![Sample our Behavioral Sciences journals, sign in here to start your access, latest two full volumes FREE to you for 14 days]({"type":"image" , "src" : "/sda/110801/TOC-Subject-Sample-2021-Behavioral-Sciences.jpg"})
ABSTRACT
Background: Alcohol and opioid use disorders are common among adults under community supervision. Although several medications (medication-assisted treatment or MAT) are Food and Drug Administration (FDA)-approved to treat such disorders, they are underutilized with this population despite established effectiveness at decreasing substance use. This paper examines how community correctional agents' understanding of addiction and views of MAT influence their professional actions regarding addiction medications. Methods: A total of 118 semistructured qualitative interviews were conducted with community correctional agents taking part in the CJ-DATS MATICCE implementation study across 20 parole/probation offices in 9 US states. Using grounded theory methodology and an iterative analytic approach, issues of role perception, views of MAT, current treatment referral, and community supervision practices were explored. Results: Agents often had limited autonomy to make direct treatment referrals, regardless of their views of MAT, as they were required to follow court orders and their organization's policies and procedures. Within some organizations, community correctional agents held sufficient autonomy to make direct treatment referrals, with agents struggling to reconcile their desire to support their clients who needed MAT with concerns about the abuse potential of opioid agonist medications. Viewing MAT as a “treatment of last resort” was counterbalanced by the view that it was an effective evidence-based practice. Agents described how MAT impacted their ability to supervise clients and how their knowledge and understanding of MAT was directly influenced by watching their clients who were successful or unsuccessful on MAT. Even those agents who were more accepting of MAT were largely unsupportive of it long-term use. Conclusions: Community correctional agents' views of MAT were influenced by their understanding of addiction as well as their experiences supervising clients receiving treatment with medications, but whether or not MAT referrals were made was not always within their control.
Acknowledgments
The authors gratefully acknowledge the qualitative research staff across the CJ-DATS MATICCE study sites as well as the assistance of Drs. Tisha Wiley and Lori Ducharme. We also offer our thanks to the community correctional agents and officers who participated in this study.
Author contributions
Mitchell, Willet, Monico and James contributed to all phases of data collection, analysis, and manuscript preparation. Rudes and Viglioni contributed to data analysis. Schwartz, Gordon, and Friedmann contributed to protocol study design. All authors assisted with manuscript revisions.
Funding
CJ-DATS was funded under a cooperative agreement from the US Department of Health and Human Services, National Institutes of Health, National Institute on Drug Abuse (NIH/NIDA), with support from the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Bureau of Justice Assistance, US Department of Justice. The authors gratefully acknowledge the collaborative contributions by NIDA; the Coordinating Center, AMAR International, Inc.; and the Research Centers participating in CJ-DATS. The Research Centers include Arizona State University and Maricopa County Adult Probation (U01DA025307); University of Connecticut and the Connecticut Department of Correction (U01DA016194); University of Delaware and the New Jersey Department of Corrections (U01DA016230); Friends Research Institute and the Maryland Department of Public Safety Correctional Services Division of Parole and Probation (U01DA025233); University of Kentucky and the Kentucky Department of Corrections (U01DA016205); University of Rhode Island, Rhode Island Hospital and the Rhode Island Department of Corrections (U01DA016191); Texas Christian University and the Illinois Department of Corrections (U01DA016190); Temple University and the Pennsylvania Department of Corrections (U01DA025284); and the University of California at Los Angeles and the Washington State Department of Corrections (U01DA016211). The views and opinions expressed in this report are those of the authors and should not be construed to represent the views of NIDA nor any of the sponsoring organizations, agencies, CJ-DATS partner sites, or the US government. Funding was also provided by NIH/NIDA 5R01DA033391-03 (Principal Investigator [PI]: Mitchell) and NIH/NIDA 5R01DA034258-04 (PI: Mitchell). There are no conflicts of interest to report.
