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Gicquelais RE, Mezuk B, Foxman B, Thomas L, Bohnert ASB. Justice involvement patterns, overdose experiences, and naloxone knowledge among men and women in criminal justice diversion addiction treatment. Harm Reduct J 2019; 16:46. [PMID: 31311572 PMCID: PMC6636104 DOI: 10.1186/s12954-019-0317-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 07/05/2019] [Indexed: 12/17/2022] Open
Abstract
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. Electronic supplementary material The online version of this article (10.1186/s12954-019-0317-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rachel E Gicquelais
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA. .,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA. .,Department of Psychiatry, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA. .,Current Address: Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, E7133A, Baltimore, MD, 21205, USA.
| | - Briana Mezuk
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Betsy Foxman
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Laura Thomas
- Department of Psychiatry, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA.,Veterans Affairs Center for Clinical Management Research, 2215 Fuller Road, Ann Arbor, MI, 48105, USA
| | - Amy S B Bohnert
- Department of Psychiatry, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA.,Veterans Affairs Center for Clinical Management Research, 2215 Fuller Road, Ann Arbor, MI, 48105, USA
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Pinals DA, Felthous AR. Introduction to this double issue: Jail diversion and collaboration across the justice continuum. BEHAVIORAL SCIENCES & THE LAW 2017; 35:375-379. [PMID: 29271027 DOI: 10.1002/bsl.2322] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 09/06/2017] [Accepted: 09/06/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Debra A Pinals
- Clinical Professor of Psychiatry, Director, Program in Psychiatry, Law, and Ethics, Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI, 48109, USA
| | - Alan R Felthous
- Professor & Director, Forensic Psychiatry Division Department of Psychiatry Behavioral Neuroscience, Saint Louis University School of Medicine
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