对社区矫正和治疗经历的看法:对接受美沙酮门诊治疗的有监禁史者的定性研究。

Substance use & addiction journal Pub Date : 2024-10-01 Epub Date: 2024-03-29 DOI:10.1177/29767342241238837
Marina Gaeta Gazzola, Lindsay M S Oberleitner, Kim Hoffman, Anthony Eller, Lynn M Madden, Ruthanne Marcus, David Oberleitner, Mark Beitel, Emma Thompson, Xiaoying Zheng, Declan T Barry
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引用次数: 0

摘要

背景:人们对接受美沙酮治疗(MT)以治疗阿片类药物使用障碍(OUD)的患者的社区矫正经历知之甚少。我们对目前正在接受门诊美沙酮治疗的有刑事法律系统经历的人对社区矫正和治疗经历的看法进行了定性调查:2017 年 1 月至 12 月,我们招募了 42 名有刑事法律系统涉案史的人,他们在康涅狄格州一家低门槛的非营利组织开设的多家诊所接受门诊 MT 治疗。一个经验丰富的定性研究团队对接受 MT 的个人进行了一对一、面对面的半结构化访谈,了解他们的监禁和治疗经历。参与者填写了一份人口统计数据调查表。访谈使用 NVivo 进行了录音、转录、去标识和独立编码:结果:参与者认为社区矫正系统具有限制性且以禁欲为重点。大多数参与者对社区矫正官员(CCOs)的看法和经历都是积极的,但对社区矫正系统的整体看法和经历都是消极的。参与者认为社区管教人员对 OUD 和 MT 的了解有限。参与者描述了社区管教人员对其 OUD 的各种判断,其中一些人表现出理解和不加评判的态度,而另一些人则被认为带有污名和偏见。很少有参与者指出 CCO 协助他们寻求 MT 或基于社区的药物使用障碍治疗。一些参与者希望改善治疗便利性,但对强迫或强制治疗持否定态度:据我们所知,这是第一项对接受门诊药物治疗的 OUD 患者的社区矫正经历进行研究的定性研究。虽然接受门诊药物治疗的人对社区矫正系统有负面体验,但他们对个别社区矫正人员的看法是积极的。需要采取干预措施,弥补社区管教人员对 OUD 和 MT 知识的不足,以优化对患有 OUD 的缓刑或假释人员的支持。为一些接受社区监管的人员提供 OUD 治疗便利似乎是可取的。
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Perceptions of Community Corrections and Treatment Experience: A Qualitative Study Among People With Incarceration Histories Receiving Outpatient Methadone Treatment.

Background: Community correctional experiences among individuals receiving methadone treatment (MT) for opioid use disorder (OUD) are poorly understood. We qualitatively investigated perceptions of community corrections and treatment experiences among individuals with criminal-legal system experience currently receiving outpatient MT.

Methods: From January to December 2017, we recruited 42 individuals with history of criminal-legal system involvement enrolled in outpatient MT at a low-barrier nonprofit organization operating multiple clinics in Connecticut. An experienced qualitative research team conducted one-to-one, in-person, semistructured interviews about incarceration and treatment experiences with individuals receiving MT. Participants completed a demographics survey. The interviews were audiorecorded, transcribed, de-identified, and independently coded using NVivo.

Results: Participants described the community corrections system as restrictive and abstinence-focused. Most participants described positive perceptions of and experiences with community corrections officers (CCOs), yet described negative perceptions of and experiences with the community corrections system overall. Participants perceived CCOs to have limited knowledge of OUD and MT. Participants described a range of CCO judgment toward their OUD, with some appearing understanding and nonjudgmental while others were perceived to have stigma and prejudice. Few participants noted assistance from CCOs with seeking MT or community-based substance use disorder care. Some participants desired improved treatment facilitation, but viewed forced or coercive treatment negatively.

Conclusion: To our knowledge, this is the first qualitative study to examine community corrections experience among people receiving outpatient medication for OUD. While individuals receiving MT have negative experiences with the community corrections system, they perceive individual CCOs positively. Interventions addressing gaps in CCOs knowledge of OUD and MT are needed to optimize support for individuals on probation or parole with OUD. Provision of OUD treatment facilitation appears desirable to some individuals in community supervision.

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Study Protocol for the Healing Opioid Misuse and Pain Through Engagement Trial: Integrated Treatment for Individuals With Co-occurring Chronic Pain and Opioid Use Disorder. Pain Care at Home to Amplify Function: Protocol Article. Addressing the Intersections of Chronic Pain and OUD: Integrative Management of Chronic Pain and OUD for Whole Recovery (IMPOWR) Research Network. Connecting Chronic Pain and Opioid Use Disorder Clinical Trials Through Data Harmonization: Wake Forest IMPOWR Dissemination, Education, and Coordination Center (IDEA-CC). The IMPOWR Network Divided or Single Exposure Study (DOSE) Protocol: A Randomized Controlled Comparison of Once Versus Split Dosing of Methadone for the Treatment of Comorbid Chronic Pain and Opioid Use Disorder.
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