《不再找借口》：为有犯罪背景的青少年进行药物使用筛查和治疗。
"No Excuses Anymore": Substance Use Screening and Treatment for Justice-involved Youth.
机构信息
From the Division of Adolescent Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA (PNG, JDW); Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA (IH, JDW).
出版信息
J Addict Med. 2023;17(4):454-462. doi: 10.1097/ADM.0000000000001159. Epub 2023 Mar 30.
OBJECTIVE
The aim of this study was to present best practices for substance use disorder (SUD) screening and treatment in the juvenile justice setting.
METHODS
Semistructured qualitative interviews, informed by the Capability-Opportunity-Motivation-Behavior Model, were conducted with medical and behavioral health providers with experience caring for justice-involved youth. Interviews were analyzed using thematic and content analysis to elucidate best practices and identify facilitators and barriers affecting implementation of evidence-based substance use screening and treatment.
RESULTS
We interviewed 14 participants from 12 unique institutions and 9 states. All participants described the populations in their facilities as predominately male and minoritized, with substance use being an exceedingly common problem. Eight main themes emerged from analysis of the barriers and facilitators discussed by participants. These included the importance of (1) ensuring substance use-specific training for all team members, (2) integrating medical and behavioral health care, (3) addressing staff reticence and stigma, (4) building an institutional culture that supports screening and treatment, (5) dedicating adequate resources with respect to time, staffing, and funding, (6) formalizing and standardizing screening and treatment protocols, (7) engaging youth using trauma-informed approaches that emphasize youth strengths and autonomy, and (8) collaborating with multidisciplinary teams and community partners to maximize linkage to follow-up care after release.
CONCLUSIONS
Our findings highlight an urgent need for improved implementation of evidence-based, developmentally appropriate substance use treatment for justice-involved youth. Although the majority of participants screen youth, they described variable implementation of behavioral health interventions and limited provision of on-site withdrawal management and treatment using medications for SUD.
目的
本研究旨在介绍青少年司法系统中物质使用障碍（SUD）筛查和治疗的最佳实践。
方法
对具有照顾涉及司法青少年经验的医疗和行为健康提供者进行半结构化定性访谈，以能力-机会-动机-行为模型为指导。使用主题和内容分析对访谈进行分析，以阐明最佳实践，并确定影响实施基于证据的物质使用筛查和治疗的促进因素和障碍。
结果
我们采访了来自 12 个不同机构和 9 个州的 14 名参与者。所有参与者都描述了他们所在机构的人群主要是男性和少数族裔，且物质使用是一个非常普遍的问题。参与者讨论的障碍和促进因素分析得出了 8 个主要主题。这些主题包括：（1）确保所有团队成员都接受特定于物质使用的培训；（2）整合医疗和行为健康护理；（3）解决工作人员的保留意见和耻辱感；（4）建立支持筛查和治疗的机构文化；（5）投入足够的时间、人员和资金资源；（6）使筛查和治疗方案正式化和标准化；（7）使用强调青年优势和自主性的创伤知情方法吸引青年；（8）与多学科团队和社区伙伴合作，最大限度地将其联系到释放后的后续护理。
结论
我们的研究结果突出了迫切需要改善对涉及司法的青少年进行循证、适合发展的物质使用治疗的实施。尽管大多数参与者对青少年进行了筛查，但他们描述了行为健康干预措施的实施情况各不相同，并且对现场戒断管理和使用药物治疗 SUD 的治疗措施提供有限。
Zotero 插件