Opioid Agonist Treatment Recipients within Criminal Justice-Involved Populations

Abstract

Background: In 2014, nearly 2.5 million Americans had a substance use disorder for opioids (e.g., prescription pain medication or heroin) with over half estimated to have had prior contact with the criminal justice system. Despite strong evidence that opioid agonist treatment (OAT) is effective in reducing overdose, increasing treatment retention, and improving physical health and well-being outcomes, the use of OAT among justice-involved individuals is relatively rare. Methods: The current study uses national data of publicly funded admissions to substance abuse treatment to assess the extent to which OAT is used for cases referred to treatment by the criminal justice system. We explore the relationship between demographics, substance use severity, and access to treatment and OAT receipt. Results: Findings indicate that fewer than 6% of criminal justice cases received OAT as part of the treatment plan. Those with daily substance use, comorbid psychiatric problems, prior treatment, females, Latinos, and those who were older and those who were living independently were more likely to receive OAT, as were those living in the Northeast and with government health insurance. Conclusions: Improving the integration of the criminal justice system with substance use treatment programs would improve access to care and potentially reduce multiple health disparities faced by those in the justice system. As criminal justice responses to substance use disorder move toward a public health approach, it is imperative that the criminal justice system consider mechanisms for improving access and referrals to OAT.

Keywords:

• Opioid use disorder
• justice-involved
• medication assisted treatment
• treatment access
• criminal justice
• opioid agonist treatment

Declaration of interest

The authors declare that they have no conflict of interest. The authors alone are responsible for the content and writing of the article.

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes

1 Detox included hospital, residential and ambulatory services; residential included non-detox hospitalization and both long and short-term residential settings; outpatient included intensive and non-intensive outpatient settings.

2 Puerto Rico was the only US Territory to utilize OAT.

3 SPSS does not provide a pooled pseudo R² value, so we reported the range in R² across the 50 imputed datasets.