The impact of financial discharge from methadone maintenance therapy on incarceration.
The impact of financial discharge from methadone maintenance therapy on incarceration.
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DOI：
10.5055/jom.2010.0034
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发表时间：
2010-09
影响因子：
--
通讯作者：
Rich JD
中科院分区：
文献类型：
--
作者：
Zaller ND;Fu JJ;Bazazi AR;Rich JD
作者试图分析接受国家补贴的 MMT 名额的个人和从 MMT 经济上解除的个人之间从美沙酮维持治疗 (MMT) 经济解除和随后参与刑事司法系统之间的关系。作者检查了 18 个月期间所有参与 MMT 补贴时段的个人以及所有因无力支付（经济性解除）从三个 MMT 计划之一中退出的个人的州级客户治疗记录。作者通过国家管理的数据库将这些记录与惩教部的记录进行了交叉引用。研究期间，对照组的个体接受 MMT 的时间较长，接受其他治疗的次数较少。经济上出院组中 81% 的人接受了其他治疗，而对照组中这一比例为 0.3% (p < 0.001)。与对照组相比，在研究期间从 MMT 经济上解除的被监禁人数是对照组的两倍多（67% vs 33%，p < 0.001）。在逻辑回归分析中，与从 MMT 中经济出院的个体相比，对照组中的个体被监禁的几率是 0.26 倍（95% CI：0.09-0.73）。 MMT 已被证明可以减少对刑事司法系统的参与，但 MMT 的成本继续限制其可及性。我们的数据表明，消除费用作为获得 MMT 的障碍可能会延长治疗时间，并最大限度地减少对刑事司法系统的参与。
The authors sought to analyze the relationship between financial discharge from methadone maintenance therapy (MMT) and subsequent involvement in the criminal justice system among individuals receiving state-subsidized MMT slots and individuals who were financially discharged from MMT. The authors examined state-level client treatment records from all individuals who were on a subsidized MMT slot and all individuals who were discharged due to their inability to pay (financial discharge) from one of the three MMT programs during an 18-month period. The authors cross-referenced these records, through a state-managed database, with records of the Department of Corrections. Individuals in the control group had longer durations of stay in MMT and fewer other kinds of treatment admissions during the study period. An 81 percent of individuals in the financially discharged group received other treatment episodes versus 0.3 percent in the control group (p < 0.001). More than twice the number of individuals financially discharged from MMT were incarcerated during the study period when compared with the control group (67 percent vs 33 percent, p < 0.001). In logistic regression analysis, individuals in the control group had 0.26 times the odds of incarceration when compared with individuals financially discharged from MMT (95% CI: 0.09-0.73). MMT has been shown to reduce involvement in the criminal justice system, yet cost of MMT continues to inhibit its accessibility. Our data suggest that removal of cost as a barrier to access MMT may facilitate longer treatment duration and minimize involvement with the criminal justice system.