Journal article
State inequities: Gaps in planned treatment for criminal legal referrals with opioid use disorder across two decades of US treatment admissions
The American journal on addictions, Vol.34(1), pp.60-68
01/2025
DOI: 10.1111/ajad.13636
PMID: 39096196
Abstract
Abstract Background and Objectives Criminal‐legal (CL) referrals to addiction treatment have historically had low utilization of medications for opioid use disorder (MOUD). While state differences have been reported, an in‐depth longitudinal analysis of state‐by‐state differences is lacking. Methods The Substance Abuse and Mental Health Services Administration Treatment Episode Dataset‐Admissions 2000–2020 provided data for individuals entering their initial treatment with an opioid as their primary substance. Outcome was planned use of MOUD, assessing odds ratio (OR) of CL referrals relative to non‐CL referrals cumulatively over the 21‐year period and as incremental change (change in relative disparity) using effect sizes, stratified by each state. Results 2,187,447 cases met the criteria. Planned MOUD occurred in 37.7% of non‐CL clients versus 6.5% of CL clients (OR = 0.11, 95% confidence interval = 0.11–0.12). For all clients, planned MOUD increased from 2000 (33.9%) to 2020 (44.8%). This increase was blunted within CL clients, increasing from 2000 (6.4%) to 2020 (13.3%). Rhode Island saw the greatest improvements in equity. Discussion and Conclusions While rates of planned MOUD increased over the 21 years, a significant disparity persisted among CL clients in most states. As opioid use disorders and opioid‐related overdoses are more prevalent among those involved with the CL system, improving this has high impact. Scientific Significance Provides the most comprehensive analysis of state‐by‐state inequities in MOUD access for CL relative to non‐CL referrals over a 21‐year period through use of a national data set. Positive outliers are used as case examples for others to follow in pursuit of more equitable care.
Details
- Title: Subtitle
- State inequities: Gaps in planned treatment for criminal legal referrals with opioid use disorder across two decades of US treatment admissions
- Creators
- Nicholas L. Bormann - Mayo ClinicAndrea N. Weber - University of IowaTyler S. Oesterle - Mayo ClinicBenjamin Miskle - University of IowaAlison C. Lynch - University of IowaStephan Arndt - University of Iowa
- Resource Type
- Journal article
- Publication Details
- The American journal on addictions, Vol.34(1), pp.60-68
- DOI
- 10.1111/ajad.13636
- PMID
- 39096196
- NLM abbreviation
- Am J Addict
- ISSN
- 1055-0496
- eISSN
- 1521-0391
- Publisher
- WILEY
- Language
- English
- Electronic publication date
- 08/03/2024
- Date published
- 01/2025
- Academic Unit
- Psychiatry; Biostatistics; Addiction Medicine; Family and Community Medicine; Nursing; Pharmacy Practice and Science; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984695459502771
Metrics
7 Record Views