Views of barriers and facilitators to continuing methadone treatment upon release from jail among people receiving patient navigation services

Mitchell, Shannon Gwin; Harmon-Darrow, Caroline; Lertch, Elizabeth; Monico, Laura B.; Kelly, Sharon M.; Sorensen, James L.; Schwartz, Robert P.

doi:10.1016/j.jsat.2021.108351

Cited by 15 publications

(9 citation statements)

References 22 publications

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“…Other studies demonstrate a range of material barriers after release for individuals with and without OUD, including a lack of both personal resources and information on how to access resources [ 26 , 34 – 36 ]. It is notable that many participants felt that the lack of resources ultimately set them up to return to prison or jail, emphasizing how social and structural factors influence criminal legal system involvement [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

“Just fighting for my life to stay alive”: a qualitative investigation of barriers and facilitators to community re-entry among people with opioid use disorder and incarceration histories

Hoffman

Thompson

Gaeta

et al. 2023

Addict Sci Clin Pract

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Background During the period of community re-entry immediately following release from jail or prison, individuals with opioid use disorder (OUD) face structural barriers to successful re-entry and high risk of overdose. Few published studies investigate experiences in the immediate period (i.e., first 24 h) of re-entry among people with OUD. Aim To understand the barriers and facilitators to treatment and reintegration of people with OUD during the initial transition from carceral settings back into the community. Methods From January–December 2017, we conducted 42 semi-structured qualitative interviews with patients with a history of incarceration who were receiving methadone at a not-for-profit, low-barrier opioid treatment program. Interviews probed participants’ community re-entry experiences immediately following incarceration. Interviews were transcribed and analyzed using a Thematic Analysis approach. Results The main themes described the experiences during the 24 h following release, reacclimating and navigating re-entry barriers, and re-entry preparedness and planning. Participants noted the initial 24 h to be a period of risk for returning to substance use or an opportunity to engage with OUD treatment as well as a tenuous period where many lacked basic resources such as shelter or money. When discussing the subsequent re-entry period, participants noted social challenges and persistent barriers to stable housing and employment. Participants overall described feeling unprepared for release and suggested improvements including formal transition programs, improved education, and support to combat the risk of overdose and return to substance use after incarceration. Conclusions In this study that qualitatively examines the experiences of people with incarceration histories and OUD enrolled in methadone treatment, we found that participants faced many barriers to community re-entry, particularly surrounding basic resources and treatment engagement. Participants reported feeling unprepared for release but made concrete suggestions for interventions that might improve the barriers they encountered. Future work should examine the incorporation of these perspectives of people with lived experience into the development of transition programs or re-entry classes.

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Section: Discussionmentioning

confidence: 99%

“Just fighting for my life to stay alive”: a qualitative investigation of barriers and facilitators to community re-entry among people with opioid use disorder and incarceration histories

Hoffman

Thompson

Gaeta

et al. 2023

Addict Sci Clin Pract

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show abstract

“…Moreover, even if adequate re-entry access to community-based MOUD treatment is readily available, individuals released from jail face numerous challenges to treatment engagement (Mitchell et al, 2021 ). Access to Medicaid coverage for MOUD is essential, as it has been demonstrated to increase MOUD treatment utilization among individuals involved with the criminal justice system (Khatri et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Availability of best practices for opioid use disorder in jails and related training and resource needs: findings from a national interview study of jails in heavily impacted counties in the U.S.

et al. 2022

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Background Jails are optimal settings in which to screen individuals for opioid use disorders (OUD) and provide needed services, especially medications for OUD (MOUD). This study sought to assess the availability of OUD “best practices” in jails located in counties heavily impacted by opioid overdose in the U.S. and their related training and resource needs. Counties were selected for study inclusion using two indicators of OUD severity: the absolute number and population rate of opioid overdose deaths. Structured interviews were completed with representatives from 185/244 (76%) of targeted counties and 185/250 (74%) of targeted jails in these counties. Ten OUD best practices were identified based on current treatment and practice guidelines. These include: screening for OUD; clinical assessment; medically managed withdrawal; MOUD administration; MOUD for pregnant people; counseling and wrap-around services; collaboration with community providers; assistance with Medicaid/insurance; re-entry services; and overdose prevention. Descriptive analyses examined the provision of any services and average percentage of services endorsed within best-practice categories, association of best-practice availability with community and jail characteristics, and related needs for training and resources. Results Over 70% of jail respondents indicated that some aspects of each of the ten OUD best practices were available within their jails, ranging from 71% using clinical assessment to 96% providing overdose prevention. However, there was considerable variability in the average percentage of items endorsed within each best-practice category, ranging from 38% of items regarding re-entry services to 88% of items regarding medically managed withdrawal. Availability of OUD best practices in jails also varied by community and jail characteristics. Jails reported the highest needs for funding for medication and clinical staff. Conclusions Policies are needed to address the identified gaps in availability of OUD best practices within jails. Training, technical assistance, and funding are needed to improve clinical capacity of jails to administer MOUD and to ensure continuity of care from jail to community, which are essential to reducing the risk of opioid-related overdose following release.

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“…Compared with the situation in the US, none of the informants we met expressed any challenges to access (Mitchell et al, 2021), and the methadone treatment program is implemented differently in Hong Kong. First, Hong Kong is a small city with a well-developed and cheap public transportation system.…”

Section: Introductionmentioning

confidence: 91%

The Impact of Later Life Events on Cessation Motivation of Older Adults with Substance Use Disorder in Hong Kong

Cheng¹,

Lapto

2023

Int J Offender Ther Comp Criminol

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Life-course researchers have found that age-graded life events, such as marriage and employment, may provoke a turning point in the trajectories of substance use and motivate young adults with substance use disorder (SUD) to seek addiction treatment and cease illegal drug use. However, few studies have focused on the impact of the life events experienced by older adults with SUD in their later life on these trajectories. Even less is known about this phenomenon in non-Western contexts. Thus, we conducted interviews with 34 older individuals with SUD in Hong Kong and explored how later life events affected their motivation to cease illegal drug use. Our findings highlight the influence of age on how life events are experienced and the need for age-specific academic studies of substance use trajectories. The results also have implications for policymakers, as the criminalization and stigmatization of drug use may have a negative impact on the trajectories of substance use among older populations.

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Views of barriers and facilitators to continuing methadone treatment upon release from jail among people receiving patient navigation services

Cited by 15 publications

References 22 publications

“Just fighting for my life to stay alive”: a qualitative investigation of barriers and facilitators to community re-entry among people with opioid use disorder and incarceration histories

“Just fighting for my life to stay alive”: a qualitative investigation of barriers and facilitators to community re-entry among people with opioid use disorder and incarceration histories

Availability of best practices for opioid use disorder in jails and related training and resource needs: findings from a national interview study of jails in heavily impacted counties in the U.S.

The Impact of Later Life Events on Cessation Motivation of Older Adults with Substance Use Disorder in Hong Kong

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