Opioid relapse and MOUD outcomes following civil commitment for opioid use.

Introduction: Opioid use disorder (OUD) continues to present a major public health problem in the United States. Civil commitment for substance use is one mandatory form of treatment for severe opioid use that has become increasingly available in recent years, but empirical data on this approach are lacking. This study examines clinical outcomes of civil commitment in a sample of adults with severe opioid use.

Methods: Participants were 121 persons with opioid use who were interviewed at the point of entry into civil commitment, then followed for 12 weeks after their release.

Results: Prior to civil commitment, this sample exhibited serious substance use characteristics (including high rates of illicit opioid use, other substance use, and injection drug use), as well as mental health problems (diagnoses of depression and anxiety disorders). During follow-up, approximately 41 % of the sample reported at least one illicit opioid use day. More than 64 % of the sample reported at least one day of medication for opioid use disorder (MOUD) receipt, and participants were significantly less likely to use illicit opioids on days that they received MOUDs. No participants died during the follow-up period.

Conclusions: In this sample of persons with severe opioid use, clinical outcomes of civil commitment included illicit opioid relapse as well as varying levels of MOUD uptake. Civil commitment may be a viable method for short-term prevention of overdose for a subset of this vulnerable patient population.