Stephanie Villaire, Thomas Sease, Jen Pankow, Ahrein Bennett, Zoe Pulitzer, Laura Hansen, Cynthia Frank, Angela Di Paola, Wayne Lehman, Mark Sanchez, Arista McQuaid, Alysse Schultheis, Brandi Stein, Sandra A Springer, Ank E Nijhawan, Kevin Knight
{"title":"A qualitative examination of barriers and facilitators to HIV prevention and treatment for people involved with the criminal justice system.","authors":"Stephanie Villaire, Thomas Sease, Jen Pankow, Ahrein Bennett, Zoe Pulitzer, Laura Hansen, Cynthia Frank, Angela Di Paola, Wayne Lehman, Mark Sanchez, Arista McQuaid, Alysse Schultheis, Brandi Stein, Sandra A Springer, Ank E Nijhawan, Kevin Knight","doi":"10.1186/s40352-025-00344-6","DOIUrl":"10.1186/s40352-025-00344-6","url":null,"abstract":"<p><strong>Background: </strong>In an effort to address health risks for HIV among justice-involved individuals, linkage to community services for HIV and substance use disorder prevention and treatment is critical. Stakeholder feedback informing the development of interventions aimed at linking individuals to care is paramount to ensuring the success of the intervention. The current study examines focus group data collected as part of a 5-year NIDA-funded project and presents this data within an implementation science framework.</p><p><strong>Methods: </strong>Six focus groups were conducted across four communities in two states. A total of 19 individuals representing 15 agencies, including both corrections and community healthcare providers, participated in the focus groups. A deductive coding strategy was used to code the focus group transcripts using Atlas.ti 9 software. Audio-recorded interviews were transcribed and coded by trained qualitative researchers.</p><p><strong>Results: </strong>The resulting 1,485 quotes were queried and analyzed using the EPIS inner and outer contexts implementation framework for reporting the findings. Inner context themes encompassing organizational characteristics, staffing processes, and leadership highlight the importance of intra-agency communication, as well as the benefit of hiring peer navigators with lived experience. Outer context themes of interest include funding, sociopolitical context, and interorganizational networks, pointing to service barriers related to funding for PrEP and HIV care, legislative regulations, and the importance of communication to connect people with justice involvement to healthcare and other services.</p><p><strong>Conclusions: </strong>Results support the use of both patient navigation and mobile health unit models to connect justice-involved individuals to healthcare. The themes that emerged during the focus groups helped inform the ACTION study protocol, and the focus group process bolstered the connection between the represented agencies. Ultimately, these focus groups provided valuable information about the communities participating in the study and provided key insights regarding study intervention implementation.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, NCT05286879. Registered 25 February 2022. https://clinicaltrials.gov/study/NCT05286879 .</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"37"},"PeriodicalIF":3.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Maternal health and incarceration: advancing pregnancy justice through research.","authors":"Camille Kramer, Denae Bradley, Rebecca J Shlafer, Carolyn Sufrin","doi":"10.1186/s40352-025-00343-7","DOIUrl":"10.1186/s40352-025-00343-7","url":null,"abstract":"<p><p>This paper will review the state of the science on maternal health and incarceration. We will provide a historical context on women, pregnancy, and mothers as it relates to mass incarceration, considering both structural racism and reproductive justice. We will discuss existing research that documents care, treatment, and outcomes of individuals who are incarcerated while pregnant or postpartum in the United States. We will discuss the implications of carceral exposure on birthing people and their families. By synthesizing current research and relevant policies, we will identify gaps that will then inform a research agenda for the next decade, including methods and content, to address inequities in and improve maternal and infant outcomes among pregnant and parenting people exposed to incarceration.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"36"},"PeriodicalIF":3.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Techna Cadet, Katherine S Elkington, Margaret Ryan, Ali Jalali, Gail A Wasserman, Faye S Taxman, Michael L Dennis, Sean M Murphy
{"title":"Correction: The cost of implementing and sustaining an evidence‑based, behavioral‑health electronic screening system in probation departments.","authors":"Techna Cadet, Katherine S Elkington, Margaret Ryan, Ali Jalali, Gail A Wasserman, Faye S Taxman, Michael L Dennis, Sean M Murphy","doi":"10.1186/s40352-025-00339-3","DOIUrl":"10.1186/s40352-025-00339-3","url":null,"abstract":"","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"35"},"PeriodicalIF":3.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aydan Kuluk, Troy Allard, Carleen Thompson, James Ogilvie, Lisa Broidy
{"title":"Examining the timing of mental health contacts across female offending trajectories.","authors":"Aydan Kuluk, Troy Allard, Carleen Thompson, James Ogilvie, Lisa Broidy","doi":"10.1186/s40352-025-00338-4","DOIUrl":"https://doi.org/10.1186/s40352-025-00338-4","url":null,"abstract":"<p><strong>Background: </strong>There is a strong relationship between mental health and female offending, but few studies use longitudinal data to capture the differences in mental health service contact and diagnoses across diverse female offending trajectories. Most studies focus on broad trends, often overlooking how mental health contacts and diagnoses differentially unfold across female offending trajectories. We address this gap by utilising state-wide, linked administrative data for all females registered as born in Queensland (Australia) in 1983 and 1984 to examine the prevalence, timing, and frequency of mental health service contact and diagnoses across distinct female offending trajectories, including comparisons with non-offending females.</p><p><strong>Results: </strong>Females with serious and persistent offending patterns were more likely to have contact with mental health services and receive earlier and more frequent mental health diagnoses than those with low or non-offending patterns. Additionally, females with adult-onset offending patterns were more likely than any other group to contact mental health services before their first recorded offence. Despite a decrease in mental health-related hospital admissions by late adolescence, all offending groups experienced a rise in community mental health contacts as they transitioned into adulthood.</p><p><strong>Conclusions: </strong>This study expands existing evidence by providing insight into the relationship between mental health and female offending trajectories. Our study also provides important implications for policy and practice to improve the mental health and well-being of females involved in the justice system.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"34"},"PeriodicalIF":3.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michele Staton, Megan F Dickson, Mary M Levi, Martha Tillson, Patricia R Freeman, Laura C Fanucchi, J Matthew Webster, Carrie B Oser
{"title":"Overdose education and naloxone distribution among women with a history of OUD transitioning to the community following jail release.","authors":"Michele Staton, Megan F Dickson, Mary M Levi, Martha Tillson, Patricia R Freeman, Laura C Fanucchi, J Matthew Webster, Carrie B Oser","doi":"10.1186/s40352-025-00337-5","DOIUrl":"https://doi.org/10.1186/s40352-025-00337-5","url":null,"abstract":"<p><strong>Background: </strong>The criminal legal system (CLS) provides a critical intervention point for women at high risk for overdose, and the need continues to rise as the number of incarcerated women increases. Effective, targeted prevention interventions to reduce overdose risk for CLS-involved women are needed, such as naloxone distribution. This study describes the overdose education and naloxone distribution (OEND) procedures used in the Kentucky-hub of the Justice Community Opioid Innovation Network (JCOIN).</p><p><strong>Method: </strong>Participants included women incarcerated in nine Kentucky jails (N = 900) who were randomly selected, screened for opioid use disorder, and consented for the study. They were followed three-months following jail release to examine naloxone utilization and overdose experiences.</p><p><strong>Results: </strong>Study findings indicate that about three-quarters (74.4%) of women in this study reported lifetime injection and more than half (54.9%) had a lifetime history of a non-fatal overdose prior to entering jail. About 70% of women reported receiving a study naloxone unit upon jail release, and of those, 30 women reported using the unit during the three-month post-release window. About 4% of the sample reported a non-fatal overdose during this same time period.</p><p><strong>Conclusions: </strong>Incarcerated women in this sample reported a history of behaviors that may signal overdose risk upon release to the community such as injection drug use and non-fatal overdose. Study findings suggest targeted OEND efforts for women in general are desperately needed, and particularly among women at highest risk during community re-entry.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"33"},"PeriodicalIF":3.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mathilde J F van Oudenaren, Anke B Witteveen, Anja J E Dirkzwager, Marit Sijbrandij
{"title":"Acceptability and feasibility of Problem Management Plus to address mental health problems among remand prisoners in the Netherlands: a pilot randomised controlled trial protocol.","authors":"Mathilde J F van Oudenaren, Anke B Witteveen, Anja J E Dirkzwager, Marit Sijbrandij","doi":"10.1186/s40352-025-00341-9","DOIUrl":"10.1186/s40352-025-00341-9","url":null,"abstract":"<p><strong>Background: </strong>Worldwide, the prevalence of mental health problems in prison populations is higher than in the general population. While prisons may provide opportunities to address mental health problems, the prison setting can also include obstacles to the actual delivery of interventions, such as mental health care staff deficiencies. A brief scalable psychological intervention such as the World Health Organization's (WHO) Problem Management Plus (PM +) intervention, which is delivered by trained non-specialists, could be valuable in addressing common mental health problems in the prison setting. The primary aim of the study is to evaluate the feasibility and acceptability of PM + , adapted for use in Dutch remand prisons. The secondary aim is to examine barriers and facilitators for scaling up the adapted version of PM + in the Dutch prison setting.</p><p><strong>Method: </strong>This single-blind pilot randomised controlled trial (RCT) will compare individual PM + with care-as-usual (PM + /CAU) to CAU only. Dutch-speaking remand prisoners (18 years or older; N = 60) who report an elevated level of psychological distress (K10 ≥ 16) will be included. The feasibility of the intervention will be reviewed using different measures such as recruitment success, intervention retention, protocol adherence, number of serious adverse events, and stakeholders' views. Participants will be assessed for self-reported anxiety, depression, self-identified problems, vulnerability for suicide and self-harm behaviour and post-traumatic stress disorder (PTSD) symptoms at baseline, one-week post-intervention and three-month follow-up. The pilot RCT will be followed by a process evaluation. For the process evaluation, stakeholders will be interviewed (N = 25), including 1) RCT participants, 2) PM + helpers, supervisors and trainers, 3) prison professionals, and 4) family members & friends of RCT participants. Data of the process evaluation will be analysed using reflexive thematic analysis.</p><p><strong>Discussion: </strong>This pilot RCT will be the first to study the potential of WHO-developed scalable interventions aimed at reducing mental health problems within (Dutch) prisons. Results from this study could subsequently inform a potential full-powered RCT.</p><p><strong>Trial registration: </strong>This trial is registered on ClinicalTrials.gov (number NCT05927987) on 13/06/2023.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"31"},"PeriodicalIF":3.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A mixed methods evaluation of well-being among incarcerated religious education participants in the United States.","authors":"Robin LaBarbera","doi":"10.1186/s40352-025-00340-w","DOIUrl":"10.1186/s40352-025-00340-w","url":null,"abstract":"<p><strong>Background: </strong>Research suggests that educational programs that impact well-being show the greatest promise for promoting behavioral change and providing incarcerated men and women with the skills necessary to reintegrate into communities successfully. The development of well-being is a key component of such educational programs, as it affords important protective factors in the face of stress and difficulty and improves individuals' chances of stable re-entry to their communities. The Urban Ministry Institute (TUMI) is a faith-based, seminary-level, higher-education program that enhances healthy thinking, prosocial behavior, and positive interpersonal relationships for incarcerated men and women in the United States.</p><p><strong>Methods: </strong>We evaluated well-being among TUMI participants incarcerated in correctional facilities in Texas, Kansas, and among groups of formerly incarcerated TUMI graduates in California, Texas, and Kansas. We conducted focus groups with 109 men and women inside six prisons, and 157 people completed mixed methods surveys, for a total of 266 data points.</p><p><strong>Results: </strong>Qualitative results fell into three primary themes related to well-being, namely healthy thinking patterns, prosocial behavior, and positive interpersonal relationships. Participants completed the Flourishing Scale, reporting agreement with all eight statements, with particularly strong agreement to statements related to healthy thinking patterns.</p><p><strong>Conclusions: </strong>Findings provided support for the growing argument that faith-based correctional education promotes wellbeing, which is a key factor in improving behavior, reducing disciplinary infractions, and preparing incarcerated men and women for successful reintegration into their communities. Overall, this research demonstrates the potential value of providing educational opportunities like TUMI to incarcerated individuals.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"32"},"PeriodicalIF":3.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael E Roettger, Jolene Tan, Brian Houle, Jake M Najman, Tara McGee
{"title":"Parental imprisonment, childhood behavioral problems, and adolescent and young adult cardiometabolic risk: results from a prospective Australian birth cohort study.","authors":"Michael E Roettger, Jolene Tan, Brian Houle, Jake M Najman, Tara McGee","doi":"10.1186/s40352-025-00329-5","DOIUrl":"https://doi.org/10.1186/s40352-025-00329-5","url":null,"abstract":"<p><strong>Objectives: </strong>Recent studies have demonstrated that parental imprisonment (PI) is associated with cardiometabolic risk later in life. However, underlying risk factors for these associations have not previously been explored. Using a life course framework, the present study explores how early childhood emotional and behavioral dysregulation and PI may be associated with progressive cardiometabolic risk factors in adolescence and young adulthood among male and female respondents in an Australian birth cohort.</p><p><strong>Methods: </strong>The study follows a subset of 7,223 live, singleton births from 1981 to 1984 in Brisbane, Australia where data was collected on parental imprisonment at ages 5 & 14 and behaviors from the Child Behavioral Checklist (CBCL) at age 5. Our sample examines 1,884 males and 1,758 females whose mothers completed prenatal, age 5, and age 14 interviews and respondents completed one or more interviews at a health clinic at ages 14, 21, and 30. Multivariate regression was used to examine cross-sectional results, while individual growth models examined longitudinal patterns.</p><p><strong>Results: </strong>Dividing the analysis by sex, we examined how parental imprisonment was potentially mediated or moderated by CBCL subscale measures for aggression, social-attention-thought (SAT) disorders, internalizing, and depression. No associations were found among male respondents. Among female respondents, controlling for these behaviors, there was a significant association between parental imprisonment and higher systolic blood pressure at age 30, while all CBCL measures were found to moderate waist circumference at age 30 and BMI at ages 14, 21, and/or 30. Using individual growth curve modelling, we observed the increased CBCL aggression and SAT scores were increasingly associated with higher BMI as respondents aged in adulthood.</p><p><strong>Conclusions: </strong>Using prospective cohort data, our results suggest that PI and emotional and behavioral dysregulation are associated with BMI, systolic blood pressure, and waist circumference in females, along with potentially increasing levels of cardiometabolic risk, as measured by increased BMI, from age 14 through age 30. The result is suggestive of the importance of examining early emotional/behavioral problems and PI as joint risk factors for developing cardiometabolic risk factors that may progress into cardiometabolic diseases at later stages in the life course.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"29"},"PeriodicalIF":3.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elizabeth M Olsen, Laura B Whiteley, Johanna B Folk, Marina Tolou-Shams, Andrew P Barnett, Daphne Koinis-Mitchell, Larry K Brown
{"title":"The behavioral health needs of legally involved sexual minority female adolescents.","authors":"Elizabeth M Olsen, Laura B Whiteley, Johanna B Folk, Marina Tolou-Shams, Andrew P Barnett, Daphne Koinis-Mitchell, Larry K Brown","doi":"10.1186/s40352-025-00335-7","DOIUrl":"https://doi.org/10.1186/s40352-025-00335-7","url":null,"abstract":"<p><strong>Background: </strong>Sexual minority (SM) female adolescents involved in the legal system experience marginalization and health inequities. This study examined the differences in psychosocial functioning and risk behaviors among legally involved SM and heterosexual female adolescents to better understand their behavioral health needs. We hypothesized that SM females, as individuals at the intersection of two marginalized groups, would demonstrate greater psychiatric symptom severity and engagement in risk behaviors than their heterosexual counterparts.</p><p><strong>Methods: </strong>Adolescents involved in the legal system (N = 423) enrolled in a prospective cohort study and completed baseline surveys assessing their demographics, SM status, psychiatric symptoms, substance use, and engagement in self-injurious, delinquent, and sexual risk behaviors. The responses of SM and heterosexual female adolescents (n = 193) were compared using bivariate and regression analyses.</p><p><strong>Results: </strong>Participants were 12 to 18 years old (M = 14.49, SD = 1.55), ethnoracially diverse, and 38.3% identified as a SM. SM females, as compared to heterosexual females, reported more PTSD and emotional symptoms, difficulties with anger control and personal adjustment, and engagement in substance use, self-injurious, and sexual risk behaviors.</p><p><strong>Conclusion: </strong>Legally involved SM female adolescents in this study had greater psychiatric, substance use, and sexual health treatment needs compared to their heterosexual peers. These findings highlight the need for enhanced understanding of how to effectively support SM female adolescents, including utilization of culturally sensitive and clinically informative screening practices that do not contribute to further discrimination within the legal system. Future work should aim to develop identity-responsive interventions tailored to this population.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"30"},"PeriodicalIF":3.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrea K Finlay, Ekaterina Pivovarova, Mengfei Yu, Christine Timko, Ingrid A Binswanger, David Smelson, Emmeline Taylor, Alex H S Harris
{"title":"Receipt of medications for opioid use disorders among veterans by race/ethnicity and legal involvement: an observational study of electronic health records.","authors":"Andrea K Finlay, Ekaterina Pivovarova, Mengfei Yu, Christine Timko, Ingrid A Binswanger, David Smelson, Emmeline Taylor, Alex H S Harris","doi":"10.1186/s40352-025-00336-6","DOIUrl":"https://doi.org/10.1186/s40352-025-00336-6","url":null,"abstract":"<p><strong>Background: </strong>The Veterans Health Administration has made strides to improve access to medications for opioid use disorder overall. However, quality improvement methods to assess treatment gaps may not sufficiently detect differences in medication access by intersecting patient factors, which may have multiplicative rather than additive effects. This study aimed to determine whether race/ethnicity and legal involvement interact in receipt of medications for opioid use disorder among Veterans Health Administration patients.</p><p><strong>Methods: </strong>Using national electronic health record data from Fiscal Years 2021-2022, we examined the receipt of medications for opioid use disorder among veterans diagnosed with opioid use disorder who received healthcare at Veterans Health Administration facilities (n = 65,883). We conducted a mixed effects multivariable logistic regression model to examine an interaction effect of race/ethnicity and legal involvement with receipt of any medications for opioid use disorder, both unadjusted and adjusted for patient and facility characteristics.</p><p><strong>Results: </strong>In an adjusted logistic regression model, the interaction effect indicated that non-Hispanic Black veterans with legal involvement had the lowest odds of medications for opioid use disorder receipt compared to non-Hispanic White veterans without legal involvement (adjusted odds ratio = 0.67, 95% confidence interval = 0.59-0.77, p <.0001). Non-Hispanic American Indian/Alaska Native patients without legal involvement (adjusted odds ratio = 0.85, 95% confidence interval = 0.73-0.99, p =.04) also had lower odds of receipt of medications for opioid use disorder compared to non-Hispanic White patients without legal involvement. Non-Hispanic White veterans with legal involvement (adjusted odds ratio = 1.07, 95% confidence interval = 1.01-1.14, p =.03) had higher odds of receipt of medications for opioid use disorder compared to non-Hispanic White patients without legal involvement.</p><p><strong>Conclusions: </strong>Veterans Health Administration quality improvement efforts should monitor interacting racial and legal status factors and understand and address patient, clinical, and regulatory barriers to medications for opioid use disorder among Black veterans with legal involvement.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"28"},"PeriodicalIF":3.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}