Departments of Psychiatry and Medicine, University of Rochester School of Medicine, Rochester, NY.
Women's Health Initiative Supporting Health, 6927University of Rochester School of Medicine, Rochester, NY.
J Interpers Violence. 2022 Nov;37(21-22):NP20513-NP20541. doi: 10.1177/08862605211052053. Epub 2022 Jan 6.
The presence and severity of childhood and adult victimization increase the likelihood of substance use disorder (SUD), crimes, antisocial behaviors, arrests, convictions, and medical and psychiatric disorders among women more than men. These problems are compounded by the impact of social determinants of health (SDH) challenges, which include predisposition to the understudied, dramatic increase in opioid dependence among women. This study examined victimization, related SDH challenges, gender-based criminogenic risk factors for female participants, and public health opportunities to address these problems. We recruited women from the first national Opioid Intervention Court, a fast-track SUD treatment response to rapidly increasing overdose deaths. We present a consensual qualitative research analysis of 24 women Opioid Intervention Court participants (among 31 interviewed) who reported childhood, adolescent, and/or adult victimization experiences in the context of substance use and recovery, mental health symptoms, heath behaviors, and justice-involved trajectories. We iteratively established codes and overarching themes. Six primary themes emerged: child or adolescent abuse as triggers for drug use; impact of combined child or adolescent abuse with loss or witnessing abuse; adult abduction or assault; trajectory from lifetime abuse, substance use, and criminal and antisocial behaviors to sobriety; role of friends and family support in recovery; and role of treatment and opioid court in recovery, which we related to SDH, gender-based criminogenic factors, and public health. These experiences put participants at risk of further physical and mental health disorders, yet indicate potential strategies. Findings support future studies examining strategies where courts and health systems could collaboratively address SDH with women Opioid Intervention Court participants.
童年和成年期受虐经历的存在和严重程度会增加女性出现物质使用障碍（SUD）、犯罪、反社会行为、被捕、定罪以及患有医疗和精神疾病的可能性，比男性更为严重。这些问题因健康社会决定因素（SDH）挑战的影响而更加复杂，其中包括易受研究不足的影响，以及女性阿片类药物依赖急剧增加。本研究考察了受虐经历、相关 SDH 挑战、女性参与者的基于性别的犯罪风险因素，以及解决这些问题的公共卫生机会。我们从第一个国家阿片类药物干预法院招募了女性参与者，这是一种针对阿片类药物过量死亡人数迅速增加的快速治疗 SUD 的反应。我们对 24 名阿片类药物干预法院参与者（在接受采访的 31 名参与者中）进行了共识定性研究分析，这些参与者报告了在物质使用和康复、心理健康症状、健康行为和涉及司法的轨迹中经历过童年、青少年和/或成年期受虐经历。我们迭代建立了代码和总体主题。出现了六个主要主题：儿童或青少年期虐待是药物使用的触发因素；童年期或青少年期遭受虐待与丧失或目睹虐待相结合的影响；成年期绑架或攻击；从一生受虐、物质使用、犯罪和反社会行为到清醒的轨迹；朋友和家人支持在康复中的作用；以及治疗和阿片类药物法院在康复中的作用，我们将这些主题与 SDH、基于性别的犯罪风险因素和公共卫生联系起来。这些经历使参与者面临进一步的身心健康障碍的风险，但也指明了潜在的策略。研究结果支持未来的研究，这些研究将考察法院和卫生系统如何与女性阿片类药物干预法院参与者合作，共同解决 SDH 问题。
