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警察转处计划和毒品法庭中药物治疗的障碍:定性分析。

Barriers to drug treatment in police diversion programs and drug courts: A qualitative analysis.

机构信息

Institute for Health and Equity.

Department of Rehabilitation Services and Technology.

出版信息

Am J Orthopsychiatry. 2022;92(6):692-701. doi: 10.1037/ort0000643. Epub 2022 Oct 13.

Abstract

Drug treatment courts and police diversion programs are designed to divert people away from incarceration and into drug treatment. This article explores barriers in linking people who use drugs (PWUD) into drug treatment facilities in urban, suburban, and rural areas of Connecticut, Kentucky, and Wisconsin. Between December 2018 and March 2020, study teams in the three states conducted in-depth, semistructured interviews with key informants involved in programs to divert PWUD from criminal justice involvement including police, lawyers, judges, and others who work in drug treatment courts, and substance use disorder treatment providers who received referrals from and worked with police diversion programs or drug courts. Police diversion programs and drug treatment courts showed intraprogram variation in the structure of their programs in the three states and in different counties within the states. Structural barriers to successfully linking PWUD to treatment included a lack of resources, for example, a limited number of treatment facilities available, difficulties in funding mandated treatment, particularly in Wisconsin where Medicaid expansion has not occurred, and PWUDs' need for additional services such as housing. Many police officers, judges, and others within drug treatment court, including drug treatment specialists, hold stigmatizing attitudes toward medications to treat opioid use disorder (MOUD) and are unlikely to recommend or actively refer to MOUD treatment. Drug courts and police diversion programs offer a welcome shift from prior emphases on criminalization of drug use. However, for such programs to be effective, more resources must be dedicated to their success. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

摘要

药物治疗法庭和警察转处计划旨在将人们从监禁中转移出来并接受药物治疗。本文探讨了在康涅狄格州、肯塔基州和威斯康星州的城市、郊区和农村地区,将吸毒者(PWUD)联系到药物治疗设施所面临的障碍。2018 年 12 月至 2020 年 3 月,三个州的研究团队对参与将 PWUD 从刑事司法中转移的计划的主要知情人(包括警察、律师、法官以及参与药物治疗法庭的其他人员)和从警察转处计划或药物法庭获得转介并与他们合作的药物滥用治疗提供者进行了深入的半结构化访谈。在这三个州以及各州内的不同县,警察转处计划和药物治疗法庭的项目结构存在差异。成功将 PWUD 与治疗联系起来的结构障碍包括资源匮乏,例如,可提供的治疗设施数量有限,难以为强制性治疗提供资金,在未扩大医疗补助的威斯康星州尤其如此,以及 PWUD 需要额外的服务,如住房。许多警察、法官和其他参与药物治疗法庭的人员,包括药物治疗专家,对治疗阿片类药物使用障碍的药物持有污名化的态度,不太可能推荐或积极转介阿片类药物使用障碍的治疗。药物法庭和警察转处计划提供了一个从以前对吸毒行为定罪的模式转变的可喜趋势。然而,为了使这些计划有效,必须投入更多的资源来支持它们的成功。

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