1
|
Tsutsumi S, Takano A, Usami T, Kumakura Y, Kanazawa Y, Takebayashi T, Sugiyama D, Matsumoto T. Risk and protective factors for early dropout from telephone monitoring for individuals with drug convictions in community mental health centers in Japan. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 162:209347. [PMID: 38494050 DOI: 10.1016/j.josat.2024.209347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/27/2024] [Accepted: 02/21/2024] [Indexed: 03/19/2024]
Abstract
INTRODUCTION Individuals involved with the criminal justice system face challenges in receiving and maintaining substance use disorder (SUD) treatment and support. Although telephone monitoring (TM) could reduce these barriers, data on TM for community-dwelling individuals involved with the criminal justice system and research on individuals who drop out of TM are scarce. We examined the factors associated with dropping out early from the Voice Bridges Project, which provides TM for individuals on probation for drug-related convictions through community mental health centers in Japan. METHODS Participants (n = 546) were individuals aged ≥20 years with methamphetamine-related convictions who were on probation. Univariate analyses examine the associations between one-year follow-up status and baseline variables, and multivariate Cox proportional hazards regression analyses identify the risk and protective factors associated with dropping out. Stratified analyses report results based on sex and halfway-house residency. RESULTS The one-year dropout rate was 43.6 % (n = 238). Multivariate analysis identified two risk factors for dropping out-halfway-house residency and suicide attempts in the past year, and two protective factors-higher education and the current use of SUD services. Sex-stratified analyses showed that halfway-house residency was a risk factor for both men and women. Attempted suicide was a risk factor for women. Conversely, higher education and current use of SUD services were protective factors for men. CONCLUSIONS Our results identify unique risk factors for women, such as a recent history of suicide attempts, and distinctive protective factors for men, including higher education and current use of SUD services, emphasizing the importance of sex-specific approaches. Furthermore, the study reveals that irrespective of sex, vulnerable individuals, such as halfway-house residents, are at a higher risk of dropping out from TM.
Collapse
Affiliation(s)
- Shiori Tsutsumi
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira-shi, Tokyo, Japan; Graduate School of Health Management, Keio University, 4411 Endo, Fujisawa-shi, Kanagawa, Japan.
| | - Ayumi Takano
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira-shi, Tokyo, Japan.
| | - Takashi Usami
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira-shi, Tokyo, Japan; Kitakyushu Municipal Mental Health and Welfare Center, 1-7-1 Bashaku, Kokurakita Ward, Kitakyushu, Fukuoka, Japan
| | - Yousuke Kumakura
- Department of Neuropsychiatry, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Yuka Kanazawa
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, Japan
| | - Toru Takebayashi
- Graduate School of Health Management, Keio University, 4411 Endo, Fujisawa-shi, Kanagawa, Japan; Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, Japan.
| | - Daisuke Sugiyama
- Graduate School of Health Management, Keio University, 4411 Endo, Fujisawa-shi, Kanagawa, Japan; Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, Japan; Faculty of Nursing and Medical Care, Keio University, 4411 Endo, Fujisawa-shi, Kanagawa, Japan.
| | - Toshihiko Matsumoto
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira-shi, Tokyo, Japan.
| |
Collapse
|
2
|
Chiappini S, Vaccaro G, Mosca A, Miuli A, Stigliano G, Stefanelli G, Giovannetti G, Carullo R, d'Andrea G, Di Carlo F, Cavallotto C, Pettorruso M, Di Petta G, Corkery JM, Guirguis A, Stair JL, Martinotti G, Fazel S, Schifano F. New trends of drug abuse in custodial settings: A systematic review on the misuse of over-the-counter drugs, prescription-only-medications, and new psychoactive substances. Neurosci Biobehav Rev 2024; 162:105691. [PMID: 38733894 DOI: 10.1016/j.neubiorev.2024.105691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024]
Abstract
The article presents a systematic literature review on the use and the psychiatric implications of over-the-counter drugs (OTC), prescription-only-medications (POM), and new psychoactive substances (NPS) within custodial settings. The searches wer carried out on 2 November 2022 on PubMed, Scopus, and Web of Science in line with PRISMA guidelines. A total of 538 records were identified, of which 37 met the inclusion criteria. Findings showed the most prevalent NPS and OTC and POM classes reported in prisons were synthetic cannabinoids receptor agonists (SCRAs) and opioids, respectively. NPS markets were shown to be in constant evolution following the pace of legislations aimed to reduce their spread. The use of such substances heavily impacts the conditions and rehabilitation of persons in custody, with consequent physical and mental health risks. It is important to raise awareness of the use and misuse of such substances in prisons (i) from an early warning perspective for law enforcement and policy makers (ii) to prompt doctors to cautiously prescribe substances that may be misused (iii) to improve and increase access to treatment provided (iv) to add such substances to routine toxicological screening procedures (v) to improve harm reduction programmes.
Collapse
Affiliation(s)
- Stefania Chiappini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK; Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Giorgia Vaccaro
- Department of Clinical, Pharmaceutical and Biological Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK
| | - Alessio Mosca
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy.
| | - Andrea Miuli
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Gianfranco Stigliano
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Giulia Stefanelli
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Giulia Giovannetti
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Rosalba Carullo
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Giacomo d'Andrea
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Francesco Di Carlo
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Clara Cavallotto
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Gilberto Di Petta
- Department of Neuroscience Department of Mental Health, ASL Napoli 2, Napoli, Nord, Italy
| | - John Martin Corkery
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK
| | - Amira Guirguis
- Swansea University Medical School, Grove Building, Swansea University, Singleton Park, Swansea, Wales SA28PP, UK
| | - Jacqueline L Stair
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK
| | - Giovanni Martinotti
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK; Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti 66100, Italy
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, and Oxford Health NHS Foundation Trust, England
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK
| |
Collapse
|
3
|
Robles-Ramamurthy B, Bath E, Lowenhaupt EA, Tolou-Shams M. Advancing Youth Justice: The Child and Adolescent Psychiatrist's Role. Child Adolesc Psychiatr Clin N Am 2024; 33:397-409. [PMID: 38823812 DOI: 10.1016/j.chc.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2024]
Abstract
Child and adolescent psychiatrists (CAPs) play a crucial role beyond the provision of clinical care. CAPs are uniquely placed to understand and help patients navigate the fine line among psychiatric care, health and well-being, and the laws and policies supporting or impairing these processes. Focusing on vulnerable populations, such as legal system impacted youth and families, CAPs can contribute to the ongoing development of a more just and equitable world for the children of today and of tomorrow.
Collapse
Affiliation(s)
- Barbara Robles-Ramamurthy
- Department Psychiatry and Behavioral Sciences, University of Texas Health San Antonio, 10004 Wurzbach Road, 283, San Antonio, TX 78230, USA.
| | - Eraka Bath
- Division of Child and Adolescent Psychiatry, UCLA Neuropsychiatric Institute, David Geffen School of Medicine
| | - Elizabeth A Lowenhaupt
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Rhode Island Hospital, 593 Eddy Street, POB-122, Providence, RI 02903, USA
| | - Marina Tolou-Shams
- San Francisco|Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; Zuckerberg San Francisco General Hospital and Trauma Center, 1001 Potrero Avenue, Building 5, Room 7M18, San Francisco, CA 94110, USA
| |
Collapse
|
4
|
Yela E, Solé N, Puig L, López Gallegos D, Clua-García R. Barriers to access to hepatitis C treatment with direct-acting antivirals in people who inject drugs in the community setting. Harm Reduct J 2024; 21:88. [PMID: 38678266 PMCID: PMC11055286 DOI: 10.1186/s12954-024-01009-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/22/2024] [Indexed: 04/29/2024] Open
Abstract
Barriers to access to hepatitis C treatment with direct-acting antivirals in people who inject drugs in the community setting. Qualitative study with prison population. Hepatitis C (HCV) treatments with direct-acting antiviral therapy (DAA) are an easy and effective option among people who inject drugs (PWID). However, difficulties in accessing and monitoring treatment in community services and dropouts on release from prison are detected among PWID. For this reason, the aim of the study is to know the access barriers in the diagnosis and treatment of HCV in community health services. An exploratory qualitative study was carried out through semi-structured interviews with 33 PWID recruited in a pre-trial detention prison in Barcelona. The information obtained was analysed using grounded theory. Among PWID sub-population entering prison, personal barriers are related to intense drug use, lack of interest and ignorance of HCV infection and treatment, as well as being in a situation of social exclusion. In relation to health providers, they reported receiving little information, the existence of language barriers in migrants, not receiving screening and treatment proposals, and having poor interactions with some professionals. Systemic barriers were expressed related to the health system circuit being complicated, perceiving little comprehensive care and lack of community support. It is recommended to intensify prevention and treatment campaigns, promoting drug substitution programmes than current ones, improve health education, make the diagnosis and treatment process more flexible, and promote social policies and holistic care for greater coverage of the needs of PWID.
Collapse
Affiliation(s)
- Elena Yela
- Sant Esteve Sesrovires Prison Health Care Team (Brians 1 Prison Centre), South Metropolitan Health Care Department, Catalan Health Institute, Sant Esteve Sesrovires, Barcelona, Spain.
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.
| | - Neus Solé
- Sant Esteve Sesrovires Prison Health Care Team (Brians 1 Prison Centre), South Metropolitan Health Care Department, Catalan Health Institute, Sant Esteve Sesrovires, Barcelona, Spain
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Lidia Puig
- Sant Esteve Sesrovires Prison Health Care Team (Brians 1 Prison Centre), South Metropolitan Health Care Department, Catalan Health Institute, Sant Esteve Sesrovires, Barcelona, Spain
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Darío López Gallegos
- South Metropolitan Health Care Department, Catalan Health Institute, Barcelona, Spain
| | - Rafael Clua-García
- Manresa Faculty of Health Sciences, University of Vic - Central University of Catalonia, Manresa, Spain
| |
Collapse
|
5
|
Edwards LM, Chang S, Zeki R, Jamieson SK, Bowman J, Cooper C, Sullivan E. The associations between social determinants of health, mental health, substance-use and recidivism: a ten-year retrospective cohort analysis of women who completed the connections programme in Australia. Harm Reduct J 2024; 21:2. [PMID: 38172944 PMCID: PMC10765932 DOI: 10.1186/s12954-023-00909-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/24/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Women with substance-use issues are overrepresented in prison. Research on women's recidivism often focuses on offending behaviour rather than the health and social circumstances women are experiencing when reimprisonment occurs. This study examines the relationship between social determinants of health (SDOH), mental health, substance-use and recidivism among women exiting prison with histories of substance-use. METHODS A retrospective cohort study of women exiting prison who completed the transitional support programme "Connections" between 2008 and 2018. Recidivism was measured up to two years post-release. Women's support needs were measured at baseline (4 weeks pre-release) and follow-up (four weeks post-release). Ongoing needs in relation to well-established SDOH were calculated if: (1) at baseline women were identified as having a re-entry need with housing, employment, finances, education, domestic violence, child-custody and social support and (2) at follow-up women reported still needing help in that area. Women's self-reported substance-use and mental health since release were captured at follow-up. Descriptive statistics were calculated for all measures. Associations between SDOH, mental health, substance-use and recidivism were estimated by multiple logistic regression, adjusting for potential confounders. We also evaluated the mediating effects of mental health on the relationship between SDOH and substance-use. RESULTS Substance-use was associated with increased odds of recidivism (adjusted odds ratio (AOR) 1.8, 95% confidence interval (CI) 1.1-2.9; p = 0.02). Poor mental health (AOR 2.9, 95% CI 1.9-4.6; p = < 0.01), ongoing social support (AOR 3.0, 95% CI 1.9-5.0; p = < 0.01), child-custody (AOR 1.9, 95% CI 1.0-3.3 p = 0.04), financial (AOR 2.0, 95% CI 1.3-3.2; p = < 0.01) and housing (AOR 1.8, 95% CI 1.1-2.9; p = 0.02) needs were individually associated with increased odds of substance-use. Mediation analysis found mental health fully mediated the effects of ongoing housing (beta efficiency (b) = - 033, standard error (SE) 0.01; p = 0.05), financial (b = 0.15, SE 0.07; p = 0.05), child-custody (b = 0.18, SE 0.01; p = 0.05) and social support (b = 0.36, SE 0.1; p = 0.05) needs onto substance-use, and partially mediated the effects of domestic violence (b = 0.57, SE 0.23; p = 0.05) onto substance-use. CONCLUSION This study underscores the critical importance of addressing the interplay between SDOH, mental health, substance-use and recidivism. An approach that targets SDOH holds the potential for reducing mental distress and substance-use, and related recidivism.
Collapse
Affiliation(s)
| | | | - Reem Zeki
- Justice Health and Forensic Mental Health Network, Malabar, Australia
- University of Newcastle Australia, Newcastle, Australia
| | | | - Julia Bowman
- Justice Health and Forensic Mental Health Network, Malabar, Australia
| | - Craig Cooper
- Justice Health and Forensic Mental Health Network, Malabar, Australia
| | - Elizabeth Sullivan
- Justice Health and Forensic Mental Health Network, Malabar, Australia.
- University of Newcastle Australia, Newcastle, Australia.
| |
Collapse
|
6
|
Mambro A, Afshar A, Leone F, Dussault C, Stoové M, Savulescu J, Rich JD, Rowan DH, Sheehan J, Kronfli N. Reimbursing incarcerated individuals for participation in research: A scoping review. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 123:104283. [PMID: 38109837 DOI: 10.1016/j.drugpo.2023.104283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/18/2023] [Accepted: 11/29/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Little is known about global practices regarding the provision of reimbursement for the participation of people who are incarcerated in research. To determine current practices related to the reimbursement of incarcerated populations for research, we aimed to describe international variations in practice across countries and carceral environments to help inform the development of more consistent and equitable practices. METHODS We conducted a scoping review by searching PubMed, Cochrane library, Medline, and Embase, and conducted a grey literature search for English- and French-language articles published until September 30, 2022. All studies evaluating any carceral-based research were included if recruitment of incarcerated participants occurred inside any non-juvenile carceral setting; we excluded studies if recruitment occurred exclusively following release. Where studies failed to indicate the presence or absence of reimbursement, we assumed none was provided. RESULTS A total of 4,328 unique articles were identified, 2,765 were eligible for full text review, and 426 were included. Of these, 295 (69%) did not offer reimbursement to incarcerated individuals. A minority (n = 13; 4%) included reasons explaining the absence of reimbursement, primarily government-level policies (n = 7). Among the 131 (31%) studies that provided reimbursement, the most common form was monetary compensation (n = 122; 93%); five studies (4%) offered possible reduced sentencing. Reimbursement ranged between $3-610 USD in total and 14 studies (11%) explained the reason behind the reimbursements, primarily researchers' discretion (n = 9). CONCLUSIONS The majority of research conducted to date in carceral settings globally has not reimbursed incarcerated participants. Increased transparency regarding reimbursement (or lack thereof) is needed as part of all carceral research and advocacy efforts are required to change policies prohibiting reimbursement of incarcerated individuals. Future work is needed to co-create international standards for the equitable reimbursement of incarcerated populations in research, incorporating the voices of people with lived and living experience of incarceration.
Collapse
Affiliation(s)
- Andrea Mambro
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Avideh Afshar
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Frederic Leone
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Camille Dussault
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Mark Stoové
- Burnet Institute, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Julian Savulescu
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, United Kingdom; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Josiah D Rich
- Center for Health and Justice Transformation, The Miriam and Rhode Island Hospitals, Departments of Medicine and Epidemiology, Brown University, Providence, Rhode Island, USA
| | - Daniel H Rowan
- Division of Infectious Disease, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | | | - Nadine Kronfli
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; Department of Medicine, Division of Infectious Disease and Chronic Viral Illness Service, McGill University, Montreal, Quebec, Canada.
| |
Collapse
|
7
|
Fleißner S, Stöver H, Schäffer D. [Take-home naloxone: a building block of drug emergency prophylaxis in Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023; 66:1035-1041. [PMID: 37233811 PMCID: PMC10465660 DOI: 10.1007/s00103-023-03705-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/19/2023] [Indexed: 05/27/2023]
Abstract
Naloxone is an opioid antagonist that reverses the (respiratory-paralyzing) effects of opioids in the body within minutes. Naloxone can therefore reduce opioid overdose deaths. Take-home naloxone (THN) is an intervention recommended by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and the World Health Organization (WHO). It involves training opioid users and their relatives or friends in the use of naloxone and providing them with the drug in case of emergency.So far, THN has been implemented in Germany mainly by individual addiction support facilities. In order to fully exploit the potential of THN, it is necessary to establish the measure nationwide. In particular, THN can be included in the services offered in (low-threshold) addiction support facilities, in psychiatric facilities, in the context of opioid substitution treatment, and in the correctional system.This discussion article reviews the development of THN in Germany since 1998, highlights the difficulties and obstacles to its widespread implementation, and outlines how THN can succeed as an effective public health intervention in Germany. This is particularly relevant in view of the increasing number of drug-related deaths over the past 10 years.
Collapse
Affiliation(s)
- Simon Fleißner
- Institut für Suchtforschung Frankfurt (ISFF), University of Applied Sciences Frankfurt, Nibelungenplatz 1, 60318, Frankfurt am Main, Deutschland.
| | - Heino Stöver
- Institut für Suchtforschung Frankfurt (ISFF), University of Applied Sciences Frankfurt, Nibelungenplatz 1, 60318, Frankfurt am Main, Deutschland
| | | |
Collapse
|
8
|
Butler A, Croxford R, Bodkin C, Akbari H, Bayoumi AM, Bondy SJ, Guenter D, McLeod KE, Gomes T, Kanagalingam T, Kiefer LA, Orkin AM, Owusu-Bempah A, Regenstreif L, Kouyoumdjian F. Burden of opioid toxicity death in the fentanyl-dominant era for people who experience incarceration in Ontario, Canada, 2015-2020: a whole population retrospective cohort study. BMJ Open 2023; 13:e071867. [PMID: 37164452 DOI: 10.1136/bmjopen-2023-071867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
OBJECTIVES To describe mortality due to opioid toxicity among people who experienced incarceration in Ontario between 2015 and 2020, during the fentanyl-dominant era. DESIGN In this retrospective cohort study, we linked Ontario coronial data on opioid toxicity deaths between 2015 and 2020 with correctional data for adults incarcerated in Ontario provincial correctional facilities. SETTING Ontario, Canada. PARTICIPANTS Whole population data. MAIN OUTCOMES AND MEASURES The primary outcome was opioid toxicity death and the exposure was any incarceration in a provincial correctional facility between 2015 and 2020. We calculated crude death rates and age-standardised mortality ratios (SMR). RESULTS Between 2015 and 2020, 8460 people died from opioid toxicity in Ontario. Of those, 2207 (26.1%) were exposed to incarceration during the study period. Among those exposed to incarceration during the study period (n=1 29 152), 1.7% died from opioid toxicity during this period. Crude opioid toxicity death rates per 10 000 persons years were 43.6 (95% CI=41.8 to 45.5) for those exposed to incarceration and 0.95 (95% CI=0.93 to 0.97) for those not exposed. Compared with those not exposed, the SMR for people exposed to incarceration was 31.2 (95% CI=29.8 to 32.6), and differed by sex, at 28.1 (95% CI=26.7 to 29.5) for males and 77.7 (95% CI=69.6 to 85.9) for females. For those exposed to incarceration who died from opioid toxicity, 10.6% died within 14 days of release and the risk was highest between days 4 and 7 postrelease, at 288.1 per 10 000 person years (95% CI=227.8 to 348.1). CONCLUSIONS The risk of opioid toxicity death is many times higher for people who experience incarceration compared with others in Ontario. Risk is markedly elevated in the week after release, and women who experience incarceration have a substantially higher SMR than men who experience incarceration. Initiatives to prevent deaths should consider programmes and policies in correctional facilities to address high risk on release.
Collapse
Affiliation(s)
- Amanda Butler
- Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Ruth Croxford
- Statistical Consultant, (freelance), Toronto, Ontario, Canada
| | - Claire Bodkin
- Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Hanaya Akbari
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Ahmed M Bayoumi
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Susan J Bondy
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Dale Guenter
- Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | | | - Tara Gomes
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Tharsan Kanagalingam
- Western University Schulich School of Medicine & Dentistry, London, Ontario, Canada
| | - Lori A Kiefer
- Ontario Ministry of the Solicitor General, Toronto, Ontario, Canada
| | - Aaron Michael Orkin
- Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | | | | |
Collapse
|
9
|
Brooks O, Hayashi K, Cui Z, Milloy MJ, Kerr T, Fairbairn N. Re-incarceration and associated social, structural and behavioural factors among people who use drugs in an urban Canadian setting. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 115:104018. [PMID: 37060885 PMCID: PMC10683765 DOI: 10.1016/j.drugpo.2023.104018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/18/2023] [Accepted: 03/21/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND People who use drugs (PWUD) are disproportionately incarcerated, however little is known about specific substance use, social and structural factors associated with re-incarceration among PWUD. We aimed to identify the socio-structural and substance use factors associated with re-incarceration among structurally-marginalized PWUD. METHODS We used longitudinal data from two prospective cohorts of PWUD in Vancouver, Canada. We included adults reporting at least one incarceration event in the last six months and who completed at least one additional follow-up study visit. We performed multivariable extended Cox regression to explore factors associated with re-incarceration. RESULTS Among 468 eligible participants, the median age was 40 years (Q1-Q3 = 34-46 years), 346 (73.9%) were men, 177 (37.8%) identified as Indigenous, and 227 (48.5%) experienced at least one re-incarceration event. Incidence rate of re-incarceration was 157 incarceration events per 1000 person years. In multivariable analyses, homelessness (adjusted hazard ratio [AHR] = 2.17; 95% confidence interval [95% CI]: 1.79-2.61), community judicial supervision (AHR = 3.89; 95% CI: 3.21-4.71) and re-incarceration during the study period (once: AHR = 1.95, 95% CI: 1.55-2.44; two or more events: AHR = 1.53, 95% CI: 1.23-1.90) were positively associated with re-incarceration. Among substance use variables that included illicit drugs, only heavy alcohol use remained significantly associated with re-incarceration across analyses after adjustment (AHR = 1.32; 95% CI: 1.06-1.65). Engagement in addiction treatment (AHR = 0.63; 95% CI: 0.53-0.75), mental illness (AHR = 0.70; 95% CI: 0.59-0.84) and age (AHR = 0.96; 95% CI: 0.95-0.97) were negatively associated with re-incarceration. CONCLUSION Access to housing and substance use services, including treatment for alcohol use disorder, following incarceration may reduce re-incarceration among PWUD. The high rates of re-incarceration of PWUD in our sample underscores how structural factors-such as homelessness and criminalization of substance use-drive re-incarceration among PWUD.
Collapse
Affiliation(s)
- Olivia Brooks
- British Columbia Centre on Substance Use, Vancouver, Canada; Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kanna Hayashi
- British Columbia Centre on Substance Use, Vancouver, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Zishan Cui
- British Columbia Centre on Substance Use, Vancouver, Canada
| | - M-J Milloy
- British Columbia Centre on Substance Use, Vancouver, Canada
| | - Thomas Kerr
- British Columbia Centre on Substance Use, Vancouver, Canada
| | - Nadia Fairbairn
- British Columbia Centre on Substance Use, Vancouver, Canada; Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
| |
Collapse
|
10
|
Russell C, Pang M, Nafeh F, Farrell Macdonald S, Derkzen D, Rehm J, Fischer B. Barriers and facilitators to opioid agonist treatment (OAT) engagement among individuals released from federal incarceration into the community in Ontario, Canada. Int J Qual Stud Health Well-being 2022; 17:2094111. [PMID: 35787743 PMCID: PMC9258049 DOI: 10.1080/17482631.2022.2094111] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Introduction Correctional populations with opioid use disorder experience increased health risks during community transition periods. Opioid Agonist Treatment (OAT) can reduce these risks, but retention is a key challenge. This study addresses a knowledge gap by describing facilitators and barriers to OAT engagement among federal correctional populations released into the community in Ontario, Canada. Methods This article describes results from a longitudinal mixed-methods study examining OAT transition experiences among thirty-five individuals released from federal incarceration in Ontario, Canada. Assessments were completed within one year of participants’ release. Data were thematically analyzed. Results The majority (77%) of participants remained engaged in OAT, however, 69% had their release suspended and 49% returned to custody. Key facilitators for OAT engagement included flexibility, positive staff rapport, and structure. Fragmented OAT transitions, financial OAT coverage, balancing reintegration requirements, logistical challenges, and inaccessibility of ‘take-home’ OAT medications were common barriers. Conclusions Post-incarceration transition periods are critical for OAT retention, yet individuals in Ontario experience barriers to OAT engagement that contribute to treatment disruptions and related risks such as relapse and/or re-incarceration. Additional measures to support community OAT transitions are required, including improved discharge planning, amendments to OAT and financial coverage policies, and an expansion of OAT options.
Collapse
Affiliation(s)
- Cayley Russell
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Michelle Pang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Frishta Nafeh
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | | | - Dena Derkzen
- Policy Sector, Research Branch, Correctional Service of Canada, Ottawa, Ontario, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Institute of Medical Science (IMS), University of Toronto, Toronto, Ontario, Canada.,Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Dresden, Germany.,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Benedikt Fischer
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Centre for Applied Research in Mental Health and Addiction (CARMHA), Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada.,Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| |
Collapse
|
11
|
Stopka TJ, Rottapel RE, Ferguson WJ, Pivovarova E, Toro-Mejias LD, Friedmann PD, Evans EA. Medication for opioid use disorder treatment continuity post-release from jail: A qualitative study with community-based treatment providers. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 110:103803. [PMID: 35965159 PMCID: PMC10117037 DOI: 10.1016/j.drugpo.2022.103803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND People released from jail are at elevated opioid overdose risk. Medications for opioid use disorder (MOUD) are effective in reducing overdoses. MOUD treatment was recently mandated in seven Massachusetts jails, but little is known about barriers and facilitators to treatment continuity post-release. We aimed to assess MOUD provider perspectives on treatment continuity among people released from jail. METHODS We conducted qualitative interviews with 36 medical, supervisory, and administrative staff at MOUD programs that serve jail-referred patients. We used the Exploration, Preparation, Implementation, and Sustainment (EPIS) implementation science framework to guide development of instruments, codes, and analyses. We employed deductive and inductive coding, and a grounded theory analytical approach to identify salient themes. RESULTS Inner context findings highlighted necessary adjustments among jail staff to approve MOUD treatment, especially with agonist medications that were previously considered contraband. Participants perceived that some staff within jails favored abstinence-based recovery, viewing agonists as a crutch. Bridging results highlighted the importance of inter-agency communication and coordination to ensure information transfer for seamless treatment continuity in the community post-release. Pre-release planning, release on pre-scheduled dates, medication provision to cover gaps between jail release and intake at community MOUD sites, and exchange of treatment information across agencies were viewed as paramount to success. Unexpected early releases and releases from court were viewed as barriers to treatment coordination. Outer context domains were largely tied to social determinants of health. Substantial barriers to treatment continuity included shelter, food security, employment, transportation, and insurance reactivation. CONCLUSION Through qualitative interviews with community-based MOUD staff, we identified salient barriers and facilitators to treatment continuity post-release from jails. Findings point to needed investments in care coordination, staffing, and funding to strengthen jail-to-community-based MOUD treatment, removing barriers to continuity, and decreasing opioid overdose deaths during this high-risk transition.
Collapse
Affiliation(s)
- Thomas J Stopka
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 200 Harrison Avenue, Boston, MA, 02111, United States.
| | - Rebecca E Rottapel
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 200 Harrison Avenue, Boston, MA, 02111, United States
| | - Warren J Ferguson
- Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, United States
| | - Ekaterina Pivovarova
- Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, United States
| | - Lizbeth Del Toro-Mejias
- University of Massachusetts Chan Medical School-Baystate, 55 N Lake Ave, Worcester, MA 01655, United States; Baystate Health, 759 Chestnut St, Springfield, MA, 01199, United States
| | - Peter D Friedmann
- University of Massachusetts Chan Medical School-Baystate, 55 N Lake Ave, Worcester, MA 01655, United States; Baystate Health, 759 Chestnut St, Springfield, MA, 01199, United States
| | - Elizabeth A Evans
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, 312 Arnold House, 715 North Pleasant Street, Amherst, MA, United States
| |
Collapse
|
12
|
Russell C, Lange S, Kouyoumdjian F, Butler A, Ali F. Opioid agonist treatment take-home doses ('carries'): Are current guidelines resulting in low treatment coverage among high-risk populations in Canada and the USA? Harm Reduct J 2022; 19:89. [PMID: 35948961 PMCID: PMC9363267 DOI: 10.1186/s12954-022-00671-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/02/2022] [Indexed: 11/12/2022] Open
Abstract
Opioid agonist treatment (OAT) is the primary intervention for opioid use disorder (OUD) in Canada and the USA. Yet, a number of barriers contribute to sub-optimal treatment uptake and retention, including daily-supervised medication administration. Thus, clients are eventually granted access to take-home OAT doses (i.e., ‘carries’) to reduce this burden. However, this decision is based on physician discretion and whether patients can demonstrate stability in various life domains, many of which are inextricably linked to the social determinants of health (SDOH). Current Canadian and USA OAT carry guidance documents are not standardized and do not take the SDOH into consideration, resulting in the potential for inequitable access to OAT carries, which may be the case particularly among marginalized populations such as individuals with OUD who have been released from custody. This perspective article posits that current OAT guidelines contribute to inequities in access to OAT carries, and that these inequities likely result in disproportionately low coverage for OUD treatment among some high-risk groups, including individuals on release from incarceration in particular. Relevant impacts of COVID-19 and related policy changes are considered, and suggestions and recommendations to amend current OAT guidance documents are provided.
Collapse
Affiliation(s)
- Cayley Russell
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin St, Toronto, ON, M5S 2S1, Canada. .,Ontario Node, Canadian Research Initiative in Substance Misuse (CRISM), 33 Ursula Franklin St, ON, M5S 2S1, Toronto, Canada.
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin St, Toronto, ON, M5S 2S1, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), ON, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Fiona Kouyoumdjian
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada.,Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | - Amanda Butler
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Farihah Ali
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin St, Toronto, ON, M5S 2S1, Canada.,Ontario Node, Canadian Research Initiative in Substance Misuse (CRISM), 33 Ursula Franklin St, ON, M5S 2S1, Toronto, Canada
| |
Collapse
|
13
|
Prevalence and factors associated with hospitalisation for bacterial skin infections among people who inject drugs: The ETHOS Engage Study. Drug Alcohol Depend 2022; 237:109543. [PMID: 35772249 DOI: 10.1016/j.drugalcdep.2022.109543] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Injecting-related skin and soft tissue infections (SSTIs) are a preventable cause of inpatient hospitalisation among people who inject drugs (PWID). This study aimed to determine the prevalence of hospitalisation for SSTIs among PWID, and identify similarities and differences in factors associated with hospitalisation for SSTIs versus non-bacterial harms related to injecting drug use. METHODS We performed cross-sectional analyses of baseline data from an observational cohort study of PWID attending drug treatment clinics and needle and syringe programs in Australia. Logistic regression models were used to identify factors associated with self-reported hospitalisation for (1) SSTIs (abscess and/or cellulitis), and (2) non-bacterial harms related to injecting drug use (e.g., non-fatal overdose; hereafter referred to as non-bacterial harms), both together and separately. RESULTS 1851 participants who injected drugs in the previous six months were enrolled (67% male; 85% injected in the past month; 42% receiving opioid agonist treatment [OAT]). In the previous year, 40% (n = 737) had been hospitalised for drug-related causes: 20% (n = 377) and 29% (n = 528) of participants were admitted to hospital for an SSTI and non-bacterial harm, respectively. Participants who were female (adjusted odds ratio [aOR]: 1.53, 95% CI: 1.19-1.97) or homeless (aOR: 1.59, 95% CI: 1.16-2.19) were more likely to be hospitalised for an SSTI, but not a non-bacterial harm. Both types of hospitalisation were more likely among people recently released from prison. CONCLUSIONS Hospitalisation for SSTIs is common among PWID. Community-based interventions to prevent SSTIs and subsequent hospitalisation among PWID will require targeting of at-risk groups, including women, people experiencing homelessness, and incarcerated people upon prison release.
Collapse
|
14
|
Reed M, Siegler A, Tabb LP, Momplaisir F, Krevitz D, Lankenau S. Changes in overdose knowledge and attitudes in an incarcerated sample of people living with HIV. Int J Prison Health 2021; AHEAD-OF-PRINT:10.1108/IJPH-01-2021-0004. [PMID: 34120416 PMCID: PMC8549484 DOI: 10.1108/ijph-01-2021-0004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to present evaluation results. People exiting incarceration who use opioids are at an elevated risk for overdose following release. People living with HIV (PLWH) who use drugs are also at increased overdose risk. Overdose education and naloxone distribution (OEND) is an effective community-based intervention, but few OEND programs have been evaluated in a correctional setting and none have specifically targeted PLWH. DESIGN/METHODOLOGY/APPROACH An OEND pilot program was implemented in the Philadelphia jail from December 2017 to June 2019. OEND was provided through an HIV case management program and naloxone given at release. Participants (n = 68) were assessed for changes in overdose knowledge and beliefs in their ability to respond to an overdose from baseline to one month later while still incarcerated. Other demographic variables were assessed via publicly available records and case manager chart abstraction. FINDINGS A total of 120 incarcerated PLWH were OEND trained; 68 (56.7%) were still incarcerated one month later and received post-tests. The 68-person sample was predominantly male (79.4%) and Black (64.7%). One-fifth reported heroin use, a third reported cocaine use and nearly 2/3 reported use of any illegal drug on date of arrest. Among these 68, overdose knowledge and overdose attitudes improved significantly (p = 0.002 and p < 0.001, respectively). ORIGINALITY/VALUE OEND in correctional settings is feasible and knowledge and overdose attitudes improved significantly from baseline. OEND programs should be implemented within the general population of incarcerated people but, as with PLWH, can be extended to other vulnerable populations within correctional settings, such as persons with mental health conditions and a history of homelessness.
Collapse
Affiliation(s)
- Megan Reed
- Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | | | - Loni P Tabb
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Florence Momplaisir
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Stephen Lankenau
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| |
Collapse
|