Fry Carrie E, Harris Jacob, Burns Marguerite E
Department of Health Policy, Vanderbilt University School of Medicine, 2525 West End Avenue, Suite 1275-G, Nashville, TN, 37203, USA.
College of Arts and Letters, University of Notre Dame, Notre Dame, IN, USA.
Health Justice. 2024 Nov 6;12(1):42. doi: 10.1186/s40352-024-00297-2.
The policy landscape around substance use has changed dramatically in the past decade, which may have affected the number and characteristics of treatment episodes for substance use disorder (SUD). In this study, we examine changes in the volume of SUD treatment referrals from the legal system and compare changes in the composition of substances used by referral source. We used publicly available discharge data on specialty SUD treatment episodes in the U.S. from 2015-2019 and included episodes involving adults that are discharged from specialty SUD treatment facilities during the study. We calculated descriptive statistics of specialty SUD treatment discharges in each year and aggregated across all years by referral source and substance(s) reported upon admission. To test differences by year and referral source, we conducted z-tests of proportions.
The proportion of referrals to specialty SUD treatment from the legal system declined between 2015 and 2019 (p < 0.001). However, referrals from probation/parole and diversionary programs grew over time (p < 0.001) in number and proportion over time. Legal referrals were most often associated with alcohol or cannabis use, though referrals for these substances declined from 2015-2019.
This research lays the groundwork for future investigations to evaluate the effect of important policy changes on referral sources to specialty SUD treatment and the quality and outcomes associated with referrals to treatment from the legal system.
在过去十年中，围绕物质使用的政策环境发生了巨大变化，这可能影响了物质使用障碍（SUD）治疗疗程的数量和特征。在本研究中，我们研究了来自法律系统的SUD治疗转诊量的变化，并比较了转诊来源所使用物质构成的变化。我们使用了2015 - 2019年美国特种SUD治疗疗程的公开出院数据，纳入了研究期间从特种SUD治疗设施出院的成年患者的疗程。我们计算了每年特种SUD治疗出院的描述性统计数据，并按转诊来源和入院时报告的物质进行了所有年份的汇总。为了检验年份和转诊来源之间的差异，我们进行了比例z检验。
2015年至2019年期间，来自法律系统的特种SUD治疗转诊比例下降（p < 0.001）。然而，来自缓刑/假释和转移项目的转诊数量和比例随时间增加（p < 0.001）。法律转诊最常与酒精或大麻使用相关，尽管2015 - 2019年期间这些物质的转诊有所下降。
本研究为未来调查奠定了基础，以评估重要政策变化对特种SUD治疗转诊来源的影响以及与法律系统治疗转诊相关的质量和结果。
