Illicit substance use after release from prison among formerly incarcerated primary care patients: a cross-sectional study
Illicit substance use after release from prison among formerly incarcerated primary care patients: a cross-sectional study
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DOI：
10.1186/s13722-019-0136-6
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发表时间：
2019-02-19
影响因子：
3.7
通讯作者：
Fox, Aaron D.
中科院分区：
文献类型：
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作者：
Chamberlain, Adam;Nyamu, SylviaH;Fox, Aaron D.
背景：在监狱或监狱中，超过80%的人报告说他们一生中使用过非法物质。从监狱释放后，恢复使用药物会带来风险，包括假释撤销、精神健康状况恶化、传染病传播和药物过量。方法：这项横断面研究使用了过渡期诊所网络(TCN)的基线数据，这是一项关于监禁后医疗护理的多点前瞻性纵向队列研究。我们调查了至少有一种慢性健康状况或年龄=50岁的成年人的药物使用情况，他们最近从监禁中获释，并在TCN站点开始护理。我们的主要结果是获释后自己报告的任何非法物质使用(海洛因或其他阿片类药物、可卡因、大麻、安非他明、致幻剂、摇头丸或非法使用处方药)。释放后饮酒是次要结果。结果：在751名参与者中，年龄中位数为47岁，主要为男性(85%)、非白人(47%为黑人，30%为西班牙裔)和假释期(80%)。参与者在出狱后不久报告使用任何非法物质和使用酒精的比例分别为18%和23%。多因素回归分析显示，男性(AOR=3.91，95%CI：1.73~8.81)、与朋友或家人同住(AOR=3.33，95%CI：1.20~9.28)、最近一次服刑年限(AOR=0.93，95%CI：0.89~0.98)、接触TCN前数周(AOR=1.07，95%CI：1.03~1.10)、假释(AOR=0.58)。95%CI：0.34~0.99)，有药物使用障碍(AOR=2.27，95%CI：1.40~3.68)。结论：在出狱后寻求医疗护理的个体中，自我报告的药物使用低于先前报道的监禁后药物使用估计。已知的风险因素，如男性性别和有药物使用障碍，与非法药物使用有关，新的风险因素，如较少监管的住房，也是如此。尽管监禁后使用非法药物可能带来严重后果，但治疗和监测干预措施应针对风险最高的个人。
Background: More than 80% of people in jail or prison report having used illicit substances in their lifetimes. After release from incarceration, resumption of substance use carries risks, including parole revocation, exacerbation of mental health conditions, transmission of infectious diseases, and drug overdose.Methods: This cross-sectional study used baseline data from the Transitions Clinic Network (TCN, www.transitionsclinic.org), a multi-site prospective longitudinal cohort study of post-incarceration medical care. We investigated substance use among adults, with at least one chronic health condition or age >= 50 years, who had been recently released from incarceration and initiated care at a TCN site. Our primary outcome was any self-reported illicit substance use (heroin or other opioids, cocaine, cannabis, amphetamines, hallucinogens, MDMA, or illicit use of prescription medications) following release from incarceration. Alcohol use post-release was a secondary outcome. Using multivariable logistic regression, we also explored factors associated with illicit substance use.Results: Among 751 participants, median age was 47; participants were mostly male (85%), non-white (47% black, 30% Hispanic), and on parole (80%). The proportion of participants reporting any illicit substance use and any alcohol use soon after release from incarceration was 18% and 23%, respectively. In multivariable regression, variables significantly associated with post-release illicit substance use were male gender (aOR = 3.91, 95% CI: 1.73-8.81), housing with friends or family (aOR = 3.33, 95% CI: 1.20-9.28), years incarcerated during latest prison term (aOR = 0.93, 95% CI: 0.89-0.98), weeks elapsed before engagement with TCN (aOR = 1.07, 95% CI: 1.03-1.10), being on parole (aOR = 0.58, 95% CI: 0.34-0.99), and having a drug use disorder (aOR = 2.27, 95% CI: 1.40-3.68).Conclusions: Among individuals seeking medical care after release from incarceration, self-reported substance use was lower than previously reported estimates of post-incarceration substance use. Known risk factors, such as male gender and having a drug use disorder, were associated with illicit substance use, as were novel risk factors, such as less supervised housing. Though illicit substance use post-incarceration can carry severe consequences, treatment and surveillance interventions should be targeted toward individuals with greatest risk.