A Scoping Review of Barriers and Facilitators to Implementation of Medications for Treatment of Opioid Use Disorder within the Criminal Justice System.
A Scoping Review of Barriers and Facilitators to Implementation of Medications for Treatment of Opioid Use Disorder within the Criminal Justice System.
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DOI：
10.1016/j.drugpo.2020.102768
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发表时间：
2020-07
期刊：
影响因子：
--
通讯作者：
Carnavale J
中科院分区：
文献类型：
--
作者：
Grella CE;Ostile E;Scott CK;Dennis M;Carnavale J
旨在解决阿片类药物过量高发生率的政策优先考虑增加获得治疗阿片类药物使用障碍（MOUD）的药物。在刑事司法系统内和/或向涉及司法的人口提供MOUD方面存在着许多障碍。本研究的目的是对关于在刑事司法环境中以及在涉及司法的人群中实施谅解备忘录的同行评审文献进行范围审查。一个系统的搜索过程中确定了53篇论文，解决有关的问题，实施障碍或便利的MOUD在惩教环境或与司法参与的人口，这些编码和定性分析的共同主题。超过一半的论文发表在美国以外（n = 28）;最常见的研究设计是调查或结构化访谈（n = 20）和定性访谈/焦点小组（n = 18）与惩教或治疗人员和被监禁的个人进行。确定了四类障碍和促进因素：体制性、方案性、态度性和系统性。体制障碍通常限制了向涉及司法的个人提供MOUD的能力，这导致了MOUD没有按照临床指南实施的方案做法，往往导致强制退出或治疗不足。这些方案性做法通常导致涉及司法的个人感到厌恶，他们因此对MOUD持负面态度，并不愿意在释放到社区后寻求MOUD治疗。MOUD实施的促进因素包括从培训干预中获得更多的知识和信息，以及在惩教和治疗工作人员中接受MOUD治疗的个人的有利经验。在文献中，很少有系统的促进者与司法参与的个人实施MOUD是显而易见的。在刑事司法环境中和/或与涉及司法的人群一起实施MOUD的障碍是普遍的，多层次的，相互依赖的。需要在协助实施MOUD方面开展更多的工作。
Policies aimed at addressing the high rates of opioid overdose have prioritized increasing access to medications for treatment of opioid use disorder (MOUD). Numerous barriers exist to providing MOUD within the criminal justice system and/or to justice-involved populations. The aim of this study was to conduct a scoping review of the peer-reviewed literature on implementation of MOUD within criminal justice settings and with justice-involved populations. A systematic search process identified 53 papers that addressed issues pertaining to implementation barriers or facilitators of MOUD within correctional settings or with justice-involved populations; these were coded and qualitatively analyzed for common themes. Over half of the papers were published outside of the U.S. (n = 28); the most common study designs were surveys or structured interviews (n = 20) and qualitative interviews/focus groups (n = 18) conducted with correctional or treatment staff and with incarcerated individuals. Four categories of barriers and facilitators were identified: institutional, programmatic, attitudinal, and systemic. Institutional barriers typically limited capacity to provide MOUD to justice-involved individuals, which led to programmatic practices in which MOUD was not implemented following clinical guidelines, often resulting in forcible withdrawal or inadequate treatment. These programmatic practices commonly led to aversive experiences among justice-involved individuals, who consequently espoused negative attitudes about MOUD and were reluctant to seek treatment with MOUD following their release to the community. Facilitators of MOUD implementation included increased knowledge and information from training interventions and favorable prior experiences with individuals being treated with MOUD among correctional and treatment staff. Few systemic facilitators to implementing MOUD with justice-involved individuals were evident in the literature. Barriers to implementing MOUD in criminal justice settings and/or with justice-involved populations are pervasive, multi-leveled, and inter-dependent. More work is needed on facilitators of MOUD implementation.
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影响因子：
3.5
作者：
Friedmann PD;Hoskinson R;Gordon M;Schwartz R;Kinlock T;Knight K;Flynn PM;Welsh WN;Stein LA;Sacks S;O'Connell DJ;Knudsen HK;Shafer MS;Hall E;Frisman LK;Mat Working Group Of CJ-Dats
通讯作者：
Mat Working Group Of CJ-Dats
影响因子：
3.5
作者：
Albizu-Garcia, Carmen E.;Caraballo, Jose Noel;Roman-Badenas, Luis
通讯作者：
Roman-Badenas, Luis
影响因子：
3.5
作者：
Friedmann, Peter D;Ducharme, Lori J;Fenster, Juliane
通讯作者：
Fenster, Juliane
影响因子：
1.4
作者：
Brinkley-Rubinstein, Lauren;Cloud, David H.;Rich, Josiah
通讯作者：
Rich, Josiah
影响因子：
2.3
作者：
Bart G
通讯作者：
Bart G