Barriers to medications for opioid use disorder in the court system: provider availability, provider “trustworthiness,” and cost

Abstract Background Medications for opioid use disorder (MOUD) significantly decrease mortality but courts rarely refer participants with opioid use disorder to MOUD providers. Previous qualitative work suggests routine court referrals to MOUD providers are more likely if court team members perceive...

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Main Authors: Fatema Z. Ahmed, Barbara Andraka-Christou, M.H. Clark, Rachel Totaram, Danielle N. Atkins, Brandon del Pozo
Format: Article
Language:English
Published: BMC 2022-07-01
Series:Health & Justice
Subjects:
Online Access:https://doi.org/10.1186/s40352-022-00188-4
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author Fatema Z. Ahmed
Barbara Andraka-Christou
M.H. Clark
Rachel Totaram
Danielle N. Atkins
Brandon del Pozo
author_facet Fatema Z. Ahmed
Barbara Andraka-Christou
M.H. Clark
Rachel Totaram
Danielle N. Atkins
Brandon del Pozo
author_sort Fatema Z. Ahmed
collection DOAJ
description Abstract Background Medications for opioid use disorder (MOUD) significantly decrease mortality but courts rarely refer participants with opioid use disorder to MOUD providers. Previous qualitative work suggests routine court referrals to MOUD providers are more likely if court team members perceive providers as “trustworthy.” Court team members may also be less likely to refer participants to MOUD if they consider MOUD unaffordable, particularly in Florida, which has not expanded Medicaid. Our aims were to explore court team members’ 1) perceptions of availability of local trustworthy MOUD providers, 2) characteristics associated with perceptions of availability of local trustworthy MOUD providers, including beliefs about MOUD efficacy, and 3) perceptions of MOUD affordability. Methods An online survey was distributed to all criminal problem-solving court and dependency court team members in Florida in 2019 and 2020. Likert scale questions assessed respondent agreement with statements about the availability of any MOUD providers, the availability of trustworthy MOUD providers, and the affordability of MOUD for court participants. An open-ended question explored MOUD barriers. Spearman’s rho, Friedman, Kruskal Wallis, and Mann-Whitney U tests were used for analyzing quantitative data and iterative categorization for qualitative data. Results One hundred fifty-one respondents completed quantitative questions (26% response rate), and 42 completed the qualitative question. Respondents were more likely to agree that local MOUD providers are more available than trustworthy MOUD providers. Perceptions of trustworthy provider availability differed significantly by MOUD type and were associated with MOUD efficacy beliefs. Qualitative results suggest that MOUD providers offering counseling and individualized treatment are more trustworthy. Conclusions Court team MOUD beliefs may influence their perceptions of providers, or negative experiences with providers may influence court team MOUD beliefs. Improving court team perceptions of local MOUD providers may be critical for facilitating court participant treatment access.
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spelling doaj.art-63282265441346559f8912a6505ec17e2022-12-22T01:33:29ZengBMCHealth & Justice2194-78992022-07-0110111310.1186/s40352-022-00188-4Barriers to medications for opioid use disorder in the court system: provider availability, provider “trustworthiness,” and costFatema Z. Ahmed0Barbara Andraka-Christou1M.H. Clark2Rachel Totaram3Danielle N. Atkins4Brandon del Pozo5School of Global Health Management & Informatics, University of Central FloridaSchool of Global Health Management & Informatics, University of Central FloridaDepartment of Learning Sciences & Educational Research, University of Central FloridaSchool of Global Health Management & Informatics, University of Central FloridaSchool of Global Health Management & Informatics, University of Central FloridaWarren Alpert Medical School, Brown UniversityAbstract Background Medications for opioid use disorder (MOUD) significantly decrease mortality but courts rarely refer participants with opioid use disorder to MOUD providers. Previous qualitative work suggests routine court referrals to MOUD providers are more likely if court team members perceive providers as “trustworthy.” Court team members may also be less likely to refer participants to MOUD if they consider MOUD unaffordable, particularly in Florida, which has not expanded Medicaid. Our aims were to explore court team members’ 1) perceptions of availability of local trustworthy MOUD providers, 2) characteristics associated with perceptions of availability of local trustworthy MOUD providers, including beliefs about MOUD efficacy, and 3) perceptions of MOUD affordability. Methods An online survey was distributed to all criminal problem-solving court and dependency court team members in Florida in 2019 and 2020. Likert scale questions assessed respondent agreement with statements about the availability of any MOUD providers, the availability of trustworthy MOUD providers, and the affordability of MOUD for court participants. An open-ended question explored MOUD barriers. Spearman’s rho, Friedman, Kruskal Wallis, and Mann-Whitney U tests were used for analyzing quantitative data and iterative categorization for qualitative data. Results One hundred fifty-one respondents completed quantitative questions (26% response rate), and 42 completed the qualitative question. Respondents were more likely to agree that local MOUD providers are more available than trustworthy MOUD providers. Perceptions of trustworthy provider availability differed significantly by MOUD type and were associated with MOUD efficacy beliefs. Qualitative results suggest that MOUD providers offering counseling and individualized treatment are more trustworthy. Conclusions Court team MOUD beliefs may influence their perceptions of providers, or negative experiences with providers may influence court team MOUD beliefs. Improving court team perceptions of local MOUD providers may be critical for facilitating court participant treatment access.https://doi.org/10.1186/s40352-022-00188-4CourtBuprenorphineMethadoneNaltrexoneTrustCost
spellingShingle Fatema Z. Ahmed
Barbara Andraka-Christou
M.H. Clark
Rachel Totaram
Danielle N. Atkins
Brandon del Pozo
Barriers to medications for opioid use disorder in the court system: provider availability, provider “trustworthiness,” and cost
Health & Justice
Court
Buprenorphine
Methadone
Naltrexone
Trust
Cost
title Barriers to medications for opioid use disorder in the court system: provider availability, provider “trustworthiness,” and cost
title_full Barriers to medications for opioid use disorder in the court system: provider availability, provider “trustworthiness,” and cost
title_fullStr Barriers to medications for opioid use disorder in the court system: provider availability, provider “trustworthiness,” and cost
title_full_unstemmed Barriers to medications for opioid use disorder in the court system: provider availability, provider “trustworthiness,” and cost
title_short Barriers to medications for opioid use disorder in the court system: provider availability, provider “trustworthiness,” and cost
title_sort barriers to medications for opioid use disorder in the court system provider availability provider trustworthiness and cost
topic Court
Buprenorphine
Methadone
Naltrexone
Trust
Cost
url https://doi.org/10.1186/s40352-022-00188-4
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