Examining predictors of substance use and treatment adequacy among formerly incarcerated opiod and cocaine users

检查以前被监禁的阿片类药物和可卡因使用者的物质使用和治疗充分性的预测因素

• 批准号: 10522324
• 负责人: TAWANDRA LASHONE ROWELL-CUNSOLO
• 金额: $ 59.58万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10522324
• 关键词: Address; American; Area; Caring; Characteristics; Cocaine; Cocaine Users; Communities; Criminal Justice; Data; Diagnosis; Drug usage; Environment; Environmental Risk Factor; Exposure to; Frequencies; Gender; General Population; Health Services Accessibility; Heroin Users; Home; Hospitalization; Illicit Drugs; Imprisonment; Income; Individual; Influentials; Institution; Intervention; Measures; Medicine; Mental Health; Neighborhoods; New York; New York City; Opioid; Overdose; Participant; Pathway interactions; Patients; Pharmaceutical Preparations; Population; Race; Reporting; Research; Residential Mobility; Resources; Risk; Risk Factors; Severities; Site; Societies; Substance Use Disorder; Supervision; Time; Treatment Effectiveness; United States; addiction; adverse outcome; cocaine use; experience; high risk; high risk behavior; illicit opioid; interest; mortality risk; multilevel analysis; novel; opioid overdose; opioid use; opioid user; overdose risk; overtreatment; parole; people of color; poor communities; probation; response; social; substance use; substance use treatment; theories; time use; transitional housing; treatment services

Project Summary Currently, 2.2 million individuals are incarcerated in the United States (US), and approximately 600,000 are released annually. Substance use disorders (SUDs) are common in this population: ~65% meet the criteria for an SUD diagnosis (vs 5% of the general population). Post- incarceration, substance use increases considerably, – the risk of drug overdose is 9-17 times higher among formerly incarcerated individuals than in the general population. However, significant gaps in our understanding of structural and individual pathways of post-incarceration substance use limit treatment effectiveness. The proposed study will examine factors associated with changes in substance use and substance use treatment adequacy over a one- year period post-release among formerly incarcerated individuals in New York City (NYC), where opioid-related overdose rates more than doubled between 2015 and 2017 and are increasing among people of color and residents in high poverty communities. We will examine the extent to which participants receive substance use treatment services recommended by their scores on the American Society of Addiction Medicine (ASAM) patient placement criteria (PPC). We will use novel spatially informed multi-level modeling strategies to investigate individual and environmental factors that influence substance use among individuals released in NYC from institutions in the New York State Department of Corrections and Community Supervision (NYSDOCCS), one of the largest U.S. criminal justice correctional agencies. Guided by social ecological theory, we will address the following Specific Aims: 1). Characterize substance use at five time points over a 12-month period (at baseline and 3-, 6-, 9-, and 12- months) among those recently released from incarceration; 2). Identify individual- and environment-level predictors of post-incarceration substance use; and 3) Investigate discrepancies between ASAM PPC composite scores (a measure of addiction severity) generated and levels of substance use treatment over time. The proposed research will identify substance use treatment gaps and influential factors that are amenable to intervention in the interest of informing effective responses to problematic substance use.

项目概要 目前，美国 (US) 有 220 万人被监禁，其中大约 每年有 600,000 人被释放，药物使用障碍 (SUD) 在该人群中很常见： 约 65% 符合 SUD 诊断标准（普通人群中这一比例为 5%）。 监禁、药物滥用显着增加——药物过量的风险是原来的 9-17 倍 然而，以前被监禁的人中的比例高于一般人群。 我们对监禁后的结构和个人路径的理解存在重大差距 拟议的研究将检查物质使用限制治疗效果的因素。 与物质使用的变化和物质使用治疗充分性有关 纽约市 (NYC) 前被监禁人员获释后一年内， 2015 年至 2017 年间，与阿片类药物相关的过量用药率增加了一倍多， 我们将研究有色人种和高度贫困社区居民的增加。 接受药物滥用治疗服务建议的程度 他们在美国成瘾医学协会 (ASAM) 患者安置标准上的得分 （PPC）。我们将使用新颖的空间信息多层次建模策略来研究。 影响释放者物质使用的个人和环境因素 NYC 来自纽约州惩教和社区部门的机构 监督局 (NYSDOCCS)，美国最大的刑事司法惩教机构之一。 在社会生态理论的指导下，我们将实现以下具体目标：1）。 12 个月期间五个时间点的物质使用情况（基线以及 3、6、9 和 12 个月） 月）在最近从监狱释放的人中；2）。 监禁后物质使用的环境水平预测因素；以及 3) 调查 ASAM PPC 综合分数（成瘾严重程度的衡量标准）之间的差异 拟议的研究将确定随着时间的推移所产生的物质使用治疗水平。 物质使用治疗差距和易于干预的影响因素 有兴趣为有问题的物质使用提供有效的应对措施。