Justice involvement patterns, overdose experiences, and naloxone knowledge among men and women in criminal justice diversion addiction treatment.
Adult
Alcoholism
/ rehabilitation
Clinical Competence
Correlation of Data
Criminal Law
/ legislation & jurisprudence
Cross-Sectional Studies
Drug Overdose
/ mortality
Female
Humans
Male
Middle Aged
Naloxone
/ therapeutic use
Narcotic-Related Disorders
/ rehabilitation
Sex Factors
Survival Rate
United States
Addiction treatment
Criminal justice system involvement
Latent class analysis
Naloxone
Opioids
Overdose
Journal
Harm reduction journal
ISSN: 1477-7517
Titre abrégé: Harm Reduct J
Pays: England
ID NLM: 101153624
Informations de publication
Date de publication:
16 07 2019
16 07 2019
Historique:
received:
16
05
2019
accepted:
05
07
2019
entrez:
18
7
2019
pubmed:
18
7
2019
medline:
17
6
2020
Statut:
epublish
Résumé
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. 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. 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]). 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.
Sections du résumé
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.
Identifiants
pubmed: 31311572
doi: 10.1186/s12954-019-0317-3
pii: 10.1186/s12954-019-0317-3
pmc: PMC6636104
doi:
Substances chimiques
Naloxone
36B82AMQ7N
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
46Subventions
Organisme : NIDA NIH HHS
ID : R34 DA035331
Pays : United States
Organisme : NIAID NIH HHS
ID : T32 AI102623
Pays : United States
Organisme : NIDA NIH HHS
ID : DA035331
Pays : United States
Organisme : National Institute of Allergy and Infectious Diseases
ID : AI102623
Pays : International
Références
Drug Alcohol Rev. 2018 May;37(4):457-463
pubmed: 29744979
MMWR Morb Mortal Wkly Rep. 2018 Mar 30;67(12):349-358
pubmed: 29596405
Ann Emerg Med. 2017 Mar;69(3):340-346
pubmed: 27745764
Eur J Epidemiol. 2007;22(7):417-28
pubmed: 17668280
MMWR Morb Mortal Wkly Rep. 2015 Dec 11;64(48):1337-41
pubmed: 26655918
Harv Rev Psychiatry. 2015 Mar-Apr;23(2):76-89
pubmed: 25747921
Int J Drug Policy. 2018 Sep;59:94-97
pubmed: 30075401
Drug Alcohol Depend. 2015 Sep 1;154:283-6
pubmed: 26143300
J Subst Abuse Treat. 2011 Sep;41(2):208-14
pubmed: 21493031
MMWR Morb Mortal Wkly Rep. 2016 Jan 01;64(50-51):1378-82
pubmed: 26720857
Addict Behav. 2018 Nov;86:104-110
pubmed: 29544869
J Subst Abuse Treat. 2016 Oct;69:44-9
pubmed: 27568509
N Engl J Med. 2007 Jan 11;356(2):157-65
pubmed: 17215533
Behav Sci Law. 2017 Sep;35(5-6):396-407
pubmed: 28913835
Am J Public Health. 2015 Nov;105(11):2373
pubmed: 26451757
Addiction. 2016 May;111(5):883-91
pubmed: 26642424
Drug Alcohol Depend. 2008 Apr 1;94(1-3):48-55
pubmed: 18082338
Drug Alcohol Depend. 2012 Jan 1;120(1-3):168-73
pubmed: 21839588
J Addict Med. 2019 Jan/Feb;13(1):61-68
pubmed: 30161038
Int J Epidemiol. 2015 Oct;44(5):1660-72
pubmed: 26228585
Addiction. 2016 Jul;111(7):1177-87
pubmed: 27028542
J Urban Health. 2018 Aug;95(4):584-593
pubmed: 29214435
Drug Alcohol Depend. 2005 Aug 1;79(2):181-90
pubmed: 16002027
Addiction. 2010 Sep;105(9):1545-54
pubmed: 20579009
J Subst Abuse Treat. 2015 Aug;55:15-20
pubmed: 25800105
Am J Epidemiol. 2004 Apr 1;159(7):702-6
pubmed: 15033648
Addiction. 2007 Dec;102(12):1954-9
pubmed: 18031430
Addiction. 2017 Mar;112(3):502-515
pubmed: 27776382
Pain. 2007 Jul;130(1-2):144-56
pubmed: 17493754
BMJ. 2003 May 3;326(7396):959-60
pubmed: 12727768
Ann Intern Med. 2013 Jan 1;158(1):1-9
pubmed: 23277895
J Am Acad Psychiatry Law. 2009;37(4):461-72
pubmed: 20018995
MMWR Morb Mortal Wkly Rep. 2015 Jun 19;64(23):631-5
pubmed: 26086633
Behav Sci Law. 2017 Sep;35(5-6):380-395
pubmed: 29034504
Drug Alcohol Depend. 2015 Aug 1;153:215-20
pubmed: 26091751
Public Health Rep. 2017 Sep/Oct;132(5):563-569
pubmed: 28750193
Addict Behav. 2013 Mar;38(3):1776-81
pubmed: 23254228
Int J Drug Policy. 2017 Aug;46:7-16
pubmed: 28575724
Struct Equ Modeling. 2007;14(4):671-694
pubmed: 19953201
Int J Drug Policy. 2018 Jan;51:27-35
pubmed: 29156400
Drug Alcohol Depend. 2015 Mar 1;148:209-12
pubmed: 25595053
Subst Abus. 2015;36(2):240-53
pubmed: 25774771
Int J Prison Health. 2017 Mar 13;13(1):25-31
pubmed: 28299971
Lancet Public Health. 2017 Mar;2(3):e133-e140
pubmed: 29253386
Ann Emerg Med. 2009 Oct;54(4):618-24
pubmed: 19540622
J Urban Health. 2003 Jun;80(2):220-9
pubmed: 12791798
J Subst Abuse Treat. 2003 Oct;25(3):189-211
pubmed: 14670524