Justice involvement patterns, overdose experiences, and naloxone knowledge among men and women in criminal justice diversion addiction treatment
Justice involvement patterns, overdose experiences, and naloxone knowledge among men and women in criminal justice diversion addiction treatment
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DOI：
10.1186/s12954-019-0317-3
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发表时间：
2019-07-16
影响因子：
4.4
通讯作者：
Bohnert, Amy S. B.
中科院分区：
文献类型：
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作者：
Gicquelais, Rachel E.;Mezuk, Briana;Bohnert, Amy S. B.
背景：接受药物成瘾治疗的人很可能在治疗后经历和/或目睹药物过量，因此可能受益于过量教育和纳洛酮分配(OEND)计划。将个人从刑事司法系统转移到成瘾治疗是一种治疗参与途径，但这些人的OEND需求尚未得到充分描述。方法：我们使用性别分层潜在阶层分析，在2014-2016年间参加刑事司法分流成瘾治疗计划的514名使用阿片类药物(PWUO)的人中，描述了司法参与模式。结果：只有56%的受试者正确地将纳洛酮识别为阿片类药物过量治疗，尽管68%的受试者经历过过量用药，79%的受试者见证了另一个人的过量用药。我们确定了两个潜在正义参与类别：低参与(20.3%的男性，46.5%的女性)，特征是首次逮捕时年龄较大，过去一年的逮捕次数较多，监禁时间较短；高参与程度(79.7%的男性，53.5%的女性)，特征是首次逮捕时年龄较小，终身逮捕和监禁时间较多。司法介入与纳洛酮知识无关。在调整了年龄、种族、教育程度、住房状况、海洛因使用和注射毒品(患病率[95%可信区间]：男性1.5[1.1-2.0])后，个人过量使用纳洛酮的男性参与者更常见地将纳洛酮视为过量治疗。结论：所有刑事司法分流项目中的PWUO都可以受益于OEND，因为参与司法参与的背景和性别都有经历和目击过量的高倾向，以及对纳洛酮了解较低。
Background: Persons in addiction treatment are likely to experience and/or witness drug overdoses following treatment and thus could benefit from overdose education and naloxone distribution (OEND) programs. Diverting individuals from the criminal justice system to addiction treatment represents one treatment engagement pathway, yet OEND needs among these individuals have not been fully described.Methods: We characterized justice involvement patterns among 514 people who use opioids (PWUO) participating in a criminal justice diversion addiction treatment program during 2014-2016 using a gender-stratified latent class analysis. We described prevalence and correlates of naloxone knowledge using quasi-Poisson regression models with robust standard errors.Results: Only 56% of participants correctly identified naloxone as an opioid overdose treatment despite that 68% had experienced an overdose and 79% had witnessed another person overdose. We identified two latent justice involvement classes: low involvement (20.3% of men, 46.5% of women), characterized by older age at first arrest, more past-year arrests, and less time incarcerated; and high involvement (79.7% of men, 53.5% of women), characterized by younger age at first arrest and more lifetime arrests and time incarcerated. Justice involvement was not associated with naloxone knowledge. Male participants who had personally overdosed more commonly identified naloxone as an overdose treatment after adjustment for age, race, education level, housing status, heroin use, and injection drug use (prevalence ratio [95% confidence interval]: men 1.5 [1.1-2.0]).Conclusions: All PWUO in criminal justice diversion programs could benefit from OEND given the high propensity to experience and witness overdoses and low naloxone knowledge across justice involvement backgrounds and genders.