Jones A A, Brant K, Bishop R E, Strong-Jones S, Kreager D A
Department of Human Development and Family Studies and Family Studies, The Pennsylvania State University, University Park, PA 16801, USA; Consortium on Substance Use and Addiction, The Pennsylvania State University, University Park, PA 16801, USA.
Consortium on Substance Use and Addiction, The Pennsylvania State University, University Park, PA 16801, USA; Department of Agricultural Economics, Sociology, and Education, The Pennsylvania State University, University Park 16802, USA.
J Subst Use Addict Treat. 2025 Feb;169:209587. doi: 10.1016/j.josat.2024.209587. Epub 2024 Nov 29.
Increasing overdose deaths and criminal legal involvement among women necessitate women-specific solutions to curb the adverse consequences of substance use disorders (SUDs). The current study is the pre-implementation phase of an implementation science study that works with various stakeholders-affected women, criminal legal professionals, and SUD treatment professionals-to identify and address high-priority needs for criminal-legal involved women with SUDs.
This study uses semi-structured interviews (N = 42) administered in 2022 to women with a history of SUD and criminal legal involvement (n = 20), SUD treatment professionals (n = 12), and criminal legal professionals (n = 10). Interviews focused on participants' history of substance use and criminal legal involvement, facilitators and barriers to initiating and completing treatment, and gender-specific issues encountered during treatment and criminal legal involvement. Drawing on the social ecological model of health, analyses identified gender-specific challenges impacting criminal-legal involved women's treatment and recovery processes.
Participants identified five gender-specific challenges impacting women across social ecological levels. At the relational level, challenges stemmed from women's roles as mothers and from victimization within healthcare and criminal legal settings; at the community level, from unequal resource allocation for treatment; and at the societal level, from stigma associated with certain intersectional identities and cultural norms that constrict job opportunities. Participants noted that providing women with effective care coordination and women-specific guidelines and spaces within the criminal-legal system could mitigate some of these challenges.
Findings highlight the need to consider gender-specific challenges faced across relational, community, and societal levels when implementing medical interventions and criminal legal proceedings for women. Given these findings and extant literature, the authors are developing an all-female, trauma-informed intervention that includes case management with female certified recovery specialists who are in recovery and have navigated the criminal legal system. By reducing some of the gender-specific barriers identified in this study, this future intervention aims to improve the substance use and criminal legal outcomes of participating women.
女性过量用药死亡人数不断增加以及她们在刑事司法系统中的涉入情况，使得必须制定针对女性的解决方案，以遏制物质使用障碍（SUDs）的不良后果。本研究是一项实施科学研究的实施前阶段，该研究与受影响的女性、刑事司法专业人员和SUD治疗专业人员等各种利益相关者合作，以识别和解决有刑事司法涉入情况的SUD女性的高度优先需求。
本研究于2022年对有SUD病史和刑事司法涉入情况的女性（n = 20）、SUD治疗专业人员（n = 12）和刑事司法专业人员（n = 10）进行了半结构化访谈（N = 42）。访谈重点关注参与者的物质使用和刑事司法涉入历史、开始和完成治疗的促进因素和障碍，以及治疗和刑事司法涉入期间遇到的性别特定问题。借鉴健康的社会生态模型，分析确定了影响有刑事司法涉入情况的女性治疗和康复过程的性别特定挑战。
参与者确定了五个在社会生态层面影响女性的性别特定挑战。在关系层面，挑战源于女性作为母亲的角色以及在医疗保健和刑事司法环境中的受害经历；在社区层面，源于治疗资源分配不平等；在社会层面，源于与某些交叉身份相关的污名以及限制就业机会的文化规范。参与者指出，在刑事司法系统中为女性提供有效的护理协调、针对女性的指导方针和空间可以减轻其中一些挑战。
研究结果强调，在为女性实施医疗干预和刑事司法程序时，需要考虑在关系、社区和社会层面所面临的性别特定挑战。鉴于这些发现和现有文献，作者正在开发一种全女性、注重创伤的干预措施，包括由处于康复期且有刑事司法系统经历认证的女性康复专家进行病例管理。通过减少本研究中确定的一些性别特定障碍，这种未来的干预措施旨在改善参与女性的物质使用和刑事司法结果。
