Author:
Shaffer Paige M.,Smelson David,Helm Abigail,Gaba Ayorkor,Marcus Sarah,Shaffer Howard J.
Abstract
Aim: Co-occurring opioid use and mental health disorders (COD) are common among people with criminal legal involvement. Reentry is a vulnerable period with low treatment engagement, often resulting in relapse, reincarceration, and overdose. While both linkage and multicomponent COD wraparound interventions have supported reentry, little is known about which are most effective for treatment engagement post release.
Methods: This quasi-experimental study included 293 nonrandomized persons involved in the criminal legal system enrolled in a multicomponent COD intervention (n=173) or a linkage only model (n=120) for treatment. Kaplan Meier Curves and Cox Proportional Hazards were computed to determine differences in engagement.
Results: Engagement was significantly different between interventions (X2=58.33, P <.0001). We observed a 73.3% reduction in hazard of early discharge for participants receiving the multicomponent COD intervention as compared to the linkage only model (P<.0001) and a higher 12-month engagement rate (51.5%) compared to the linkage only model (20.8%).
Conclusions: Future research should include a randomized controlled trial to examine factors that influence post-release engagement as well as treatment effects and outcomes. We suggest that programs consider both interventions and assess client reentry needs in advance of release to match to the best suited post-release COD treatment.
Reference91 articles.
1. Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: results from the 2020 National Survey on Drug Use and Health. 2020.
2. Bronson J, Berzofsky M. Indicators of mental health problems reported by prisoners and jail inmates. In: Bureau of Justice Statistics UDoJ, editor. 2017.
3. Winkelman T, Chang VW, Binswanger IA. Health, polysubstance use, and criminal justice involvement among adults with varying levels of opioid use. JAMA network open 2018; 1(3). https://doi.org/10.1001/jamanetworkopen.2018.0558
4. Bradizza CM, Stasiewicz PR, Paas ND. Relapse to alcohol and drug use among individuals diagnosed with co-occurring mental health and substance use disorders: a review. Clinical psychology review. 2006; 26(2): 162-78. https://doi.org/10.1016/j.cpr.2005.11.005
5. Baillargeon J, Penn JV, Knight K, Harzke AJ, Baillargeon G, Becker EA. Risk of reincarceration among prisoners with co-occurring severe mental illness and substance use disorders. Administration and Policy in Mental Health and Mental Health Services Research. 2009; 37(4): 367-74. https://doi.org/10.1007/s10488-009-0252-9