NYC Department of Health and Mental Hygiene, Bureau of Alcohol and Drug Use Prevention, Care, and Treatment, 42-09 28th St, Long Island City, NY, 11101, USA.
NYC Department of Health and Mental Hygiene, Bureau of Alcohol and Drug Use Prevention, Care, and Treatment, 42-09 28th St, Long Island City, NY, 11101, USA.
Drug Alcohol Depend. 2021 Sep 1;226:108867. doi: 10.1016/j.drugalcdep.2021.108867. Epub 2021 Jun 24.
Past studies have identified frequent criminal legal system (CLS) involvement among overdose decedents and highlight the need for connecting individuals at risk of overdose with effective interventions during CLS encounters. While some programs divert individuals at risk of overdose to treatment during CLS encounters, eligibility is frequently restricted to those with limited prior CLS involvement. However, differences by race/ethnicity have not been examined.
We assessed racial disparities in CLS involvement and eligibility for diversion following arrest for misdemeanor drug possession among New York City (NYC) overdose decedents.
We matched death certificates for 5018 NYC residents who died of an unintentional drug overdose between 2008 and 2015 with CLS data and compared CLS involvement by race/ethnicity. We compared prior felony involvement at the first misdemeanor drug arrest by race/ethnicity among 2719 decedents with at least one misdemeanor drug arrest.
Higher proportions of Black (86 %, 95 % CI: 83.9, 87.9) and Latino (84 %, 95 % CI: 82.2, 86.0) decedents had ever been arrested than White decedents (73 %, 95 % CI: 71.5, 75.2). At the first misdemeanor drug arrest, Black and Latino decedents were twice as likely as White decedents to have a prior felony conviction, adjusted for age at arrest and gender (RR = 2.08, 95 % CI: 1.71, 2.54 and 2.14, 95 % CI: 1.77, 2.59, respectively).
Given racial disparities in CLS involvement among NYC overdose decedents, diversion eligibility is inequitable by race/ethnicity. Diversion programs that restrict eligibility based on prior CLS involvement will have racially disparate effects.
过去的研究已经确定了过量死亡者经常与刑事司法系统（CLS）有关，并强调需要在 CLS 接触期间将有过量风险的个人与有效的干预措施联系起来。虽然有些项目在 CLS 接触期间将有过量风险的个人转移到治疗中，但资格通常仅限于那些 CLS 参与度有限的人。然而，种族/族裔差异尚未得到检验。
我们评估了在纽约市（NYC）过量死亡者因轻罪毒品持有被捕后，CLS 参与度和转移资格方面的种族差异。
我们将 5018 名在 2008 年至 2015 年间死于非故意药物过量的 NYC 居民的死亡证明与 CLS 数据相匹配，并按种族/族裔比较 CLS 的参与度。我们比较了 2719 名至少有一次轻罪毒品被捕的死者中，首次轻罪毒品被捕时的先前重罪参与情况按种族/族裔划分。
黑人（86%，95%CI：83.9，87.9）和拉丁裔（84%，95%CI：82.2，86.0）死者中，曾经被捕的比例高于白人死者（73%，95%CI：71.5，75.2）。在第一次轻罪毒品被捕时，黑人死者和拉丁裔死者与白人死者相比，有前科重罪的可能性是白人死者的两倍，调整了被捕时的年龄和性别因素（RR=2.08，95%CI：1.71，2.54 和 2.14，95%CI：1.77，2.59）。
鉴于 NYC 过量死亡者中 CLS 参与的种族差异，基于 CLS 参与情况的转移资格存在种族不平等。基于先前 CLS 参与情况限制资格的转移计划将产生不同的种族影响。
