1
|
Rázuri EB, Yang Y, Tinius E, Knight DK. Adaptation of a trauma-informed intervention to prevent opioid use among youth in the legal system. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 163:209294. [PMID: 38272116 DOI: 10.1016/j.josat.2024.209294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/24/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
INTRODUCTION Youth in the legal system are at high risk for opioid and other substance use problems and exhibit high rates of trauma exposure. Trauma-focused therapeutic approaches to prevent substance use show promise, but few evidence-based interventions are designed with justice-involved youth in mind. Consequently, implementing trauma-informed, evidence-based interventions within juvenile justice systems is challenging. The current paper describes the systematic adaptation of Trust-Based Relational Intervention (TBRI) as a family-centered substance use prevention program for youth transitioning from secure residential facilities. METHODS The study utilized the ADAPT-ITT methodological framework to adapt TBRI Caregiver Training, an evidence-based, trauma-informed intervention designed to help caregivers support children and youth with histories of trauma. Phases of adaptation included (1) Assessment, (2) Decision, (3) Prototype Development, and (4) Testing and Integration. The adaptation process explored contextual factors (e.g., systems, facilities, and staff) and the needs of the new target population (i.e., youth in the legal system and their caregivers). Adaptations were made to both content (e.g., terminology and activities) and structure (e.g., session duration and delivery setting) with input from participants from the target population, key stakeholders, and content experts. RESULTS The systematic adaptation of the intervention model resulted in a two-phase, four-component intervention package that can be implemented in juvenile justice settings as part of youth reentry services. The primary intervention, delivered while youth are in residential facilities, includes the TBRI Caregiver Curriculum, TBRI Youth & Young Adult Curriculum, and TBRI Nurture Groups. The secondary intervention, delivered after youth transition home, includes the TBRI Family Coaching Curriculum. CONCLUSIONS Utilizing a systematic methodological framework to guide adaptation has implications for developing accessible, culturally relevant, and contextually appropriate interventions. Accounting for contextual factors and population needs can improve the fit of evidence-based interventions for youth in the legal system, facilitating uptake and ultimately improving outcomes for youth at risk for substance use problems. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04678960.
Collapse
Affiliation(s)
- Erin Becker Rázuri
- Karyn Purvis Institute of Child Development, Texas Christian University, United States.
| | - Yang Yang
- Institute of Behavioral Research, Texas Christian University, United States
| | - Elaine Tinius
- Institute of Behavioral Research, Texas Christian University, United States
| | - Danica Kalling Knight
- Karyn Purvis Institute of Child Development, Texas Christian University, United States; Institute of Behavioral Research, Texas Christian University, United States
| |
Collapse
|
2
|
Oser CB, McGladrey M, Booty M, Surratt H, Knudsen HK, Freeman PR, Stevens-Watkins D, Roberts MF, Staton M, Young A, Draper E, Walsh SL. Rapid jail-based implementation of overdose education and naloxone distribution in response to the COVID-19 pandemic. HEALTH & JUSTICE 2024; 12:27. [PMID: 38935213 PMCID: PMC11212218 DOI: 10.1186/s40352-024-00283-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 06/19/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND People incarcerated in jails are highly impacted by the opioid epidemic, and overdose education and naloxone distribution (OEND) is an effective strategy to reduce opioid overdose deaths. This study examines barriers and facilitators of fast-track OEND implementation within the jails in the Wave 1 Kentucky counties of the HEALing Communities Study during the COVID-19 pandemic. METHODS Meeting minutes with jail stakeholders were qualitatively coded using the Practical, Robust Implementation and Sustainability Model (PRISM) as the coding framework. The analysis highlighted the top barriers and facilitators to fast-track OEND implementation within the PRISM framework. RESULTS Space and staffing shortages related to the COVID-19 pandemic, disruptions in interorganizational programming from pandemic-related service suspensions, and a lack of technological solutions (e.g., reliable Internet access) for socially distanced delivery were the top barriers to fast-track OEND implementation. In addition, there were limitations on non-jail staff access to jails during COVID-19. Top facilitators included jail leadership support, the option to prioritize high-risk groups, and the incorporation of OEND processes into existing communications and management software. While the COVID-19 pandemic strained jail infrastructure, jail and partner agency collaboration led to creative implementation strategies for the successful integration of OEND into jail operations. Urban jails were more likely than rural jails to be early adopters of OEND during the public health emergency. CONCLUSIONS Understanding the barriers to and facilitators of OEND within jails will improve implementation efforts seeking to curb opioid overdose deaths. Jail leadership support and interorganizational efforts were key facilitators to implementation; therefore, it is recommended to increase buy-in with multiple agencies to promote success. Challenges brought on by COVID-19 have resulted in a need for innovative solutions for implementation. CLINICAL TRIAL INFORMATION ClinicalTrials.gov, NCT04111939, Submitted 30 September 2019, https://clinicaltrials.gov/study/NCT04111939?titles=HEALing%20Communities%20Study&rank=1 .
Collapse
Affiliation(s)
- Carrie B Oser
- Department of Sociology, Center for Health Equity Transformation, Center on Drug & Alcohol Research, University of Kentucky, 1531 Patterson Office Tower, Lexington, KY, 40506, USA.
| | - Margaret McGladrey
- Department of Health Management and Policy, Center for Innovation in Population Health, University of Kentucky, 111 Washington Avenue, Lexington, KY, 40508, USA
| | - Marisa Booty
- Department of Sociology, University of Kentucky, 1515 Patterson Office Tower, Lexington, KY, 40506, USA
| | - Hilary Surratt
- Department of Behavioral Science, Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY 40508, USA
| | - Hannah K Knudsen
- Department of Behavioral Science, Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY 40508, USA
| | - Patricia R Freeman
- Department of Pharmacy Practice & Science, Center for the Advance of Pharmacy Practice, University of Kentucky, 789 S. Limestone, Lexington, KY 40508, USA
| | - Danelle Stevens-Watkins
- Department of Educational, School, and Counseling Psychology, Center on Drug & Alcohol Research, University of Kentucky, 103 Dickey Hall, Lexington, KY 40506, USA
| | - Monica F Roberts
- Substance Use Priority Research Area, University of Kentucky, 845 Angliana Avenue, Lexington, KY 40508, USA
| | - Michele Staton
- Department of Behavioral Science, Center on Drug & Alcohol Research, University of Kentucky, 1100 Veterans Drive, Medical Behavioral Science Building, Lexington, KY, 40536, USA
| | - April Young
- Department of Epidemiology and Environmental Health, Center on Drug & Alcohol Research, University of Kentucky, 111 Washington Ave, Lexington, KY 40508, USA
| | - Emma Draper
- Department of Psychology, Williams College, 25 Stetson Ct., Williamstown, MA, 01267, USA
| | - Sharon L Walsh
- Department of Behavioral Science, Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY 40508, USA
| |
Collapse
|
3
|
Knudsen HK, Walker DM, Mack N, Kinnard EN, Huerta TR, Glasgow L, Gilbert L, Garner BR, Dasgupta A, Chandler R, Walsh SL, Tin Y, Tan S, Sprunger J, Sprague-Martinez L, Salsberry P, Saucier M, Rudorf M, Rodriguez S, Oser CB, Oga E, Nakayima J, Linas BS, Lefebvre RC, Kosakowski S, Katz RE, Hunt T, Holman A, Holloway J, Goddard-Eckrich D, Fareed N, Christopher M, Aldrich A, Adams JW, Drainoni ML. Reducing perceived barriers to scaling up overdose education and naloxone distribution and medications for opioid use disorder in the United States in the HEALing (helping end addiction long-term®) communities study. Prev Med 2024; 185:108034. [PMID: 38857770 DOI: 10.1016/j.ypmed.2024.108034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND Scaling up overdose education and naloxone distribution (OEND) and medications for opioid use disorder (MOUD) is needed to reduce opioid overdose deaths, but barriers are pervasive. This study examines whether the Communities That HEAL (CTH) intervention reduced perceived barriers to expanding OEND and MOUD in healthcare/behavioral health, criminal-legal, and other/non-traditional venues. METHODS The HEALing (Helping End Addiction Long-Term®) Communities Study is a parallel, wait-list, cluster randomized trial testing the CTH intervention in 67 communities in the United States. Surveys administered to coalition members and key stakeholders measured the magnitude of perceived barriers to scaling up OEND and MOUD in November 2019-January 2020, May-June 2021, and May-June 2022. Multilevel linear mixed models compared Wave 1 (intervention) and Wave 2 (wait-list control) respondents. Interactions by rural/urban status and research site were tested. RESULTS Wave 1 respondents reported significantly greater reductions in mean scores for three outcomes: perceived barriers to scaling up OEND in Healthcare/Behavioral Health Venues (-0.26, 95% confidence interval, CI: -0.48, -0.05, p = 0.015), OEND in Other/Non-traditional Venues (-0.53, 95% CI: - 0.84, -0.22, p = 0.001) and MOUD in Other/Non-traditional Venues (-0.34, 95% CI: -0.62, -0.05, p = 0.020). There were significant interactions by research site for perceived barriers to scaling up OEND and MOUD in Criminal-Legal Venues. There were no significant interactions by rural/urban status. DISCUSSION The CTH Intervention reduced perceived barriers to scaling up OEND and MOUD in certain venues, with no difference in effectiveness between rural and urban communities. More research is needed to understand facilitators and barriers in different venues.
Collapse
Affiliation(s)
- Hannah K Knudsen
- Department of Family and Community Medicine, Ohio State University, Suite 5000, 700 Ackerman Rd, Columbus, OH 43202, USA.
| | - Daniel M Walker
- Department of Family and Community Medicine, Ohio State University, Suite 5000, 700 Ackerman Rd, Columbus, OH 43202, USA.
| | - Nicole Mack
- Center for Official Statistics, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA.
| | - Elizabeth N Kinnard
- Section of Infectious Diseases, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, 801 Massachusetts Avenue, Boston, MA 02118, USA.
| | - Timothy R Huerta
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, Department of Family and Community Medicine, Department of Biomedical Informatics, The Ohio State University, 540 W. Spring St., Columbus, OH 43215, USA.
| | - LaShawn Glasgow
- Center for Program and Policy Evaluation to Advance Community Health, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA.
| | - Louisa Gilbert
- School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA.
| | - Bryan R Garner
- Department of Internal Medicine, The Ohio State University, 2050 Kenny Road Columbus, OH 43221, USA.
| | - Anindita Dasgupta
- School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA.
| | - Redonna Chandler
- National Institute on Drug Abuse, 301 North Stonestreet Ave, Bethesda, MD 20892, USA.
| | - Sharon L Walsh
- Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Room 202, Lexington, KY 40508, USA.
| | - Yjuliana Tin
- General Internal Medicine, University of Colorado School of Medicine, 12631 E 17th Ave Aurora, CO 80045, USA.
| | - Sylvia Tan
- Center for Clinical Research, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA.
| | - Joel Sprunger
- Center for Addiction Research, University of Cincinnati College of Medicine, 3131 Harvey Ave, Suite 204, Cincinnati, OH 45229, USA.
| | | | - Pamela Salsberry
- College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, USA.
| | - Merielle Saucier
- Clinical Addiction Research and Evaluation Unit, Section of General Internal Medicine, Boston Medical Center, 801 Massachusetts Avenue, Boston, MA 02118, USA.
| | - Maria Rudorf
- General Internal Medicine, Boston Medical Center, 801 Massachusetts Avenue, Boston, MA 02118, USA.
| | - Sandra Rodriguez
- School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA.
| | - Carrie B Oser
- Department of Sociology, Center on Drug & Alcohol Research, Center for Health Equity Transformation, University of Kentucky, 1531 Patterson Office Tower, Lexington, KY 40506, USA.
| | - Emmanuel Oga
- Center for Public Health Surveillance and Technology, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA.
| | - Julie Nakayima
- Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY 40508, USA.
| | - Beth S Linas
- Center for Public Health Surveillance and Technology, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA.
| | - R Craig Lefebvre
- Communication Practice Area, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA.
| | - Sarah Kosakowski
- General Internal Medicine, Boston Medical Center, 801 Massachusetts Avenue, Boston, MA 02118, USA.
| | - Rachel E Katz
- Addiction Services, Clinical & Support Options, 8 Atwood Dr Suite 201, Northampton, MA 01060, USA.
| | - Timothy Hunt
- School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA.
| | - Ari Holman
- School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA.
| | - JaNae Holloway
- Center for Clinical Research, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA.
| | - Dawn Goddard-Eckrich
- School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA.
| | - Naleef Fareed
- Biomedical Informatics, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USA.
| | - Mia Christopher
- Center for Public Health Surveillance and Technology, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA.
| | - Alison Aldrich
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, The Ohio State University, Suite 5000, 700 Ackerman Rd, Columbus, OH 43202, USA.
| | - Joella W Adams
- Center for Public Health Surveillance and Technology, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA.
| | - Mari-Lynn Drainoni
- Section of Infectious Diseases, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine/Boston Medical Center, and Department of Health Law, Policy and Management, Boston University School of Public Health, 801 Massachusetts Avenue, Room 2014, Boston, MA, 02118, USA.
| |
Collapse
|
4
|
M FM, Doug LM, Peter F, Vivian F G, Wiley J, P Todd K, William M, Mai P, David S, Tom S, Ryan W, William Z, M YA, Lf CH. Correlates of overdose among 2711 people who use drugs and live in 7 rural US sites. Drug Alcohol Depend 2024; 258:111261. [PMID: 38581919 DOI: 10.1016/j.drugalcdep.2024.111261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 02/29/2024] [Accepted: 03/03/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Overdose rates in rural areas have been increasing globally, with large increases in the United States. Few studies, however, have identified correlates of non-fatal overdose among rural people who use drugs (PWUD). The present analysis describes correlates of nonfatal overdose among a large multistate sample of rural PWUD. METHODS This is a cross-sectional analysis of data gathered via surveys with PWUD recruited through seven Rural Opioid Initiative (ROI) sites. Descriptive analyses were conducted to assess the prevalence of past 30-day overdose. Generalized estimating equations were used to estimate a series of multivariable models quantifying relationships of select factors to past-month overdose; factors were selected using the Risk Environment Framework. RESULTS The multisite sample included 2711 PWUD, 6% of whom reported overdosing in the past 30 days. In the fully adjusted model, houselessness (AOR=2.27, 95%CI[1.48, 3.48]), a positive test result for Hepatitis C infection (AOR=1.73 95%CI[1.18, 2.52]) and heroin/fentanyl use (AOR= 8.58 95%CI [3.01, 24.50]) were associated with an increased risk of reporting past 30-day overdose, while having a high-school education or less was associated with reduced odds of overdose (AOR=0.52, 95% CI[0.37, 0.74]). CONCLUSION As in urban areas, houselessness, Hepatitis C infection, and the use of heroin and fentanyl were significant correlates of overdose. Widespread access to overdose prevention interventions - including fentanyl test strips and naloxone - is critical in this rural context, with particular outreach needed to unhoused populations, people living with Hepatitis C, and people using opioids.
Collapse
Affiliation(s)
- Fadanelli Monica M
- Rollins School of Public Health, 1518 Clifton Dr, Atlanta, GA 30329, USA.
| | | | - Friedmann Peter
- UMass Chan Medical School - Baystate, 3601 Main Street, Springfield, MA 01199, USA
| | - Go Vivian F
- Gillings School of Global Public Health, 135 Dauer Dr, Chapel Hill, NC 27599, USA
| | - Jenkins Wiley
- SIU School of Medicine, 801 N Rutledge St., Springfield, IL 62702, USA
| | - Korthuis P Todd
- Oregon Health & Science University, School of Medicine, 3266 SW Research Dr, Portland, OR 97239, USA
| | - Miller William
- Gillings School of Global Public Health, 135 Dauer Dr, Chapel Hill, NC 27599, USA
| | - Pho Mai
- The University of Chicago Medicine, 5841 S. Maryland Avenue, Chicago, IL 60637, USA
| | - Seal David
- Tulane School of Public Health & Tropical Medicine, 1440 Canal St, New Orleans, LA 70112, USA
| | - Stopka Tom
- Tufts University School of Medicine, Public Health and Community Medicine, 136 Harrison Avenue, Boston, MA 02111, USA
| | - Westergaard Ryan
- University of Wisconsin, School of Medicine and Public Health, 1685 Highland Ave, Madison, WI 53705-2281, USA
| | - Zule William
- Research Triangle Park, 3040 East Cornwallis Road, P.O. Box 12194, NC 27709-2194, USA
| | - Young April M
- University of Kentucky, College of Public Health, 111 Washington Ave., Lexington, KY 40536, USA
| | - Cooper Hannah Lf
- Rollins School of Public Health, 1518 Clifton Dr, Atlanta, GA 30329, USA
| |
Collapse
|
5
|
Boyas JF, Valera P, McCoy L, Woodiwiss J. Residential Instability and Suicidal Ideation Among Persons on Parole. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2023; 67:1526-1546. [PMID: 36896882 DOI: 10.1177/0306624x231159894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Parolees experience numerous barriers that may impact successful reintegration into society. Residential instability may further add to these obstacles, as there may be limited opportunities for housing given their criminal history. The present study aimed to examine the impact of residential instability on suicidal ideation among parolees. Results indicated that residentially stable and unstable individuals had similar risk factors which were significantly associated with suicidality, such as age and having perceived unmet mental health needs. Other risk factors differed among the two groups, highlighting the importance of treatment and preparation for re-entry into society while in the prison setting.
Collapse
|
6
|
McAuley A, Palmateer N, Goldberg DJ, Shivaji T, Ritchie T, Licence K, Carter D, Hutchinson SJ. Increased risk of non-fatal overdose associated with non-prescribed benzodiazepine use in Scotland, UK. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023:104236. [PMID: 37865531 DOI: 10.1016/j.drugpo.2023.104236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/26/2023] [Accepted: 10/09/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Drug-related deaths (DRDs) in Scotland increased for seven years in a row between 2014 and 2020, consolidating Scotland's place at the top of the United Kingdom and European drug-related mortality charts. One of the defining features of this recent and rapid rise has been the role of benzodiazepines, which are now involved in the majority of all DRDs. These deaths are linked to use of non-prescribed, benzodiazepine-type novel psychoactive substances (NPS) which have been identified by the United Nations as a global threat to public health. This study aimed to estimate the prevalence and determinants of non-prescribed benzodiazepine use and its association with recent non-fatal overdose among a national sample of people who inject drugs (PWID). METHODS Data from the 2019-20 Needle Exchange Surveillance Initiative (NESI) was analysed using logistic regression. NESI is a voluntary, anonymous, biennial, cross-sectional, bio-behavioural survey of PWID attending community-based services providing injecting equipment in mainland Scotland. RESULTS Prevalence of non-prescribed benzodiazepine use in the past six months was 52% and significantly associated with age (aOR 0.97, 0.96-0.98), frequent incarceration (aOR 1.29, 1.07-1.57), recent public injecting (aOR 3.25, 2.33-4.55), a recent methadone prescription (aOR 1.87, 1.51-2.33), and a history of benzodiazepine prescription (aOR 1.92, 1.47-2.52). In addition, non-prescribed benzodiazepine use was significantly associated with non-fatal overdose in the past year among PWID (aOR 2.47, 1.90-3.21). CONCLUSION This study found a high prevalence of non-prescribed benzodiazepine use among a national sample of PWID in Scotland. Prevalence was highest among populations known to be at increased risk of drug-related death and use was strongly associated with overdose. These novel findings highlight the scale of the non-prescribed benzodiazepine issue Scotland faces, and the urgency required to expand its harm reduction infrastructure to address this unique element of its overdose crisis.
Collapse
Affiliation(s)
- A McAuley
- Public Health Scotland, Glasgow, UK; School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
| | - N Palmateer
- Public Health Scotland, Glasgow, UK; School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - D J Goldberg
- Public Health Scotland, Glasgow, UK; School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | | | - T Ritchie
- Glasgow Alcohol and Drug Recovery Services, Glasgow, UK
| | | | - D Carter
- Glasgow Alcohol and Drug Recovery Services, Glasgow, UK
| | - S J Hutchinson
- Public Health Scotland, Glasgow, UK; School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| |
Collapse
|
7
|
Sumnall HR, Atkinson AM, Anderson M, McAuley A, Trayner K. How to save a life: Public awareness of a national mass media take home naloxone campaign, and effects of exposure to campaign components on overdose knowledge and responses. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023:104111. [PMID: 37563039 DOI: 10.1016/j.drugpo.2023.104111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/18/2023] [Accepted: 06/20/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Take home naloxone (THN) programmes are effective at reducing opioid related mortality, but require high levels of distribution, including to the general public. Mass media campaigns can be effective in improving public understanding of a topic and encouraging behavior change. Whilst mass media campaigns focusing on naloxone have been developed internationally, there is a lack of research on their potential impact. We investigated the effects of components of a recent national mass media campaign (Scotland, UK) designed to improve public awareness of drug related deaths, and readiness to intervene. METHODS We undertook a cross-sectional online experimental study with a randomized design, conducted with a nationally representative sample. Participants (N = 1551; 52.6% female; age 46.1±16.5 years) were assessed on overdose knowledge and readiness to intervene after presentation of eight combinations of campaign components. RESULTS Compared to a basic campaign description, exposure to all types of campaign component were associated with higher overdose knowledge (p < .001), but not knowledge of what to do in response to an overdose (p = .374), or readiness to intervene (p= .286). The greatest effects were associated with a media rich audio-visual resource (animated video with a popular song on the soundtrack, and narrated by a well-known actor). CONCLUSION Our data suggest that harm reduction is an appropriate topic for large-scale mass media campaigns. However, effects may be limited to knowledge and awareness raising in the general public, and may be related to the types of media used. Audience segmentation is important and more general messaging about drug related deaths may be more appropriate for the majority of audiences.
Collapse
Affiliation(s)
- H R Sumnall
- Public Health Institute, Liverpool John Moores University, Liverpool, UK.
| | - A M Atkinson
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - M Anderson
- Scottish Drugs Forum, Glasgow, UK; MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, UK
| | - A McAuley
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Health Protection Scotland, Glasgow, UK
| | - Kma Trayner
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Health Protection Scotland, Glasgow, UK
| |
Collapse
|
8
|
Booty MD, Harp K, Batty E, Knudsen HK, Staton M, Oser CB. Barriers and facilitators to the use of medication for opioid use disorder within the criminal justice system: Perspectives from clinicians. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 149:209051. [PMID: 37084815 PMCID: PMC10198928 DOI: 10.1016/j.josat.2023.209051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/09/2023] [Accepted: 04/15/2023] [Indexed: 04/23/2023]
Abstract
INTRODUCTION This study examines social service clinicians' (SSCs) perspectives of factors within the criminal justice system that impact justice-involved individuals' use of medications for opioid use disorder (MOUD). Opioid use disorder (OUD) rates are high among justice-involved individuals, and overdose risk is heightened upon release from incarceration. This study is innovative, as it specifically focuses on criminal justice contexts that influence the MOUD continuum of care from the perspective of clinicians working within the criminal justice system. Understanding criminal justice-related facilitators and barriers to MOUD treatment will guide tailored policy intervention to increase MOUD use and promote recovery and remission among justice-involved individuals. METHODS The study completed qualitative interviews with 25 SSCs who are employed by a state department of corrections to provide assessment and referrals to substance use treatment to individuals on community supervision. The study used NVivo software to code the major themes found within each transcribed interview; two research assistants participated in consensus coding to ensure consistency in coding across transcripts. This study focused on the secondary codes that fell under the "Criminal Justice System" primary code, as well as codes that indicated barriers and facilitators to MOUD treatment. RESULTS SSCs cited sentencing time credits as structural facilitators of MOUD treatment; clients sought more information about extended-release naltrexone since time off of their sentence was available if initiated. Support for extended-release naltrexone by officers and judges was often mentioned as an attitudinal facilitator of initiation. Poor intra-agency collaboration among department of corrections agents was an institutional barrier to MOUD. Also, probation and parole officers' stigma surrounding other types of MOUD, specifically buprenorphine and methadone, was an attitudinal barrier to MOUD within the criminal justice system. CONCLUSIONS Future research should examine the effect that time credits have on extended-release naltrexone initiation, considering the wide consensus among SSCs that their clients were motivated to initiate this type of MOUD because of the resulting time off their sentences. Stigma among probation and parole officers and lack of communication within the criminal justice system need to be addressed so that more individuals with OUD may be exposed to life-saving treatments.
Collapse
Affiliation(s)
- Marisa D Booty
- University of Kentucky College of Arts & Sciences, Department of Sociology, 1515 Patterson Office Tower, Lexington, KY 40506, United States of America.
| | - Kathi Harp
- University of Kentucky College of Public Health, Department of Health Management & Policy, 111 Washington Ave, Lexington, KY 40536, United States of America
| | - Evan Batty
- University of Kentucky College of Arts & Sciences, Department of Sociology, 1515 Patterson Office Tower, Lexington, KY 40506, United States of America; University of Kentucky Center on Drug & Alcohol Research, 845 Angliana Ave, Lexington, KY 40508, United States of America
| | - Hannah K Knudsen
- University of Kentucky College of Medicine, Department of Behavioral Science, 109 Medical Behavioral Science Building, Lexington, KY 40536, United States of America; University of Kentucky Center on Drug & Alcohol Research, 845 Angliana Ave, Lexington, KY 40508, United States of America
| | - Michele Staton
- University of Kentucky College of Medicine, Department of Behavioral Science, 109 Medical Behavioral Science Building, Lexington, KY 40536, United States of America; University of Kentucky Center on Drug & Alcohol Research, 845 Angliana Ave, Lexington, KY 40508, United States of America
| | - Carrie B Oser
- University of Kentucky College of Arts & Sciences, Department of Sociology, 1515 Patterson Office Tower, Lexington, KY 40506, United States of America; University of Kentucky Center on Drug & Alcohol Research, 845 Angliana Ave, Lexington, KY 40508, United States of America; University of Kentucky Center for Health Equity Transformation, Suite 460 Healthy Kentucky Research Building, 760 Press Avenue, Lexington, KY 40536, United States of America
| |
Collapse
|
9
|
Ray B, Christian K, Bailey T, Alton M, Proctor A, Haggerty J, Lowder E, Aalsma MC. Antecedents of fatal overdose in an adult cohort identified through administrative record linkage in Indiana, 2015-2022. Drug Alcohol Depend 2023; 247:109891. [PMID: 37120921 DOI: 10.1016/j.drugalcdep.2023.109891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND The United States continues to experience unprecedented rates of overdose mortality and need to identify effective policies or practices that can be implemented. This study aims to measure the prevalence, frequency, timing, and rate of touchpoints that occurred prior to a fatal overdose where communities might intervene. METHODS In collaboration with Indiana state government, we conducted record-linkage of statewide administrative datasets to vital records (January 1, 2015, through August 26, 2022) to identify touchpoints (jail booking, prison release, prescription medication dispensation, emergency department visits, and emergency medical services). We examined touchpoints within 12-months prior to a fatal overdose among an adult cohort and explored variation over time and by demographic characteristics. RESULTS Over the 92-month study period there were 13,882 overdose deaths (89.3% accidental poisonings, X40-X44) in our adult cohort that were record-linked to multiple administrative datasets and revealed nearly two-thirds (64.7%; n=8980) experienced an emergency department visit, the most prevalent touchpoint followed by prescription medication dispensation, emergency medical services responses, jail booking, and prison release. However, with approximately 1 out of every 100 returning citizens dying from drug overdose within 12-months of release, prison release had the highest touchpoint rate followed by emergency medical services responses, jail booking, emergency department visits, and prescription medication dispensation. CONCLUSION Record-linking administrative data from routine practice to vital records from overdose mortality is a viable means of identifying where resources should be situated to reduce fatal overdose, with potential to evaluate the effectiveness of overdose prevention efforts.
Collapse
Affiliation(s)
- Bradley Ray
- RTI International, 3040 Cornwallis Road, Research Triangle Park, NC27709, United States.
| | - Kaitlyn Christian
- Indiana Management Performance Hub, 100 North Senate Avenue, Room N855, Indianapolis, IN46204, United States
| | - Timothy Bailey
- Indiana Management Performance Hub, 100 North Senate Avenue, Room N855, Indianapolis, IN46204, United States
| | - Madison Alton
- Indiana Division of Mental Health and Addiction, 402 West Washington Street W353, Indiana, IN46204, United States
| | - Alison Proctor
- RTI International, 3040 Cornwallis Road, Research Triangle Park, NC27709, United States
| | - John Haggerty
- RTI International, 3040 Cornwallis Road, Research Triangle Park, NC27709, United States
| | - Evan Lowder
- Department of Criminology, Law and Society, George Mason University, 4400 University Drive, 4F4, Fairfax, VA22030, United States
| | - Matthew C Aalsma
- Department of Pediatrics, Indiana University School of Medicine, 340 W. 10th StreetIndianapolisIN46202, United States
| |
Collapse
|
10
|
Parent S, Buttemer S, Philpott J, Moore K. Opioid-related deaths in Kingston, Frontenac, Lennox and Addington in Ontario, Canada: the shadow epidemic. Health Promot Chronic Dis Prev Can 2023; 43:62-72. [PMID: 36794823 PMCID: PMC10026608 DOI: 10.24095/hpcdp.43.2.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
INTRODUCTION In the Kingston, Frontenac, Lennox and Addington (KFL&A) health unit, opioid overdoses are an important preventable cause of death. The KFL&A region differs from larger urban centres in its size and culture; the current overdose literature that is focussed on these larger areas is less well suited to aid in understanding the context within which overdoses take place in smaller regions. This study characterized opioidrelated mortality in KFL&A, to enhance understanding of opioid overdoses in these smaller communities. METHODS We analyzed opioid-related deaths that occurred in the KFL&A region between May 2017 and June 2021. Descriptive analyses (number and percentage) were performed on factors conceptually relevant in understanding the issue, including clinical and demographic variables, as well as substances involved, locations of deaths and whether substances were used while alone. RESULTS A total of 135 people died of opioid overdose. The mean age was 42 years, and most participants were White (94.8%) and male (71.1%). Decedents often had the following characteristics: being currently or previously incarcerated; using substances alone; not using opioid substitution therapy; and having a prior diagnosis of anxiety and depression. CONCLUSION Specific characteristics such as incarceration, using alone and not using opioid substitution therapy were represented in our sample of people who died of an opioid overdose in the KFL&A region. A robust approach to decreasing opioid-related harm integrating telehealth, technology and progressive policies including providing a safe supply would assist in supporting people who use opioids and in preventing deaths.
Collapse
Affiliation(s)
- Stephanie Parent
- Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Samantha Buttemer
- Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Jane Philpott
- Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Kieran Moore
- Ontario Ministry of Health, Toronto, Ontario, Canada
| |
Collapse
|
11
|
Lafferty L, Schroeder S, Marshall AD, Drysdale K, Higgs P, Stoové M, Baldry E, Dietze P, Treloar C. Trust and service engagement among people who inject drugs after release from prison. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 111:103925. [PMID: 36525780 DOI: 10.1016/j.drugpo.2022.103925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Compounding histories of injecting drug use and incarceration can marginalise people engaging with services, making it difficult for them to address their health and social welfare needs, particularly when they navigate community re-entry service supports. Drawing on Hall and colleagues' five components of trust, this paper seeks to understand how trust in service providers fosters (or inhibits) effective service engagement from the perspective of people who inject drugs during the prison post-release period. METHODS Between September 2018 and May 2020, qualitative in-depth interviews were completed with 48 adults (33 men, 15 women) recruited from SuperMIX (a longitudinal cohort study of people with a history of injection drug use in Victoria, Australia). Data relating to service engagement were coded against the five components of trust: competence, fidelity, honesty, global trust, and confidence. RESULTS Reflections of post-release service engagement frequently focused on interactions with community corrections (parole) officers. Depictions of trust were consistently portrayed within the context of negative experiences and deficits, whereby trusting provider relationships and interactions were rarely described. Most participants recounted a stark absence of fidelity (that is, "pursuing a [client's] best interests"), with some participants detailing circumstances in which their vulnerability was purposefully, almost strategically, exploited. These encounters nearly always had the consequence of impeding the participant's positive progression in the post-release integration period. CONCLUSION There is an urgent need to prioritise the client in health and social service delivery in the post-release transition-to-community period and recognise the importance of trust in delivering effective services to people whose life histories make them highly vulnerable to marginalisation.
Collapse
Affiliation(s)
- L Lafferty
- Centre for Social Research in Health, UNSW Sydney, Level 1, Goodsell Building, Sydney NSW 2052, Australia; The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth, Sydney NSW 2052, Australia.
| | - S Schroeder
- Behaviours and Health Risks, Burnet Institute, 85 Commercial Road,, Melbourne VIC 3004, Australia; Department of Epidemiology and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne VIC 3004, Australia
| | - A D Marshall
- Centre for Social Research in Health, UNSW Sydney, Level 1, Goodsell Building, Sydney NSW 2052, Australia; The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth, Sydney NSW 2052, Australia
| | - K Drysdale
- Centre for Social Research in Health, UNSW Sydney, Level 1, Goodsell Building, Sydney NSW 2052, Australia
| | - P Higgs
- Behaviours and Health Risks, Burnet Institute, 85 Commercial Road,, Melbourne VIC 3004, Australia; Department of Public Health, La Trobe University, Plenty Rd, Bundoora VIC 3086, Australia
| | - M Stoové
- Behaviours and Health Risks, Burnet Institute, 85 Commercial Road,, Melbourne VIC 3004, Australia; Department of Epidemiology and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne VIC 3004, Australia
| | - E Baldry
- Division of Equity, Diversity and Inclusion, UNSW Sydney, Sydney NSW 2052, Australia
| | - P Dietze
- Behaviours and Health Risks, Burnet Institute, 85 Commercial Road,, Melbourne VIC 3004, Australia; Department of Epidemiology and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne VIC 3004, Australia; National Drug Research Institute, Curtin University, GPO Box U1987, Perth, WA 6845, Australia
| | - C Treloar
- Centre for Social Research in Health, UNSW Sydney, Level 1, Goodsell Building, Sydney NSW 2052, Australia
| |
Collapse
|
12
|
Scott CK, Grella CE, Dennis ML, Carnevale J, LaVallee R. Availability of best practices for opioid use disorder in jails and related training and resource needs: findings from a national interview study of jails in heavily impacted counties in the U.S. HEALTH & JUSTICE 2022; 10:36. [PMID: 36538121 PMCID: PMC9763789 DOI: 10.1186/s40352-022-00197-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 11/09/2022] [Indexed: 05/17/2023]
Abstract
BACKGROUND Jails are optimal settings in which to screen individuals for opioid use disorders (OUD) and provide needed services, especially medications for OUD (MOUD). This study sought to assess the availability of OUD "best practices" in jails located in counties heavily impacted by opioid overdose in the U.S. and their related training and resource needs. Counties were selected for study inclusion using two indicators of OUD severity: the absolute number and population rate of opioid overdose deaths. Structured interviews were completed with representatives from 185/244 (76%) of targeted counties and 185/250 (74%) of targeted jails in these counties. Ten OUD best practices were identified based on current treatment and practice guidelines. These include: screening for OUD; clinical assessment; medically managed withdrawal; MOUD administration; MOUD for pregnant people; counseling and wrap-around services; collaboration with community providers; assistance with Medicaid/insurance; re-entry services; and overdose prevention. Descriptive analyses examined the provision of any services and average percentage of services endorsed within best-practice categories, association of best-practice availability with community and jail characteristics, and related needs for training and resources. RESULTS Over 70% of jail respondents indicated that some aspects of each of the ten OUD best practices were available within their jails, ranging from 71% using clinical assessment to 96% providing overdose prevention. However, there was considerable variability in the average percentage of items endorsed within each best-practice category, ranging from 38% of items regarding re-entry services to 88% of items regarding medically managed withdrawal. Availability of OUD best practices in jails also varied by community and jail characteristics. Jails reported the highest needs for funding for medication and clinical staff. CONCLUSIONS Policies are needed to address the identified gaps in availability of OUD best practices within jails. Training, technical assistance, and funding are needed to improve clinical capacity of jails to administer MOUD and to ensure continuity of care from jail to community, which are essential to reducing the risk of opioid-related overdose following release.
Collapse
Affiliation(s)
- Christy K. Scott
- Chestnut Health Systems, 221 W. Walton St, Chicago, IL 60610 USA
| | | | | | - John Carnevale
- Carnevale Associates LLC, 4 Belinder Rd, Gaithersburg, MD 20878 USA
| | - Robin LaVallee
- Carnevale Associates LLC, 4 Belinder Rd, Gaithersburg, MD 20878 USA
| |
Collapse
|
13
|
Russell C, Pang M, Nafeh F, Farrell Macdonald S, Derkzen D, Rehm J, Fischer B. Barriers and facilitators to opioid agonist treatment (OAT) engagement among individuals released from federal incarceration into the community in Ontario, Canada. Int J Qual Stud Health Well-being 2022; 17:2094111. [PMID: 35787743 PMCID: PMC9258049 DOI: 10.1080/17482631.2022.2094111] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Introduction Correctional populations with opioid use disorder experience increased health risks during community transition periods. Opioid Agonist Treatment (OAT) can reduce these risks, but retention is a key challenge. This study addresses a knowledge gap by describing facilitators and barriers to OAT engagement among federal correctional populations released into the community in Ontario, Canada. Methods This article describes results from a longitudinal mixed-methods study examining OAT transition experiences among thirty-five individuals released from federal incarceration in Ontario, Canada. Assessments were completed within one year of participants’ release. Data were thematically analyzed. Results The majority (77%) of participants remained engaged in OAT, however, 69% had their release suspended and 49% returned to custody. Key facilitators for OAT engagement included flexibility, positive staff rapport, and structure. Fragmented OAT transitions, financial OAT coverage, balancing reintegration requirements, logistical challenges, and inaccessibility of ‘take-home’ OAT medications were common barriers. Conclusions Post-incarceration transition periods are critical for OAT retention, yet individuals in Ontario experience barriers to OAT engagement that contribute to treatment disruptions and related risks such as relapse and/or re-incarceration. Additional measures to support community OAT transitions are required, including improved discharge planning, amendments to OAT and financial coverage policies, and an expansion of OAT options.
Collapse
Affiliation(s)
- Cayley Russell
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Michelle Pang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Frishta Nafeh
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | | | - Dena Derkzen
- Policy Sector, Research Branch, Correctional Service of Canada, Ottawa, Ontario, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Institute of Medical Science (IMS), University of Toronto, Toronto, Ontario, Canada.,Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Dresden, Germany.,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Benedikt Fischer
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Centre for Applied Research in Mental Health and Addiction (CARMHA), Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada.,Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| |
Collapse
|
14
|
Ford JA, Ortiz K, Schepis TS, McCabe SE. Types of criminal legal system exposure and polysubstance use: Prevalence and correlates among U.S. adults in the National Survey on Drug Use and Health, 2015-2019. Drug Alcohol Depend 2022; 237:109511. [PMID: 35752022 PMCID: PMC10862373 DOI: 10.1016/j.drugalcdep.2022.109511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 05/21/2022] [Accepted: 05/23/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Criminal legal system (CLS) exposed adults experience higher rates of substance use, substance use disorder (SUD), and overdose. As most CLS exposed adults are not incarcerated, it is important to focus on CLS exposure across the carceral continuum. METHODS This research used pooled data from adult respondents (N = 206,314) in the National Survey on Drug Use and Health (2015-2019). Survey weighted descriptive statistics and Poisson regression were used to estimate prevalence of polysubstance use (i.e., concurrent use) across CLS exposure types (i.e., arrest, probation, parole), identifying relevant correlates. RESULTS The prevalence of polysubstance use was higher among CLS exposed adults, and nearly two-thirds of CLS exposed adults who used multiple types of substances indicated having an SUD. Comparing CLS exposure types, polysubstance use was less likely among adults on probation (IRR=0.89, 95%CI=0.84,0.94) or parole (IRR=0.82, 95%CI=0.76,0.87) compared to those arrested. Polysubstance use was also more likely among adults on probation (IRR=1.09, 95%CI =1.01,1.17) compared to those on parole. While some characteristics (i.e., age, ethnicity, SUD) were consistently associated with polysubstance use across types of CLS exposure, other characteristics (i.e., sexual identity, marital status, suicidal ideation) were not. CONCLUSIONS There is heterogeneity in health risks as a function of CLS exposure type. Further research is needed to identify causal mechanisms and differences based on demographic characteristics. Given high levels of polysubstance use across CLS exposure types, a shift towards a more comprehensive approach in substance use epidemiology may facilitate building an evidence-base to maximize treatment related interventions to reduce polysubstance-involved overdoses.
Collapse
Affiliation(s)
- Jason A Ford
- Department of Sociology, University of Central Florida, Orlando, FL, USA; Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI, USA.
| | - Kasim Ortiz
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI, USA; Department of Sociology & Criminology, University of New Mexico, Albuquerque, NM, USA
| | - Ty S Schepis
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI, USA; Department of Psychology, Texas State University, San Marcos, TX, USA
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI, USA; Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA; Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, USA; Institute for Social Research, University of Michigan, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
15
|
Cooper JA, Onyeka I, O'Reilly D, Kirk R, Donnelly M. Record linkage studies of drug-related deaths among former adult prisoners who have been released to the community: a scoping review protocol. BMJ Open 2022; 12:e056598. [PMID: 35351720 PMCID: PMC8966574 DOI: 10.1136/bmjopen-2021-056598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Prisoners often have a complex mix of health and care needs including needs relating to mental and physical ill-health conditions. In addition, substance use disorders are common in prisoners. The transition between prison and community poses risks in terms of a disruption to treatment and care and a deterioration in health. Studies have demonstrated an increased risk of drug-related deaths among former prisoners during the first weeks following release from custody. The aim of this scoping review is to provide an up-to-date account of evidence from record linkage studies about drug-related deaths among former adult prisoners. METHODS AND ANALYSIS This is a protocol for a scoping review. The framework for conducting scoping reviews by Arksey and O'Malley, in addition to the methodology and guidance developed by the Joanna Briggs Institute (JBI) and the JBI Collaboration will be followed. MEDLINE, EMBASE, PsychINFO and Web of Science will be searched for studies from 2011 to 2021 using search terms relating to 'mortality', 'drugs' and 'ex-prisoner'. A preliminary search in MEDLINE identified at least 473 potentially eligible papers. Two authors will independently screen all titles and abstracts for eligibility using the inclusion and exclusion criteria. There will be no geographical restrictions but non-English language papers will be excluded. Data will be extracted using a piloted customised charting form and the findings will be mapped (guided by the population, concept and context inclusion criteria) and grouped by main conceptual categories (including methodology, key findings and gaps in the research). DISCUSSION, ETHICS AND DISSEMINATION This scoping review will identify, map and summarise publicly available sources of research and therefore does not require ethical approval. The results will inform our empirical investigation of ex-prisoner mortality as well as being shared with key stakeholders, disseminated in a peer-reviewed journal and presented at relevant conferences.
Collapse
Affiliation(s)
- Janine A Cooper
- Administrative Data Research Centre Northern Ireland (ADRC NI), Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Belfast, UK
| | - Ifeoma Onyeka
- Administrative Data Research Centre Northern Ireland (ADRC NI), Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Belfast, UK
| | - Dermot O'Reilly
- Administrative Data Research Centre Northern Ireland (ADRC NI), Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Belfast, UK
| | - Richard Kirk
- South Eastern Health and Social Care Trust, Ulster Hospital, Dundonald, UK
| | - Michael Donnelly
- Administrative Data Research Centre Northern Ireland (ADRC NI), Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Belfast, UK
| |
Collapse
|
16
|
Laine R, Myrskylä M, Kaskela T, Pitkänen T. Imprisonment, community sanctions and mortality by cause of death among patients with substance use disorder - a 28-year follow-up using Finnish register data. Drug Alcohol Depend 2022; 232:109327. [PMID: 35123360 DOI: 10.1016/j.drugalcdep.2022.109327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 01/13/2022] [Accepted: 01/18/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND The first few weeks' post-imprisonment are associated with high mortality, particularly among individuals with a history of substance use. Excess risk may vary by societal context due to a range of penal systems and substance use patterns. Using data on Finnish individuals who had sought treatment for substance use, we studied the association between criminal sanctions with cause-specific mortality. METHODS The database contained 10887 individuals who had sought treatment between 1990 and 2009. Their treatment data were combined with register data on imprisonments and community sanctions and weekly mortality between 1992 and 2015. Mortality was analysed using discrete-time survival models. We controlled for age and sociodemographic factors, and analysed whether education, type of substance used and the type of latest sentence modified the associations. FINDINGS Mortality was high in the first two weeks after sanctions (all-cause odds ratio [OR] 2.61, 95% confidence interval [CI] 1.67-4.07; drug-related deaths OR 8.52, 95% CI 4.64-15.7). Excess risk declined over time (OR after 12 weeks: 1.19, 95% CI 1.07-1.31). Most of the excess risk was attributable to external causes. Mortality was low during imprisonment, but not during community sanctions. The patterns were similar by level of education, substance use and the type of latest sentence. CONCLUSIONS Community sanctions were not associated with mortality among people with substance use disorders. Mortality was low during imprisonment, but high post-release. Criminal sanctions should be better utilised as intervention touchpoints and follow-up resources should target prisoners with substance use treatment history to reduce post-release mortality.
Collapse
Affiliation(s)
- Riku Laine
- Centre for Social Data Science, University of Helsinki, Unioninkatu 37 (P.O. Box 54), 00014, Finland; A-Clinic Foundation, Ratamestarinkatu 7A, 00520 Helsinki, Finland; Finnish Youth Research Society, Kumpulantie 3, 00520 Helsinki, Finland.
| | - Mikko Myrskylä
- Centre for Social Data Science, University of Helsinki, Unioninkatu 37 (P.O. Box 54), 00014, Finland; Max Planck Institute for Demographic Research, Konrad-Zuse-Str. 1, 18057 Rostock, Germany; Population Research Unit, University of Helsinki, Unioninkatu 37 (P.O. Box 54), 00014, Finland
| | - Teemu Kaskela
- A-Clinic Foundation, Ratamestarinkatu 7A, 00520 Helsinki, Finland
| | - Tuuli Pitkänen
- A-Clinic Foundation, Ratamestarinkatu 7A, 00520 Helsinki, Finland; Finnish Youth Research Society, Kumpulantie 3, 00520 Helsinki, Finland
| |
Collapse
|
17
|
Developing a cascade of care for opioid use disorder among individuals in jail. J Subst Abuse Treat 2022; 138:108751. [DOI: 10.1016/j.jsat.2022.108751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/25/2022] [Accepted: 02/14/2022] [Indexed: 12/30/2022]
|
18
|
Lin LA, Bonar EE, Zhang L, Girard R, Coughlin LN. Alcohol-involved overdose deaths in US veterans. Drug Alcohol Depend 2022; 230:109196. [PMID: 34894477 PMCID: PMC8714700 DOI: 10.1016/j.drugalcdep.2021.109196] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Alcohol-involved overdose deaths are increasing and often occur with other substances but have been minimally studied compared to other causes of overdose. METHODS We used national Veterans Health Administration (VHA) records linked to National Death Index data from 2012 to 2018 to examine trends in alcohol-related overdose mortality. Patient characteristics and treatment receipt were compared across categories of alcohol overdose deaths (alcohol-only, alcohol+opioids which may include additional substances, and alcohol+other substances without opioids). RESULTS From 2012-2018, 2421 Veterans died from an alcohol-involved overdose (alcohol-only: 868, alcohol+opioids: 1269, alcohol+other substances: 284). The alcohol-involved overdose rate increased 57% during this period. Compared to those who died of an alcohol-only overdose, Veterans who died from alcohol+opioids and alcohol+other substances were more likely Black or Hispanic, and to have an opioid use disorder, but less likely to live in rural areas or to be diagnosed with alcohol use disorder (AUD). Only 32.5% of those who died from alcohol-involved overdose received treatment in a substance use disorder clinic in the year preceding death, compared to 65.1% seen in mental health and 85.7% in primary care. Only 9.5% of Veterans who died from alcohol overdose received medication treatment for AUD and 24.8% received psychotherapy for AUD in the year preceding death. CONCLUSIONS Alcohol overdose is increasing primarily related to overdoses involving opioids and other substances. Most patients did not receive any effective medication or psychotherapy treatments for AUD, suggesting further need to identify those at risk and to target treatment for this vulnerable group in healthcare settings.
Collapse
Affiliation(s)
- Lewei A Lin
- VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Building 16 2800 Plymouth Rd, Ann Arbor, MI 48109, United States; Addiction Center, Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, United States; University of Michigan Injury Prevention Center, 2800 Plymouth Road, Suite B10-G080, Ann Arbor, MI 48109-2800, United States.
| | - Erin E Bonar
- Addiction Center, Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, United States; University of Michigan Injury Prevention Center, 2800 Plymouth Road, Suite B10-G080, Ann Arbor, MI 48109-2800, United States
| | - Lan Zhang
- VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Building 16 2800 Plymouth Rd, Ann Arbor, MI 48109, United States; Addiction Center, Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, United States
| | - Rachel Girard
- VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Building 16 2800 Plymouth Rd, Ann Arbor, MI 48109, United States; Addiction Center, Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, United States
| | - Lara N Coughlin
- Addiction Center, Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, United States; University of Michigan Injury Prevention Center, 2800 Plymouth Road, Suite B10-G080, Ann Arbor, MI 48109-2800, United States
| |
Collapse
|
19
|
Scott CK, Dennis ML, Grella CE, Mischel AF, Carnevale J. The impact of the opioid crisis on U.S. state prison systems. HEALTH & JUSTICE 2021; 9:17. [PMID: 34304335 PMCID: PMC8310396 DOI: 10.1186/s40352-021-00143-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/28/2021] [Indexed: 05/11/2023]
Abstract
BACKGROUND Prior studies have documented limited use of medications to treat opioid use disorders (OUD) for people incarcerated within state prisons in the United States. Using the framework of the criminal justice OUD service cascade, this study interviewed representatives of prison systems in states most heavily impacted by opioid overdose regarding the provision of medications for OUD (MOUD). METHODS A stratified sampling strategy included states with high indicators of opioid-overdose deaths. Two sampling strata targeted states with: 1) OUD overdose rates significantly higher than the per capita national average; or 2) high absolute number of OUD overdose fatalities. Interviews were completed with representatives from 21 of the 23 (91%) targeted states in 2019, representing 583 prisons across these states. Interviews assessed service provision across the criminal justice OUD service cascade, including OUD screening, withdrawal management, MOUD availability and provision, overdose prevention, re-entry services, barriers, and needs for training and technical assistance. RESULTS MOUD (buprenorphine, methadone, or naltrexone) was available in at least one prison in approximately 90% of the state prison systems and all three medications were available in at least one prison in 62% of systems. However, MOUD provision was limited to subsets of prisons within these systems: 15% provided buprenorphine, 9% provided methadone, 36% provided naltrexone, and only 7% provided all three. Buprenorphine and methadone were most frequently provided to pregnant women or individuals already receiving these at admission, whereas naltrexone was primarily used at release. Funding was the most frequently cited barrier for all medications. CONCLUSION Study findings yield a complex picture of how, when, and to whom MOUD is provided across prisons within prison systems in states most heavily impacted by opioid overdose in the United States and have implications for expanding availability.
Collapse
Affiliation(s)
- Christy K. Scott
- Chestnut Health Systems, 221 W. Walton St, Chicago, IL 60610 USA
| | | | | | | | - John Carnevale
- Carnevale Associates LLC, 4 Belinder Rd, Gaithersburg, MD 20878 USA
| |
Collapse
|