Medication assisted treatment (MAT) in criminal justice settings as a double-edged sword: balancing novel addiction treatments and voluntary participation

Lobmaier, Philipp

doi:10.1186/s40352-020-0106-9

Cited by 10 publications

(5 citation statements)

References 61 publications

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“…One relevant example of mandatory therapy in a vulnerable population is court-ordered medical treatment subsequent to a drug possession and distribution offense; such policies lead to potentially coercive use of MAT for SUDs in incarcerated populations. These types of programs have been studied since the late 1990s and have grown substantially in the populations they serve [ 38 , 39 ]. Therefore, we surveyed pharmacist-rated support or opposition for the mandatory and voluntary use of vaccine-based therapies across various clinical scenarios and in different vulnerable populations (Fig.…”

Section: Resultsmentioning

confidence: 99%

Pharmacy stakeholder reports on ethical and logistical considerations in anti-opioid vaccine development

Wartenweiler

Chung²,

Stewart

et al. 2021

BMC Med Ethics

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Background As opioid use disorder (OUD) incidence and its associated deaths continue to persist at elevated rates, the development of novel treatment modalities is warranted. Recent strides in this therapeutic area include novel anti-opioid vaccine approaches. This work compares logistical and ethical considerations surrounding currently available interventions for opioid use disorder with an anti-opioid vaccine approach. Methods The opinions of student pharmacists and practicing pharmacists assessing knowledge, perceptions, and attitudes toward current and future OUD management strategies were characterized using a staged, multi-modal research approach incorporating a focus group, pilot survey development and refinement, and final survey deployment. Survey responses were assessed using one- and two-way parametric and non-parametric analyses where appropriate, and multi-dimensional matrix profiles were compared using z-tests following an exhaustive combinatorial sum of differences calculation between items within each compared matrix. Results Focus group content analysis revealed a high level of agreeableness among participants regarding anti-opioid vaccine technology and a sense of shared ownership regarding solutions to the opioid epidemic at large. Pilot survey results demonstrated subject ability to consider both pragmatic and ethical considerations related to current therapeutics and novel interventions in a single instrument, with high endurance amongst engaged subjects. Access inequality was the most concerning ethical consideration identified for anti-opioid vaccines. Support for anti-opioid vaccine implementation across various clinical scenarios was strongest for voluntary use amongst individuals in recovery, and lowest for mandatory use in at-risk individuals. Conclusions Ethical and logistical concerns surrounding anti-opioid vaccines were largely similar to those for current OUD therapeutics overall. Anti-opioid vaccines were endorsed as helpful potential additions to current OUD therapeutic approaches, particularly for voluntary use in the later stages of clinical progression.

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Section: Resultsmentioning

confidence: 99%

Pharmacy stakeholder reports on ethical and logistical considerations in anti-opioid vaccine development

Wartenweiler

Chung²,

Stewart

et al. 2021

BMC Med Ethics

View full text Add to dashboard Cite

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“…There are numerous studies supporting the effectiveness of court-mandated treatment on completion rates (Brinkley-Rubinstein et al, 2018;Coviello et al, 2013;DeFulio et al, 2013;Kiluk et al, 2015;Longinaker & Terplan, 2014), yet utilization of court-mandated treatment remains minimal. The criminal justice system possesses a unique position to authorize potential lifesaving treatment, yet these agencies maintain a passive role in mandating OUD treatment (Hyatt & Lobmaier, 2020). When considering the severity of the opioid epidemic, we posit that the common goal must focus on successful treatment outcomes despite the pathway of treatment admission.…”

Section: Discussionmentioning

confidence: 99%

“…The key to successful treatment for opioid addiction does not rely on the pathway in which one entered treatment, regardless of the motivational factors, the predictor of successful completion may be retention which leads to higher completion rates (Wild, Yuan, Rush, & Urbanoski, 2016). Further studies done with both mandated and non-mandated treatment options found low motivation for both groups, but retention remained 10 times higher for the mandated population (Hyatt & Lobmaier, 2020). It stands to reason that longer treatment retention reduces the likelihood of treatment dropout rates, promotes higher treatment alliance, and leads to higher completion outcomes (O'Connor, Cousins, Durand, Barry, & Boland, 2020).…”

Section: Court-mandated Treatment As a Successful Treatment Optionmentioning

confidence: 99%

Court-Mandated Treatment Outcomes for Prescribed Opioid Use Disorder: A Gender Based Study

Lucabeche

Quinn

2021

Journal of Drug Issues

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This study provides empirical information suggesting court-mandated treatment may be a more effective treatment pathway for opioid use disorder (OUD). To examine the effects of mandated treatment for prescription opioid users, we consider the differences in discharge completion rates for court-mandated and non-mandated treatment for both males and females. We use the Treatment Episode Data Set-Discharges (TEDS-D) from 2015 to 2017 with 13,239, 14,765, and 15,433 cases, respectively, to study successful completion rates for males and females with OUD. Logistic regression analysis confirms a greater completion rate for mandated treatment episodes. Of all mandated females, 59% completed treatment in each of the 3 years as compared to the 59%, 65%, and 64% of successful completion for mandated males, respectively, from 2015 to 2017. Our results suggest court-mandated treatment pathways are more effective on treatment completion for individuals with OUD, yet treatment completion disparity between sexes increases even when females are mandated.

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“…These types of programs have been studied since the late 1990s and have grown substantially in the populations they serve. 38,39 Therefore, we surveyed pharmacist-rated support or opposition for the mandatory and voluntary use of vaccine-based therapies across various clinical scenarios and in different vulnerable populations (Figure 8). A global preference for voluntary use as compared to mandatory use was reported (p<0.05 for all comparisons).…”

Section: Application Of Anti-opioid Vaccines In Ethically-variable Clinical Practice Settings and Populationsmentioning

confidence: 99%

Pharmacy Stakeholder Reports on Ethical and Logistical Considerations in Anti-Opioid Vaccine Development

Wartenweiler

Chung

Stuart

et al. 2021

Preprint

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BACKGROUND: As opioid use disorder (OUD) incidence and its associated deaths continue to persist at elevated rates, the development of novel treatment modalities is warranted. Recent strides in this therapeutic area include novel anti-opioid vaccine approaches. This work compares logistical and ethical considerations surrounding currently available interventions for opioid use disorder with an anti-opioid vaccine approach. METHODS: The opinions of student pharmacists and practicing pharmacists assessing knowledge, perceptions, and attitudes toward current and future OUD management strategies were characterized using a staged, multi-modal research approach incorporating a focus group, pilot survey development and refinement, and final survey deployment. Survey responses were assessed using one- and two-way parametric and non-parametric analyses where appropriate, and multi-dimensional matrix profiles were compared using z-tests following an exhaustive combinatorial sum of differences calculation between items within each compared matrix.RESULTS: Focus group content analysis revealed a high level of agreeableness among participants regarding anti-opioid vaccine technology and a sense of shared ownership regarding solutions to the opioid epidemic at large. Pilot survey results demonstrated subject ability to consider both pragmatic and ethical considerations related to current therapeutics and novel interventions in a single instrument, with high endurance amongst engaged subjects. Access inequality was the most concerning ethical consideration identified for anti-opioid vaccines. Support for anti-opioid vaccine implementation across various clinical scenarios was strongest for voluntary use amongst individuals in recovery, and lowest for mandatory use in at-risk individuals. CONCLUSIONS: Ethical and logistical concerns surrounding anti-opioid vaccines were largely similar to those for current OUD therapeutics overall. Anti-opioid vaccines were endorsed as helpful potential additions to current OUD therapeutic approaches, particularly for voluntary use in the later stages of clinical progression.

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Medication assisted treatment (MAT) in criminal justice settings as a double-edged sword: balancing novel addiction treatments and voluntary participation

Cited by 10 publications

References 61 publications

Pharmacy stakeholder reports on ethical and logistical considerations in anti-opioid vaccine development

Pharmacy stakeholder reports on ethical and logistical considerations in anti-opioid vaccine development

Court-Mandated Treatment Outcomes for Prescribed Opioid Use Disorder: A Gender Based Study

Pharmacy Stakeholder Reports on Ethical and Logistical Considerations in Anti-Opioid Vaccine Development

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