scholarly journals Treating Opioid Use Disorders in Drug Court: Participants’ Views on Using Medication-Assisted Treatments (MATs) to Support Recovery

2019 ◽  
Vol 29 (3) ◽  
pp. 249-261 ◽  
Author(s):  
John R. Gallagher ◽  
Elizabeth A. Wahler ◽  
Raychel M. Minasian ◽  
Abigail Edwards
Keyword(s):  
Lived Experiences ◽  
Drug Court ◽  
Drug Courts ◽  
Future Research ◽  
Dade County ◽  
Criminal Recidivism ◽  
Opioid Epidemic ◽  
Opioid Use ◽  
Behavioral Therapies ◽  
Opioid Use Disorders

Drug courts began in 1989 in Miami-Dade County, FL. Due to their success in treating substance use disorders and reducing criminal recidivism, they have expanded globally and are currently operating in countries such as Australia, Canada, and Scotland, to name a few. Drug courts can be a key intervention in addressing the opioid epidemic. This is the first known qualitative study to ask drug court participants ( n = 38) who have opioid use disorders questions related to their lived experiences in drug court, as well as direct questions related to the use of medication-assisted treatments (MATs) in drug court. Overall, drug court participants felt that MATs were helpful for treating their opioid use disorders; however, some participants reported using other drugs while on MATs and they viewed their recovery through a harm reduction lens. Additionally, participants emphasized the importance of using MATs in combination with counseling that used cognitive and behavioral therapies. Implications for drug court practice and future research are discussed.

Improving graduation rates in drug court: A qualitative study of participants’ lived experiences

2016 ◽  
Vol 17 (4) ◽  
pp. 468-484 ◽  
Author(s):  
John Robert Gallagher ◽  
Anne Nordberg ◽  
Elyse Lefebvre
Keyword(s):  
Substance Use ◽  
Qualitative Study ◽  
Lived Experiences ◽  
Justice System ◽  
Drug Testing ◽  
Drug Court ◽  
Drug Courts ◽  
Criminal Recidivism ◽  
Frequent Contact

For nearly three decades, drug courts have provided a rehabilitative approach within the criminal justice system for individuals who have a substance use disorder. The goal of drug courts is to reduce criminal recidivism, and research has consistently suggested that participants that graduate drug court are less likely to recidivate than those who are terminated from the program. This qualitative study adds to the literature by asking drug court participants ( N = 42) their views on the most helpful aspects of the program that support them in graduating and how the program could be more helpful to support them in graduating. Two themes emerged from the data: (1) participants felt that interventions that are common to drug courts, such as drug testing and having frequent contact with the judge, were most helpful in supporting them in graduating the program; (2) participants felt that the agencies that offered treatment for their substance use disorders used punitive tactics and judgmental approaches that compromised the quality of treatment they received, and they felt that this was a barrier to them graduating the program. The findings are discussed in reference to drug court practice.

scholarly journals Reduction in opioid use with perioperative non-pharmacologic analgesia in total knee arthroplasty and ACL reconstruction: a systematic review

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 63
Author(s):  
Ryan B Juncker ◽  
Faisal M Mirza ◽  
Joel J Gagnier
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Acl Reconstruction ◽  
Knee Arthroplasty ◽  
Cruciate Ligament ◽  
Future Research ◽  
Opioid Epidemic ◽  
Clinical Implementation ◽  
Opioid Use ◽  
Total Knee

Introduction: The world’s opioid epidemic has gotten increasingly severe over the last several decades and projects to continue worsening. Orthopedic surgery is the largest contributor to this epidemic, accounting for 8.8% of postoperative opioid dependence cases. Total knee arthroplasty (TKA) and anterior cruciate ligament (ACL) reconstruction are commonly performed orthopedic operations heavily reliant on opioids as the primary analgesic in the peri- and immediate postoperative period. These downfalls highlight the pressing need for an alternate, non-pharmacologic analgesic to reduce postoperative opioid use in orthopedic patients. The presented systematic review aimed to analyze and compare the most promising non-pharmacologic analgesic interventions in the available literature to guide future research in such a novel field. Methods: A systematic search of PubMed, MEDLINE, Embase, Cochrane, and Web of Science was performed for studies published before July 2020 based on the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines, and the obtained manuscripts were evaluated for inclusion or exclusion against strict, pre-determined criteria. Risk-of-bias and GRADE (grades of recommendation, assessment, development, and evaluation) assessments were then performed on all included studies. Results: Six studies were deemed fit for inclusion, investigating three non-pharmacologic analgesics: percutaneous peripheral nerve stimulation, cryoneurolysis, and auricular acupressure. All three successfully reduced postoperative opioid use while simultaneously maintaining the safety and efficacy of the procedure. Discussion: The results indicate that all three presented non-pharmacologic analgesic interventions are viable and warrant future research. That said, because of its slight advantages in postoperative pain control and operational outcomes, cryoneurolysis seems to be the most promising. Further research and eventual clinical implementation of these analgesics is not only warranted but should be a priority because of their vast potential to reduce orthopedics surgeries’ contribution to the opioid epidemic.

scholarly journals Community-Engaged Research (CER) as the Avenue to Promoting Well-being and Recovery in Drug Court

2020 ◽  
Vol 1 (2) ◽  
Author(s):  
John Robert Gallagher ◽  
Anne Nordberg ◽  
Raychel Minasian ◽  
Sydney Szymanowski ◽  
Jesse Carlton ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Support Groups ◽  
Drug Court ◽  
Well Being ◽  
The United States ◽  
Drug Courts ◽  
Recidivism Rate ◽  
Criminal Recidivism ◽  
Community Engaged Research

Drug courts are an alternative to incarceration for individuals who have substance use disorders and have been arrested for drug-related crimes (e.g. possession of a controlled substance). The first drug court began in 1989 in Florida and it is estimated that there are over 3,000 drug courts now operating throughout the United States.  This community-engaged research (CER) evaluated the St. Joseph County (Indiana) drug court by identifying who was most likely to graduate, who was most likely to recidivate, and whether drug court or probation was more effective at reducing criminal recidivism.  Furthermore, although drug courts are found in many communities, research rarely describes the process used to develop and implement CER.  Therefore, this article also highlights the collaborative process used in this drug court evaluation.   The findings from this study suggest that the St. Joseph County (Indiana) drug court is an effective program at reducing criminal recidivism and a valuable resource for individuals who have substance use disorders, the community, and other stakeholders. Drug court participants were less likely to recidivate than probationers, and a lower recidivism rate clearly equates to many benefits to the community.  The article concludes with community-based implications, such as starting recovery support groups that are welcoming to individuals who receive medication-assisted treatment (MAT), marketing drug court to racial and ethnic minorities to increase their representation in drug court, and disseminating research findings throughout the community via local news stories and public lectures.

Psychosocial interventions for chronic pain and comorbid prescription opioid use disorders: A narrative review of the literature

2018 ◽  
Vol 14 (5) ◽  
pp. 345-358 ◽  
Author(s):  
Valerie Hruschak, MSW ◽  
Gerald Cochran, PhD ◽  
Ajay D. Wasan, MD, MSc
Keyword(s):  
Chronic Pain ◽  
Psychosocial Interventions ◽  
Treatment Modalities ◽  
Prescription Opioid ◽  
Future Research ◽  
Motivational Enhancement Therapy ◽  
Opioid Misuse ◽  
Opioid Use ◽  
Chronic Noncancer Pain ◽  
Opioid Use Disorders

Objective: Opioid misuse in the context of chronic noncancer pain (CNCP) is a multifaceted and complex issue. As opioid misuse and corresponding rates of addiction and overdose deaths exceed epidemic proportions, there is an urgent need for research in this area. The objective of this review is to evaluate the literature addressing psychosocial interventions targeting CNCP and prescription opioid misuse.Design: A systematic search of PubMed, MEDLINE, PsychINFO, ClinicalTrials. gov was conducted to identify studies evaluating psychosocial interventions targeting CNCP and prescription opioid misuse. The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Results: 56 peer-reviewed research articles from 1993 to July, 2016, which included studies of psychosocial interventions for CNCP and opioid use disorders. Studies that examined psychosocial interventions for CNCP, treatment modalities included: cognitive behavioral therapy (CBT), acceptance and commitment therapy, mindfulness-based cognitive therapy and mindfulness-based stress reduction, and chronic pain self-management programs. The psychosocial interventions for opioid misuse included: CBT and relapse prevention, motivational enhancement therapy and stages of change, contingency management, and self-help and peer support-based groups.Conclusions: The findings of this review offer clinical insight and reinforce the importance of psychosocial interventions in CNCP and opioid use disorders. However, little empirical data are available to guide practitioners in treating patients with CNCP who misuse opioid medications, and thus future research on integrated approaches, is needed.

The Effects of Drug Treatment and Supervision on Time to Rearrest among Drug Treatment Court Participants

2003 ◽  
Vol 33 (2) ◽  
pp. 385-412 ◽  
Author(s):  
Duren Banks ◽  
Denise C. Gottfredson
Keyword(s):  
Drug Treatment ◽  
Drug Court ◽  
Past Research ◽  
Drug Courts ◽  
Future Research ◽  
Survival Times ◽  
Risk Of Failure ◽  
Equivalent Rate ◽  
Main Components

Past research has generally shown that drug courts are reaching their target offenders and that program participants are rearrested at a lower or equivalent rate than comparison offenders. Few analyses have been conducted to test the relative effects of different drug court elements, however. The current research takes a closer look at the two main components of the drug court, supervision and treatment, to determine whether one is more effective at preventing failure, or whether the combination of both is necessary to observe a decreased risk of failure. Attending treatment significantly decreased the risk of failure over a two-year follow-up period, while receiving supervision did not. Offenders who received both supervision and treatment had the longest survival times, but not significantly longer than those who received treatment only. Implications for drug courts in general are discussed, as well as avenues for future research in this field.

scholarly journals The Impact of an Indiana (United States) Drug Court on Criminal Recidivism

2014 ◽  
Vol 15 (2) ◽  
pp. 507-521 ◽  
Author(s):  
John R. Gallagher ◽  
Eric Ivory ◽  
Jesse Carlton ◽  
Hon. Jane Woodward Miller
Keyword(s):  
United States ◽  
Metropolitan Area ◽  
Drug Court ◽  
Demographic Characteristics ◽  
Future Research ◽  
Criminal Record ◽  
Criminal Recidivism ◽  
Policy Advocacy ◽  
The Impact ◽  
Court Practice

This study evaluated a drug court located in a metropolitan area of Indiana (United States), focusing specifically on identifying variables that predicted recidivism among drug court participants and comparing criminal recidivism patterns among drug court and probation participants. Drug court participants were most likely to recidivate if they were younger, had a violation within the first 30 days of the program, had a previous criminal record, and were terminated unsuccessfully from the program. Furthermore, drug court participants were less likely to recidivate than probationers who had similar offense and demographic characteristics. Implications for drug court practice, policy advocacy, and future research are discussed.

Effectiveness of Treatment-Based Drug Courts in Reducing Criminal Recidivism

2000 ◽  
Vol 27 (1) ◽  
pp. 72-96 ◽  
Author(s):  
ROGER H. PETERS ◽  
MARY R. MURRIN
Keyword(s):  
Substance Abuse ◽  
Clinical Practice ◽  
Outcome Research ◽  
Direct Relationship ◽  
Drug Court ◽  
Drug Courts ◽  
Criminal Recidivism ◽  
Comparison Groups ◽  
Probation Supervision

This study examined outcomes for two treatment-based drug court programs during a 30-month follow-up period. Outcomes for drug court graduates were contrasted with those of nongraduates and of comparison groups that consisted of offenders who were placed on probation supervision during the same period and did not receive drug court services. Drug court graduates from both programs were significantly less likely to be arrested and had fewer arrests during follow-up in comparison to matched probationers and nongraduates. For both drug courts, the rates of arrest during the 30-month follow-up period declined in direct relationship to the duration of drug court involvement. Drug court graduates had lower rates of substance abuse than comparable groups of treated offenders. The implications for clinical practice and the need for additional drug court outcome research are discussed.

Responding to the Opioid Epidemic

2021 ◽  
pp. 77-91
Keyword(s):  
Rural Areas ◽  
Complex Disease ◽  
Opioid Use Disorder ◽  
Opioid Addiction ◽  
Rural Populations ◽  
Opioid Epidemic ◽  
Opioid Use ◽  
Medication Assisted Treatment ◽  
Correctional Settings ◽  
Opioid Use Disorders

Chapter 6 examines the complex disease of opioid use disorder and the barriers that exist within the very system designed to help. It also highlights some promising pockets of progress, focusing especially on two environments hit hard by opioid addiction: correctional settings and rural areas. Elizabeth Connolly argues that medication-assisted treatment (MAT) improves outcomes for incarcerated individuals with opioid use disorders and presents examples of successful MAT programs in Massachusetts and Colorado. John Gale explains the complex factors that contribute to opioid addiction among rural populations and why those communities are disproportionately impacted by this epidemic. The chapter concludes with a look at why more progress has not been made.

scholarly journals Characterizing non-heroin opioid overdoses using electronic health records

JAMIA Open ◽  
2019 ◽  
Vol 3 (1) ◽  
pp. 77-86
Author(s):  
Amelia J Averitt ◽  
Benjamin H Slovis ◽  
Abdul A Tariq ◽  
David K Vawdrey ◽  
Adler J Perotte
Keyword(s):  
Average Rate ◽  
Medical Center ◽  
Academic Medical Center ◽  
Future Research ◽  
Opioid Epidemic ◽  
Opioid Use ◽  
Electronic Health Record Data ◽  
Individual Level ◽  
Electronic Health ◽  
The Individual

Abstract Introduction The opioid epidemic is a modern public health emergency. Common interventions to alleviate the opioid epidemic aim to discourage excessive prescription of opioids. However, these methods often take place over large municipal areas (state-level) and may fail to address the diversity that exists within each opioid case (individual-level). An intervention to combat the opioid epidemic that takes place at the individual-level would be preferable. Methods This research leverages computational tools and methods to characterize the opioid epidemic at the individual-level using the electronic health record data from a large, academic medical center. To better understand the characteristics of patients with opioid use disorder (OUD) we leveraged a self-controlled analysis to compare the healthcare encounters before and after an individual’s first overdose event recorded within the data. We further contrast these patients with matched, non-OUD controls to demonstrate the unique qualities of the OUD cohort. Results Our research confirms that the rate of opioid overdoses in our hospital significantly increased between 2006 and 2015 (P < 0.001), at an average rate of 9% per year. We further found that the period just prior to the first overdose is marked by conditions of pain or malignancy, which may suggest that overdose stems from pharmaceutical opioids prescribed for these conditions. Conclusions Informatics-based methodologies, like those presented here, may play a role in better understanding those individuals who suffer from opioid dependency and overdose, and may lead to future research and interventions that could successfully prevent morbidity and mortality associated with this epidemic.

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