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Booty M, 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. J Subst Use Addict Treat 2023; 149:209051. [PMID: 37084815 DOI: 10.1016/j.josat.2023.209051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [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 article 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.
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Affiliation(s)
- Marisa 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
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Oser CB, Harp K, Pullen E, Bunting AM, Stevens-Watkins D, Staton M. African-American Women's Tobacco and Marijuana Use: The Effects of Social Context and Substance Use Perceptions. Subst Use Misuse 2019; 54:873-884. [PMID: 30849266 PMCID: PMC6476643 DOI: 10.1080/10826084.2018.1528464] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Despite the status of tobacco and marijuana as two of the most commonly used substances in the U.S., both have detrimental health and social consequences for disfranchized African-Americans. Substance use may be shaped by social contextual influences from families and peers in African-American communities, and little research has examined perceptions of wrongfulness, harms, and dangers associated with daily tobacco and marijuana use among African-American women. OBJECTIVES This study explores the effects of African-American women's social context and substance use perceptions (wrongfulness/harmfulness/dangerousness) on daily tobacco and marijuana use. METHODS Survey data was collected in-person from 521 African-American women. Multivariate logistic models identified the significant correlates of women's daily use of tobacco and marijuana in the past six months. RESULTS 52.59% of participants reported daily tobacco use and 10.56% used marijuana daily. Multivariate models indicated that women were more likely to be daily tobacco users if they had a family member with a substance use problem or perceived tobacco use to be wrong, harmful, or more dangerous than marijuana. In the models with marijuana as the dependent variable, women who lived with a person who used drugs were more likely to use marijuana daily. Perceiving marijuana use as wrong or harmful to one's health was protective against daily marijuana use. CONCLUSIONS Findings stress the need for prevention and intervention efforts for African-American women that highlight social context influences and promote greater awareness of the health risks associated with daily tobacco and marijuana use.
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Affiliation(s)
- 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,
| | - Kathi Harp
- Department of Health Management & Policy, 111 Washington Ave., College of Public Health Building, University of Kentucky, Lexington, KY 40536
| | - Erin Pullen
- Indiana University Network Science Institute, 1001 E. State Road, Bloomington, IN 47408
| | - Amanda M. Bunting
- Department of Sociology, 1515 Patterson Office Tower, Lexington, KY 40506,
| | - Danelle Stevens-Watkins
- Department of Educational, School, & Counseling Psychology, Center on Drug & Alcohol Research, University of Kentucky, 235 Dickey Hall, Lexington, KY 40506,
| | - Michele Staton
- Department of Behavioral Science, Center on Drug & Alcohol Research, University of Kentucky, 141 Medical Behavioral Science Building, Lexington, KY 40536,
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