Yatsco Andrea J, Champagne-Langabeer Tiffany, Holder Travis F, Stotts Angela L, Langabeer James R
Houston Emergency Opioid Engagement System, The University of Texas Health Science Center, 7000 Fannin Street, Suite 1690, Houston TX 77030, USA.
Houston Emergency Opioid Engagement System, The University of Texas Health Science Center, 7000 Fannin Street, Suite 1690, Houston TX 77030, USA.
Int J Drug Policy. 2020 Sep;83:102849. doi: 10.1016/j.drugpo.2020.102849. Epub 2020 Jul 9.
With the current opioid epidemic impacting well over half of all counties across the United States, initiatives that encourage interagency collaboration between first responder organizations appear necessary to comprehensively address this crisis. Police, fire, and emergency medical services (EMS) are in a unique position to identify substance users and provide necessary resources to initiate treatment, yet there is not sufficient evidence of joint collaborative programs between law enforcement/first responders and healthcare providers.
In this scoping review we examine the current state of joint criminal justice and healthcare interventions, specifically, opioid and substance use pre-arrest initiatives via emergency first responders and police officers. We relied on data from the last 10 years across three major databases to assess the extent of criminal justice (CJ) and healthcare collaborations as a response to individuals with opioid use disorder (OUD). We specifically focused on interventional programs between criminal justice first responders (pre-arrest) and healthcare providers where specific outcomes were documented.
We identified only a small number (6) of studies involving interventions that met this criteria, suggesting very limited study of joint interagency collaboration between law enforcement first responders and healthcare providers. Most had small samples, none were in the southern states, and all but one were initiated within the last 5 years.
Although studies describing joint efforts of early intercept criminal justice responses and healthcare interventions were few, existing studies suggest that such programs were effective at improving treatment referral and retention outcomes. Greater resources are needed to encourage criminal justice and healthcare collaboration and policies, making it easier to share data, refer patients, and coordinate care for individuals with OUD.
当前阿片类药物泛滥问题影响了美国超过半数的县，因此，鼓励急救响应组织之间开展跨部门合作的举措对于全面应对这场危机似乎很有必要。警察、消防和紧急医疗服务（EMS）处于识别药物使用者并提供启动治疗所需资源的独特位置，但执法部门/急救人员与医疗保健提供者之间联合协作项目的证据并不充分。
在这项范围综述中，我们研究了刑事司法与医疗保健联合干预的现状，具体而言，是通过急救人员和警察开展的阿片类药物及物质使用的逮捕前干预举措。我们依靠过去10年来自三个主要数据库的数据，来评估刑事司法（CJ）与医疗保健合作在应对阿片类药物使用障碍（OUD）个体方面的程度。我们特别关注刑事司法急救人员（逮捕前）与医疗保健提供者之间有具体成果记录的干预项目。
我们仅发现少量（6项）符合此标准的干预研究，这表明执法急救人员与医疗保健提供者之间跨部门联合协作的研究非常有限。大多数研究样本量较小，没有一项在南部各州开展，除一项外，其他所有研究都是在过去5年内启动的。
尽管描述早期拦截刑事司法应对措施与医疗保健干预联合努力的研究很少，但现有研究表明，此类项目在改善治疗转诊和留存结果方面是有效的。需要更多资源来鼓励刑事司法与医疗保健之间的合作及政策制定，以便更轻松地共享数据、转诊患者并协调对患有阿片类药物使用障碍个体的护理。
