About 4 million people who reported using or abusing prescription opioids or heroin in 2014 also reported being on concurrent arrest or on active probation or parole status. People who report using opioids are much more likely to have been arrested than those who do not.
Opioid agonist treatment, which includes federally approved drugs such as methadone, buprenorphine, and naltrexone, reduces withdrawal symptoms, food cravings, blocks the effects of opioid use, and reduces risk of death by 33%. Yet this treatment among those involved in justice is relatively rare.
Researchers from Florida Atlantic Universityit’s College of Social Work and Criminal Justice and collaborators conducted a study of the differences between those involved in the criminal justice system who received opioid agonist treatment as part of their treatment plan and those who did not. They compared demographics, severity of substance use, and access to treatment and identified predictors of treatment to account for disparities within a criminal justice population in the United States.
The nationally representative database they used included 105,988 admissions referred to criminal justice system treatment who reported heroin Or other opiate as the primary, secondary or tertiary substance used.
The results of the study, published in the journal Substance use and abuse, have shown that less than 6 percent criminal justice records received opioid agonist treatment as part of the treatment plan. Those with daily substance use, comorbid psychiatric conditions, prior treatment, women, Latinos and those who were older, and those who lived independently were more likely to receive this treatment, as were those who lived in the North -Is and with government health insurance.
“The criminal justice system is well positioned to facilitate an individual’s engagement in effective care at multiple points of care, including contact with first responders, case adjudication, sentencing, supervision and reintegration,” said Wendy P. GuastaferroPh.D., Senior Author, Director and Associate Professor, FAU School of Criminology and Criminal Justice. “We know that opioid agonist treatment is linked to better outcomes for those involved in justice, including reduced opioid use, reduced overdose deaths, better treatment uptake, reduced criminal behavior and the costs of crime. However, only a fraction of litigants benefit from this treatment, although its effectiveness no longer needs to be demonstrated.
Among the results of the study:
- The majority of the sample was made up of polydrug users who reported heroin as their drug of choice and had ever received treatment for addiction. Yet treatment with opioid agonists was not part of the treatment plan for the overwhelming majority of these cases (95 percent).
- In 2014, more than 100,000 criminal justice system cases had an opioid use disorder diagnosis, but 15 states did not have a certified opioid treatment program.
- Only 15 percent of US counties reportedly have licensed opioid treatment programs that dispense methadone and nearly half of all US counties do not have a physician licensed to prescribe or dispense buprenorphine.
- The opioid agonist treatment group included more people with government insurance or no insurance compared to those with private insurance.
- Older people had significantly higher odds of receiving treatment compared to young adults. These results provide some support for the idea that treatment is reserved for those most likely to succeed or who are considered more “deserving” of treatment, as age is often associated with a reduction in criminal behavior.
- For women, 5 percent of those who received treatment in their treatment plan were pregnant at admission, compared with 1.5% of those who did not have opioid agonist treatment in their treatment plan.
- Even in states where opioid agonist treatment is available, cases referred from the criminal justice system in the Western and Midwestern regions of the United States were significantly less likely to receive opioid agonist treatment than their counterparts in the northeast.
- Latinos were statistically more likely to receive opioid agonist therapy as part of their treatment plan.
- Almost 26 percent of the study sample were reported for alcohol consumption at admission, but were less likely to participate in an opioid agonist treatment program.
Although widely presented as a problem that affects white people, opioid use has also had a significant and growing impact on non-white communities. Between 2010 and 2018, opioid overdose death increase 355 percent among black people and 218 percent for Hispanic individuals.
“Dismantling barriers to treatment can improve both public health and community safety,” Guastaferro said. “The criminal justice system must reduce regulatory burdens and systemic resistance to opioid agonist treatment while increasing funding for treatment access to effectively serve people with opioid use disorder .”
The other co-authors of the study are Deborah KoetzlePhD, professor, John Jay College of Criminal Justicethe City University of New York; Laura Lutgen-NievesPh.D., Assistant Professor, Department of Criminal Justice, Indiana Southern University; and Brent TeasdalePh.D., professor and president, Department of Criminal Justice Sciences, Illinois State University.
About the College of Social Work and Criminal Justice:
The College of Social Work and Criminal Justice includes the Phyllis & Harvey Sandler School of Social Work and the School of Criminology & Criminal Justice, which collectively offer one doctoral degree, two master’s degree programs, and two undergraduate degree programs; three specialty certificate programs in child protection, healthy aging and addictions; and four graduate certificate programs, including paralegal, legal nurse consultant, dialectical behavior therapy (DBT), and cognitive-behavioral therapy (CBT). The college is also home to a number of research and service centers, including the Child Welfare Institute, Healthy Aging Academy, Bureau of Substance Use Disorder, Mental Health, and Recovery Research; and the Robin Rubin Center for Happiness and Life Improvement. Additionally, more than 300 community agencies from Miami-Dade to Vero Beach have partnered with the College of Social Work & Criminal Justice to provide students with meaningful experience and job-readiness skills in their chosen field. For more information, visit fau.edu/sw-cj.
About Florida Atlantic University:
Florida Atlantic University, established in 1961, officially opened in 1964 as Florida’s fifth public university. Today, the University is home to more than 30,000 undergraduate and graduate students across six campuses located along Florida’s southeast coast. In recent years, the University has doubled its research expenditures and surpassed its peers in student success rates. Through the coexistence of access and excellence, FAU embodies an innovative model where traditional achievement gaps disappear. FAU is designated as a Hispanic-serving institution, ranked among the top public universities by U.S. News & World Report, and as a high-research institution by the Carnegie Foundation for the Advancement of Education. For more information, visit www.fau.edu.
Substance use and abuse
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Beneficiaries of opioid agonist treatment in criminal justice populations
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