"page":"169-179","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effects of the Connections program on return\u2010to\u2010custody, mortality and treatment uptake among people with a history of opioid use: Retrospective cohort study in an Australian prison system"],"prefix":"10.1111","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8718-2753","authenticated-orcid":false,"given":"Elizabeth","family":"Sullivan","sequence":"first","affiliation":[{"name":"College of Health, Medicine and Wellbeing University of Newcastle  Callaghan NSW Australia"},{"name":"Justice Health and Forensic Mental Health Network  Malabar NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem","family":"Zeki","sequence":"additional","affiliation":[{"name":"College of Health, Medicine and Wellbeing University of Newcastle  Callaghan NSW Australia"},{"name":"Justice Health and Forensic Mental Health Network  Malabar NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1651-0614","authenticated-orcid":false,"given":"Stephen","family":"Ward","sequence":"additional","affiliation":[{"name":"Justice Health and Forensic Mental Health Network  Malabar NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juanita","family":"Sherwood","sequence":"additional","affiliation":[{"name":"University of Technology Sydney  Ultimo NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Remond","sequence":"additional","affiliation":[{"name":"College of Health, Medicine and Wellbeing University of Newcastle  Callaghan NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sungwon","family":"Chang","sequence":"additional","affiliation":[{"name":"University of Technology Sydney  Ultimo NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9657-9904","authenticated-orcid":false,"given":"Kypros","family":"Kypri","sequence":"additional","affiliation":[{"name":"College of Health, Medicine and Wellbeing University of Newcastle  Callaghan NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Brown","sequence":"additional","affiliation":[{"name":"University of Technology Sydney  Ultimo NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,19]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Australian Bureau of Statistics (ABS).Prisoners in Australia 2020.2020."},{"key":"e_1_2_11_3_1","unstructured":"Institute for Crime and Justice Policy Research.World Prison Brief: USA.2018."},{"key":"e_1_2_11_4_1","volume-title":"UK Prison Population Statistics.","author":"Sturge G","year":"2020"},{"key":"e_1_2_11_5_1","unstructured":"Institute for Crime and Justice Policy Research.World Prison Brief: Canada.2018."},{"key":"e_1_2_11_6_1","unstructured":"SturgeG TunnicliffeR.UK Prison Population Statistics.2021."},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61053-7"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.111.096370"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/09595230600741198"},{"key":"e_1_2_11_10_1","volume-title":"2015 Network Patient Health Survey Report","author":"Justice Health & Forensic Mental Health Network","year":"2017"},{"key":"e_1_2_11_11_1","unstructured":"BorzyckiM BaldryE.Promoting integration: the provision of prisoner post\u2010release services.Canberra: Australia;2003. 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