Belenko Steven, LaPollo Archana Bodas, Gesser Nili, Weiland Doris, Perron Lauren, Johnson Ingrid Diane
Temple University, United States of America.
Public Health Management Corporation, United States of America.
J Subst Abuse Treat. 2021 Dec;131:108581. doi: 10.1016/j.jsat.2021.108581. Epub 2021 Jul 30.
Peer recovery specialist (PRS) support has been used to varying degrees in community substance use and mental health treatment for a number of years. Although there has been some evidence of positive PRS impacts on client outcomes, previous research has shown inconsistent findings and methodological shortcomings. Given the high prevalence of substance use disorders among people involved in the criminal justice system, and limited available treatment opportunities, PRS support could provide a cost-effective opportunity to promote positive client outcomes. Drug courts, with their focus on treatment and rehabilitation rather than punishment, are an ideal laboratory to test the impacts of PRS on substance use recurrence and recidivism.
The present study is, to our knowledge, the first experimental test of the PRS model in a justice system setting. We implemented a pilot experiment in the Philadelphia Treatment Court, randomizing 76 drug court participants to be linked to a PRS or to services as usual, and analyzed client outcomes over a nine-month follow-up period. Most participants' drug of choice was marijuana.
The results showed a reduction in rearrests and improvement in drug court engagement, but no impact on substance use recurrence or treatment engagement.
The mixed findings suggest some promise for the PRS model in the drug court setting, but the need for further research with more diverse and higher-risk drug court populations.
多年来，同伴康复专家（PRS）支持已在社区药物使用和心理健康治疗中得到不同程度的应用。尽管有一些证据表明PRS对服务对象的治疗效果有积极影响，但先前的研究结果并不一致，且存在方法上的缺陷。鉴于参与刑事司法系统的人群中药物使用障碍的高患病率以及有限的可用治疗机会，PRS支持可能提供一个具有成本效益的机会来促进服务对象取得积极的治疗效果。毒品法庭注重治疗和康复而非惩罚，是测试PRS对药物使用复发和再犯影响的理想场所。
据我们所知，本研究是在司法系统环境中对PRS模式进行的首次实验性测试。我们在费城治疗法庭开展了一项试点实验，将76名毒品法庭参与者随机分为两组，一组与PRS建立联系，另一组接受常规服务，并在九个月的随访期内分析服务对象的治疗效果。大多数参与者选择的毒品是大麻。
结果显示再次被捕的情况有所减少，毒品法庭参与度有所提高，但对药物使用复发或治疗参与度没有影响。
这些混合的研究结果表明，PRS模式在毒品法庭环境中有一定前景，但需要对更多样化和更高风险的毒品法庭人群进行进一步研究。
