Justice involvement patterns, overdose experiences, and naloxone knowledge among men and women in criminal justice diversion addiction treatment

Abstract Background Persons in addiction treatment are likely to experience and/or witness drug overdoses following treatment and thus could benefit from overdose education and naloxone distribution (OEND) programs. Diverting individuals from the criminal justice system to addiction treatment repres...

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Main Authors: Rachel E. Gicquelais, Briana Mezuk, Betsy Foxman, Laura Thomas, Amy S. B. Bohnert
Format: Article
Language:English
Published: BMC 2019-07-01
Series:Harm Reduction Journal
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12954-019-0317-3
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author Rachel E. Gicquelais
Briana Mezuk
Betsy Foxman
Laura Thomas
Amy S. B. Bohnert
author_facet Rachel E. Gicquelais
Briana Mezuk
Betsy Foxman
Laura Thomas
Amy S. B. Bohnert
author_sort Rachel E. Gicquelais
collection DOAJ
description Abstract Background Persons in addiction treatment are likely to experience and/or witness drug overdoses following treatment and thus could benefit from overdose education and naloxone distribution (OEND) programs. Diverting individuals from the criminal justice system to addiction treatment represents one treatment engagement pathway, yet OEND needs among these individuals have not been fully described. Methods We characterized justice involvement patterns among 514 people who use opioids (PWUO) participating in a criminal justice diversion addiction treatment program during 2014–2016 using a gender-stratified latent class analysis. We described prevalence and correlates of naloxone knowledge using quasi-Poisson regression models with robust standard errors. Results Only 56% of participants correctly identified naloxone as an opioid overdose treatment despite that 68% had experienced an overdose and 79% had witnessed another person overdose. We identified two latent justice involvement classes: low involvement (20.3% of men, 46.5% of women), characterized by older age at first arrest, more past-year arrests, and less time incarcerated; and high involvement (79.7% of men, 53.5% of women), characterized by younger age at first arrest and more lifetime arrests and time incarcerated. Justice involvement was not associated with naloxone knowledge. Male participants who had personally overdosed more commonly identified naloxone as an overdose treatment after adjustment for age, race, education level, housing status, heroin use, and injection drug use (prevalence ratio [95% confidence interval]: men 1.5 [1.1–2.0]). Conclusions All PWUO in criminal justice diversion programs could benefit from OEND given the high propensity to experience and witness overdoses and low naloxone knowledge across justice involvement backgrounds and genders.
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spelling doaj.art-a1ef5b4132d64ad59a77d1090a3e908c2022-12-21T22:40:46ZengBMCHarm Reduction Journal1477-75172019-07-0116111110.1186/s12954-019-0317-3Justice involvement patterns, overdose experiences, and naloxone knowledge among men and women in criminal justice diversion addiction treatmentRachel E. Gicquelais0Briana Mezuk1Betsy Foxman2Laura Thomas3Amy S. B. Bohnert4Department of Epidemiology, University of Michigan School of Public HealthDepartment of Epidemiology, University of Michigan School of Public HealthDepartment of Epidemiology, University of Michigan School of Public HealthDepartment of Psychiatry, University of MichiganDepartment of Psychiatry, University of MichiganAbstract Background Persons in addiction treatment are likely to experience and/or witness drug overdoses following treatment and thus could benefit from overdose education and naloxone distribution (OEND) programs. Diverting individuals from the criminal justice system to addiction treatment represents one treatment engagement pathway, yet OEND needs among these individuals have not been fully described. Methods We characterized justice involvement patterns among 514 people who use opioids (PWUO) participating in a criminal justice diversion addiction treatment program during 2014–2016 using a gender-stratified latent class analysis. We described prevalence and correlates of naloxone knowledge using quasi-Poisson regression models with robust standard errors. Results Only 56% of participants correctly identified naloxone as an opioid overdose treatment despite that 68% had experienced an overdose and 79% had witnessed another person overdose. We identified two latent justice involvement classes: low involvement (20.3% of men, 46.5% of women), characterized by older age at first arrest, more past-year arrests, and less time incarcerated; and high involvement (79.7% of men, 53.5% of women), characterized by younger age at first arrest and more lifetime arrests and time incarcerated. Justice involvement was not associated with naloxone knowledge. Male participants who had personally overdosed more commonly identified naloxone as an overdose treatment after adjustment for age, race, education level, housing status, heroin use, and injection drug use (prevalence ratio [95% confidence interval]: men 1.5 [1.1–2.0]). Conclusions All PWUO in criminal justice diversion programs could benefit from OEND given the high propensity to experience and witness overdoses and low naloxone knowledge across justice involvement backgrounds and genders.http://link.springer.com/article/10.1186/s12954-019-0317-3OpioidsOverdoseNaloxoneAddiction treatmentCriminal justice system involvementLatent class analysis
spellingShingle Rachel E. Gicquelais
Briana Mezuk
Betsy Foxman
Laura Thomas
Amy S. B. Bohnert
Justice involvement patterns, overdose experiences, and naloxone knowledge among men and women in criminal justice diversion addiction treatment
Harm Reduction Journal
Opioids
Overdose
Naloxone
Addiction treatment
Criminal justice system involvement
Latent class analysis
title Justice involvement patterns, overdose experiences, and naloxone knowledge among men and women in criminal justice diversion addiction treatment
title_full Justice involvement patterns, overdose experiences, and naloxone knowledge among men and women in criminal justice diversion addiction treatment
title_fullStr Justice involvement patterns, overdose experiences, and naloxone knowledge among men and women in criminal justice diversion addiction treatment
title_full_unstemmed Justice involvement patterns, overdose experiences, and naloxone knowledge among men and women in criminal justice diversion addiction treatment
title_short Justice involvement patterns, overdose experiences, and naloxone knowledge among men and women in criminal justice diversion addiction treatment
title_sort justice involvement patterns overdose experiences and naloxone knowledge among men and women in criminal justice diversion addiction treatment
topic Opioids
Overdose
Naloxone
Addiction treatment
Criminal justice system involvement
Latent class analysis
url http://link.springer.com/article/10.1186/s12954-019-0317-3
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