Examining the Impact of the Innovative Opioid Court Model on Treatment Access and Court Outcomes for Court Participants.

IF 4.2 3区 医学 Q1 SUBSTANCE ABUSE
Katherine S Elkington, Margaret E Ryan, Cale Basaraba, Renald Dambreville, Dan Alschuler, Melanie M Wall, Alejandra Garcia, Monica Christofferson, Howard F Andrews, Edward V Nunes
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引用次数: 0

Abstract

Objective: The opioid intervention court (OIC) is an innovative, pre-plea treatment court to facilitate rapid linkage to medications for opioid use disorder (MOUD) for people at risk of overdose. This study compares participants in OIC and participants with opioid use problems in a traditional drug treatment court model on (i) initiation for any substance use (SU) treatment, (ii) initiation of MOUD, (iii) number of days to MOUD initiation, and (iv) retention in the OIC program/retention on MOUD.

Methods: We used administrative court records from n = 389 OIC and n = 229 drug court participants in 2 counties in New York State. Differences in outcomes by court were assessed using logistic, multinomial, or linear regressions.

Results: After adjusting for current charge severity, gender, race/ethnicity, age, and county, OIC participants were no more likely to initiate any SU treatment but were significantly more likely to initiate MOUD (81.2% OIC vs 45.9% drug court, P < 0.001) and were more quickly linked to any SU treatment (hazard ratio = 1.68, 95% confidence interval = 1.35-2.08) and MOUD (hazard ratio = 4.25, 95% confidence interval = 3.23-5.58) after starting the court. Retention in court/MOUD was higher among drug court participants and may speak to the immediate sanctions (eg, jail) for noncompliance with drug court directives as compared with opioid court, which does not carry such immediate sanctions for noncompliance.

Conclusions: These analyses suggest that the new OIC model can more rapidly link participants to treatment, including MOUD, as compared with traditional drug court model, and may demonstrate improved ability to immediately stabilize and reduce overdose risk in court participants.

研究创新型阿片类药物法庭模式对法庭参与者获得治疗和法庭结果的影响。
目标:阿片类药物干预法庭(OIC)是一种创新性的诉前治疗法庭,旨在帮助有用药过量风险的人快速获得治疗阿片类药物使用障碍(MOUD)的药物。本研究比较了 OIC 参与者和传统戒毒法庭模式下有阿片类药物使用问题的参与者在以下方面的情况:(i) 开始接受任何药物使用(SU)治疗,(ii) 开始接受 MOUD 治疗,(iii) 开始接受 MOUD 治疗的天数,(iv) 在 OIC 项目中的保留时间/在 MOUD 治疗中的保留时间:我们使用了纽约州 2 个县的 389 名 OIC 和 229 名毒品法庭参与者的法庭行政记录。我们使用逻辑、多项式或线性回归评估了不同法院的结果差异:在对当前指控的严重程度、性别、种族/民族、年龄和郡县进行调整后,OIC 参与者启动任何 SU 治疗的可能性并不大,但启动 MOUD 治疗的可能性明显更大(81.2% 的 OIC 与 45.9% 的毒品法庭相比,P < 0.001),而且在开始接受法庭治疗后,他们更快地接受任何 SU 治疗(危险比 = 1.68,95% 置信区间 = 1.35-2.08)和 MOUD 治疗(危险比 = 4.25,95% 置信区间 = 3.23-5.58)。与阿片类药物法庭相比,毒品法庭的参与者在法庭/MOUD中的保留率更高,这可能与不遵守毒品法庭指令会受到立即制裁(如监禁)有关,而阿片类药物法庭不会对不遵守指令的行为进行立即制裁:这些分析表明,与传统的毒品法庭模式相比,新的 OIC 模式能更快地将参与者与治疗(包括 MOUD)联系起来,并能更好地立即稳定和降低法庭参与者的用药过量风险。
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来源期刊
Journal of Addiction Medicine
Journal of Addiction Medicine 医学-药物滥用
CiteScore
6.10
自引率
9.10%
发文量
260
审稿时长
>12 weeks
期刊介绍: The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.
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