Beliefs about medications for opioid use disorder among Florida criminal problem-solving court & dependency court staff
Beliefs about medications for opioid use disorder among Florida criminal problem-solving court & dependency court staff
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DOI：
10.1080/00952990.2020.1807559
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发表时间：
2020-09-21
影响因子：
2.7
通讯作者：
Atkins, Danielle
中科院分区：
文献类型：
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作者：
Andraka-Christou, Barbara;Atkins, Danielle
背景刑事问题解决和依赖(儿童/依赖)法院工作人员将患有阿片类药物使用障碍(OUD)的患者转介给治疗并制定治疗政策。此前，法院工作人员曾报告过对阿片类药物使用障碍(Moud)药物的安全性和有效性的负面看法。MOD优于其他OUD干预措施，严重未得到充分利用，即使在没有行为治疗的情况下也非常有效。目的调查佛罗里达州法院工作人员的Moud信念，探索其与法院类型和工作人员角色的关系。我们还探讨了关于Moud与儿童团聚、咨询、多物质使用和滴定要求的关系的看法。方法我们对先前开发的横断面调查方法进行了修改。我们在佛罗里达州所有解决犯罪问题和依赖法院工作人员中进行了在线调查。Likert量表被问及关于美沙酮、丁丙诺啡和缓释纳曲酮的信念。我们使用描述性统计和Logistic回归分析了调查结果。结果共有154人(占总人数的26%)进行了调查。只有1/3的人认为Moud治疗OUD比非药物治疗更有效。31%的人认为美沙酮治疗会让父母很难重新获得孩子的监护权。解决刑事问题的法庭工作人员更有可能报告对纳曲酮的某些积极信念。只有不到10%的人认为任何穆德都应该在没有咨询的情况下被允许。超过60%的人认为，处方商应该为每个穆德患者制定缩减计划。人们普遍认为纳曲酮比丁丙诺啡更积极，丁丙诺啡比美沙酮更积极。结论需要对法院工作人员进行穆德效能教育。政策制定者应该禁止法院禁止穆德和阻止父母使用穆德的儿童团聚。
Background Criminal problem-solving and dependency (child/dependent) court staff refer clients with opioid use disorder (OUD) to treatment and set treatment policies. Negative beliefs regarding the safety and efficacy of medications for opioid use disorder (MOUD) have previously been reported in court staff. MOUD is superior to other OUD interventions, is severely underutilized, and is highly effective even in the absence of behavioral treatment. Objective We examined Florida court staff MOUD beliefs, exploring associations with court type and staff role. We also explored beliefs about the relationship of MOUD to child reunification, counseling, polysubstance use, and titration requirements. Methods We modified a previously developed cross-sectional survey. We fielded the online survey among all Florida criminal problem-solving and dependency court staff. Likert scale questions were asked about beliefs regarding methadone, buprenorphine, and extended-release naltrexone. We analyzed responses using descriptive statistics and logistic regression. Results 154 individuals (26% of the population) responded. Only 1/3 believed MOUD was more effective for OUD than nonpharmacological treatment. 31% believed methadone treatment makes it difficult for parents to regain child custody. Criminal problem-solving court staff were more likely to report certain positive beliefs about naltrexone. Fewer than 10% felt any MOUD should be permitted without counseling. Over 60% felt prescribers should have tapering plans for each MOUD patient. Beliefs were generally more positive for naltrexone than buprenorphine, and more positive for buprenorphine than methadone. Conclusions Court staff need education about MOUD efficacy. Policymakers should prohibit courts from banning MOUD and from preventing child reunification for parents utilizing MOUD.