Technical violations and infractions are drivers of disengagement from methadone treatment among people with opioid use disorder discharged from Connecticut jails 2014-2018.

IF 3 3区 医学 Q2 SUBSTANCE ABUSE
Phillip Marotta, Alissa Hass, Adam Viera, Molly Doernberg, Russell Barbour, Lauretta E Grau, Robert Heimer
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引用次数: 0

Abstract

Background: We investigated the interaction between arrests for technical violations vs. receiving new charges with receiving community-based methadone treatment on time-to reincarceration (TTR) in a cohort of men with opioid use disorder (OUD) released from custody from two Connecticut jails from 2014 to 2018.

Methods: Hazard ratios (HR) were estimated for time to reincarceration for technical violations/infractions, misdemeanors only, felonies only, and both misdemeanors and felonies after adjusting for age, race/ethnicity, and receiving methadone treatment during incarceration or in the community following release. Moderation analyses tested the hypotheses that the benefits of receiving methadone in jail or the community on TTR were significantly different for people with only technical violations and infractions compared to misdemeanor and felony charges.

Results: In the sample of 788 men who were reincarcerated, 29.4% received technical violations with no new charges (n = 232) with the remainder of the sample receiving new charges consisting of 26.9% new misdemeanor charges, 6.5% felony charges, and 37.2% both felony and misdemeanor charges. Compared to men who received new misdemeanor charges, TTR was significantly shorter among those who received technical violations and infractions with no new charges amounting to a 50% increase in TTR (334.5 days, SD = 321.3 vs. 228.1 days, SD = 308.0, p < 0.001; aHR = 1.5, 95% CI = 1.3, 1.8, p < 0.001). TTR of men who resumed methadone and were charged with a new crime was 50% longer than those who resumed methadone and received technical violations/infractions with no new charges. (230.2 days, SD = 340.2 vs. 402.3 days, SD = 231.3; aHR = 1.5, 95%CI = 1.0, 2.2, p = 0.038).

Conclusions: Reducing technical violations may enhance the benefits of providing community-based methadone following release from incarceration on extending the time between incarcerations during the vulnerable time post-incarceration and reduce the burden on correctional systems.

Abstract Image

Abstract Image

2014-2018年康涅狄格州监狱释放的阿片类药物使用障碍患者中,技术违规和违纪行为是脱离美沙酮治疗的驱动因素。
背景:我们调查了2014年至2018年从康涅狄格州两所监狱获释的阿片类药物使用障碍(OUD)男性队列中,因技术违规被捕与接受新指控和接受社区美沙酮治疗对重新监禁时间(TTR)的交互作用。方法:在对年龄、种族/族裔以及监禁期间或出狱后在社区接受美沙酮治疗等因素进行调整后,估算了技术违规/违规、仅轻罪、仅重罪以及轻罪和重罪的再监禁时间的危险比(HR)。调节分析检验了以下假设:仅有技术违规和违纪行为的人与轻罪和重罪指控的人相比,在监狱或社区接受美沙酮治疗对TTR的益处有显著不同:在 788 名被重新监禁的男性样本中,29.4% 的人受到了技术性违规指控,但没有受到新的指控(n = 232),其余受到新指控的样本中,26.9% 的人受到新的轻罪指控,6.5% 的人受到重罪指控,37.2% 的人同时受到重罪和轻罪指控。与受到新的轻罪指控的男性相比,受到技术性违规和违纪指控的男性的服刑时间明显缩短,而没有受到新指控的男性的服刑时间增加了 50%(334.5 天,SD = 321.3 vs. 228.1 天,SD = 308.0,P 结论:减少技术性违规可能会提高服刑时间,但也可能会降低服刑时间:减少技术性违规可能会提高刑满释放后在社区提供美沙酮的益处,延长刑满释放后脆弱时期的监禁间隔时间,减轻管教系统的负担。
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来源期刊
CiteScore
5.20
自引率
0.00%
发文量
73
审稿时长
19 weeks
期刊介绍: Substance Abuse Treatment, Prevention, and Policy is an open access, peer-reviewed journal that encompasses research concerning substance abuse, with a focus on policy issues. The journal aims to provide an environment for the exchange of ideas, new research, consensus papers, and critical reviews, to bridge the established fields that share a mutual goal of reducing the harms from substance use. These fields include: legislation pertaining to substance use; correctional supervision of people with substance use disorder; medical treatment and screening; mental health services; research; and evaluation of substance use disorder programs.
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