Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
Department of Behavioral Sciences, University of Kentucky, Lexington, KY, USA.
Am J Drug Alcohol Abuse. 2022 May 4;48(3):356-366. doi: 10.1080/00952990.2021.1995402. Epub 2022 Feb 7.
Rural areas have high rates of opioid and stimulant involved polysubstance use which are known to contribute to overdose. Justice-involved women are likely to have multiple substance use disorders and are particularly vulnerable in rural areas where treatment is limited. The research had three aims to (1) identify the patterns of polysubstance use of rural Appalachian justice-involved women, (2) examine how women's engagement in polysubstance use changed in the 12-months following initial release from jail, and (3) determine if women's changes in substance use patterns were associated with re-incarceration during the 12-months of post-release follow-up. A total of 339 women with recent substance use histories were randomly recruited from three rural jails. Latent transition analysis of women's substance use from baseline (in jail) to 6 and 12-months was examined, including the effect of re-incarceration on transitions (changes in substance use patterns). Three latent classes were found: (36.3% baseline), (57.3% baseline), and (6.4% baseline). Polysubstance use classes were characterized by use of opioids and benzodiazepines; the class was distinct in co-use and injection use of methamphetamine. Post-release, women transitioned to latent classes of reduced substance use and/or reduced injection drug use, particularly in the first six months. Women who were re-incarcerated during follow-up were likely to remain engaged in, or transition to, the class (ORs: 3.14-46.56). Justice-involved women in Appalachia reported risky polysubstance use. The first six-months post-release were a critical period for changes in substance use.
农村地区阿片类药物和兴奋剂的多药使用率较高，已知这会导致用药过量。涉及司法的女性可能有多发性物质使用障碍，在治疗有限的农村地区尤其脆弱。这项研究有三个目的：(1)确定农村阿巴拉契亚地区涉及司法的女性的多药使用模式；(2)研究女性在最初从监狱获释后的 12 个月内多药使用的变化情况；(3)确定女性的物质使用模式变化是否与获释后 12 个月内重新入狱有关。共有 339 名有近期物质使用史的女性从三个农村监狱随机招募。研究了女性物质使用从基线（入狱时）到 6 个月和 12 个月的潜在转变分析，包括重新入狱对转变（物质使用模式的变化）的影响。发现了三个潜在的类别：(36.3%基线)，(57.3%基线)，和(6.4%基线)。多药使用类别特征为阿片类药物和苯二氮䓬类药物的使用；第 类在共用药和注射用甲基苯丙胺方面明显不同。在释放后，女性转变为物质使用减少和/或注射毒品使用减少的潜在类别，特别是在前六个月。在随访期间重新入狱的女性更有可能继续参与或转变为第 类（比值比：3.14-46.56）。阿巴拉契亚地区涉及司法的女性报告了危险的多药使用。释放后的前六个月是物质使用变化的关键时期。
