Department of Pediatrics, Boston University School of Medicine and Boston Medical Center, 88 E. Newton, Vose Hall 3rd Floor, Boston, MA 02118, United States; Division of General Academic Pediatrics, MassGeneral Hospital for Children, 125 Nashua St. Suite 860, Boston, MA 02114, United States.
Department of Health Law, Policy, and Management, Boston University School of Public Health, 715 Albany Street, T3W, Boston, MA, 02118, United States; Section of Infectious Disease, Boston University School of Medicine, United States; Center for Healthcare Organization and Implementation Research, ENRM VA Hospital, United States.
J Subst Abuse Treat. 2017 Nov;82:41-47. doi: 10.1016/j.jsat.2017.09.003. Epub 2017 Sep 9.
The increasing rates of opioid use disorder and resulting overdose deaths are a public health emergency, yet only a fraction of individuals in need receive treatment.
To describe the implementation of and participants' experiences with a novel police-led addiction treatment referral program.
Follow-up telephone calls to participants in the Gloucester Police Department's Angel Program from June 2015-May 2016. Open-ended survey questionnaires assessed experiences of program participants and their close contacts, confirmed police-reported placement, and queried self-reported substance use and treatment outcomes.
Surveys were completed by 198 of 367 individuals (54% response rate) who participated 214 times. Reasons for participation included: the program was a highly-visible entry point to the treatment system, belief that placement would be obtained, poor prior treatment system experiences, and external pressure to seek treatment. Most participants reported positive experiences citing the welcoming, non-judgmental services. In 75% (160/214) of the encounters, entry into referral placement was confirmed. Participants expressed frustration when they did not meet program entry requirements and had difficulty finding sustained treatment following initial program placement. At a mean follow-up time of 6.7months, 37% of participants reported abstinence since participation, with no differences between participants who entered referral placement versus those who did not.
A police-led referral program was feasible to implement and acceptable to participants. The program was effective in finding initial access to treatment, primarily through short-term detoxification services. However, the program was not able to overcome a fragmented treatment system focused on acute episodic care which remains a barrier to long-term recovery.
阿片类药物使用障碍和由此导致的过量死亡的发生率不断上升,这是一个公共卫生紧急事件,但只有一小部分有需要的人接受了治疗。
描述一个新的警察主导的成瘾治疗转介项目的实施情况和参与者的经验。
对 2015 年 6 月至 2016 年 5 月期间参加格洛斯特警察局“天使计划”的参与者进行后续电话随访。开放式调查问卷评估了项目参与者及其密切接触者的经验、确认了警方报告的安置情况,并询问了自我报告的药物使用和治疗结果。
367 名参与者中有 198 名(54%的回复率)完成了调查,共参加了 214 次。参与的原因包括:该项目是进入治疗系统的一个高度可见的切入点、相信可以获得安置、以前对治疗系统的体验不佳,以及外部压力要求接受治疗。大多数参与者报告了积极的体验,提到了欢迎、非评判性的服务。在 214 次接触中,有 75%(160/214)确认了进入转介安置。当参与者不符合项目进入要求,并且在最初的项目安置后难以找到持续的治疗时,他们会感到沮丧。在平均 6.7 个月的随访中,37%的参与者报告自参与以来已戒除,进入转介安置的参与者与未进入转介安置的参与者之间没有差异。
警察主导的转介项目是可行的,并且得到了参与者的认可。该项目在寻找初始治疗方面是有效的,主要是通过短期戒毒服务。然而,该项目未能克服以急性偶发性护理为重点的分散的治疗系统,这仍然是长期康复的一个障碍。