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监狱特征与阿片类药物治疗服务的可及性:一项全国代表性调查的结果。

Jail Characteristics and Availability of Opioid Treatment Services: Results from a Nationally Representative Survey.

机构信息

UNC Health Sciences at the Mountain Area Health Education Center (MAHEC), 121 Hendersonville Road, Asheville, NC, 28803, USA.

出版信息

J Behav Health Serv Res. 2024 Jul;51(3):313-324. doi: 10.1007/s11414-024-09881-8. Epub 2024 Mar 22.

Abstract

The current wave of the opioid epidemic has contributed to a record number of drug-related overdoses and a significant proportion of people who experience opioid use disorder are admitted to local jails. These correctional facilities serve as the principal entry point to the criminal justice system as nearly every person who is taken into custody is admitted to a local detention center. Although jails are recognized as primary intervention points for people who may require treatment for opioid use disorder, services in these facilities remain deficient. The absence of jail-based treatment has become a pressing concern as the number of drug-related deaths in custody continues to rise and the risk of post-release overdose also remains high. The present study draws on the opioid-related module of the 2019 Bureau of Justice Statistics' Census of Jails to assess the relationships between the characteristics of 2588 local detention centers and the availability of treatment services. These specific approaches included screening for opioid use disorder, providing medication to manage withdrawal symptoms, administering medication for opioid use disorder (MOUD), providing overdose reversal medication at the time of release, and linking people with community-based care following release from the detention center. The results demonstrate facilities located in the Northeast, larger jails, those in urban areas, and detention centers with higher turnover rates are significantly more likely to provide a wider variety of opioid treatment services. These findings have important implications for the prioritization of policies and the allocation of resources to support the adoption of opioid treatment services in local jails.

摘要

当前的阿片类药物泛滥浪潮导致了创纪录数量的药物相关过量用药,而经历阿片类药物使用障碍的人中有相当大的比例被送进当地监狱。这些惩教设施是进入刑事司法系统的主要入口,因为几乎每一个被拘留的人都被送进当地拘留中心。尽管监狱被认为是可能需要治疗阿片类药物使用障碍的人的主要干预点,但这些设施的服务仍然不足。由于被拘留者中与毒品相关的死亡人数继续上升,并且出狱后再次过量用药的风险仍然很高,因此监狱内没有治疗服务已成为一个紧迫的问题。本研究利用 2019 年司法统计局的监狱普查中的阿片类药物相关模块,评估了 2588 个地方拘留中心的特征与治疗服务的可用性之间的关系。这些具体方法包括对阿片类药物使用障碍进行筛查,提供药物来缓解戒断症状,为阿片类药物使用障碍(MOUD)提供药物治疗,在释放时提供解毒药物,以及在从拘留中心获释后将人们与社区护理联系起来。研究结果表明,位于东北部、规模较大、位于城市地区以及周转率较高的设施更有可能提供更广泛的阿片类药物治疗服务。这些发现对优先制定政策和分配资源以支持在当地监狱中采用阿片类药物治疗服务具有重要意义。

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