Moore Kelly E, Siebert Shania L, Kromash Rachelle, Owens Mandy D, Allen Diamond C
Department of Psychology, East Tennessee State University, 420 Rogers-Stout Hall P.O. Box 70649, Johnson City, TN 37614, USA.
Addictions, Drug & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, University of Washington, USA.
Drug Alcohol Depend Rep. 2022 Apr 25;3:100056. doi: 10.1016/j.dadr.2022.100056. eCollection 2022 Jun.
Stigma is a barrier to the treatment of opioid use disorder (OUD) in the criminal legal system. Staff sometimes have negative attitudes about medications for OUD (i.e., MOUD), but there is little research on what drives these attitudes. How staff think about criminal involvement and addiction may explain their attitudes toward MOUD.
A convenience sample of U.S. criminal legal staff (e.g., correctional/probation officers, nurses, psychologists, court personnel) were recruited via online methods ( = 152). Participants completed an online survey of their attitudes about justice-involved people and addiction, and these were entered as predictors of an adapted version of the Opinions about Medication Assisted Treatment survey (OAMAT) in a linear regression, controlling for sociodemographics (cross-sectional design).
At the bivariate level, measures capturing more stigmatizing attitudes toward justice-involved people, believing addiction represents a moral weakness, and believing people with addiction are responsible for their actions and their recovery were related to more negative attitudes about MOUD, whereas higher educational attainment and believing addiction has a genetic basis were related to more positive attitudes about MOUD. In a linear regression, only stigma toward justice-involved people significantly predicted negative attitudes about MOUD ( = -.27, = .010).
Criminal legal staff's stigmatizing attitudes about justice-involved people, such as believing they are untrustworthy and cannot be rehabilitated, contributed significantly to negative attitudes about MOUD, above their beliefs about addiction. The stigma tied to criminal involvement needs to be addressed in attempts to increase MOUD adoption in the criminal legal system.
耻辱感是刑事司法系统中阿片类物质使用障碍（OUD）治疗的一个障碍。工作人员有时对用于治疗OUD的药物（即药物辅助治疗，MOUD）持有消极态度，但对于驱动这些态度的因素，相关研究较少。工作人员对犯罪与成瘾的看法可能解释了他们对MOUD的态度。
通过在线方式招募了美国刑事司法工作人员的便利样本（如惩教/缓刑官员、护士、心理学家、法庭工作人员）（n = 152）。参与者完成了一项关于他们对涉司法人员和成瘾的态度的在线调查，并将这些作为药物辅助治疗意见调查（OAMAT）改编版的预测因素纳入线性回归分析，同时控制社会人口统计学因素（横断面设计）。
在双变量水平上，对涉司法人员持有更多耻辱态度的测量指标、认为成瘾代表道德弱点、认为成瘾者应对自己的行为及其康复负责，这些都与对MOUD的更消极态度相关，而较高的教育程度和认为成瘾有遗传基础则与对MOUD的更积极态度相关。在线性回归分析中，只有对涉司法人员的耻辱感显著预测了对MOUD的消极态度（β = -0.27，p = 0.010）。
刑事司法工作人员对涉司法人员的耻辱态度，如认为他们不可信且无法改过自新，在很大程度上导致了对MOUD的消极态度，这超过了他们对成瘾的看法。在刑事司法系统中增加MOUD的采用率的尝试中，需要解决与犯罪相关的耻辱感问题。
