Framework for opioid use disorder screening and diagnosis in carceral settings.

Autor: Jack HE; Division of General Internal Medicine, Department of Medicine, University of Washington, 325 9th Avenue, Box 359780, 98104 Seattle, WA, USA; Washington State Department of Corrections, 7345 Linderson Way SW, 98501 Tumwater, WA, USA. Electronic address: HJack@uw.edu., Smith CL; Washington State Department of Corrections, 7345 Linderson Way SW, 98501 Tumwater, WA, USA., Brinkley-Rubinstein L; Department of Population Health Sciences, Duke University, 215 Morris Street, 27701, Durham, NC, USA., Berk J; Departments of Medicine and Pediatrics, Alpert Medical School at Brown University, 245 Chapman St, Ste 100, 02905 Providence, RI, USA.
Jazyk: angličtina
Zdroj: The International journal on drug policy [Int J Drug Policy] 2024 Oct 29; Vol. 134, pp. 104627. Date of Electronic Publication: 2024 Oct 29.
DOI: 10.1016/j.drugpo.2024.104627
Abstrakt: In the United States, the opioid overdose crisis disproportionately affects incarcerated individuals, with opioid overdose risk in the two weeks after release 50 times higher than the general population. As a response, many prisons and jails are starting to offer medication for opioid use disorder (MOUD), including methadone or buprenorphine, during incarceration or prior to release. One implementation barrier is how to identify who would benefit from treatment, given that opioid use disorder screening and diagnostic testing are imperfect, particularly in criminal-legal settings. Prisons and jails use a variety of OUD assessment strategies, including brief self-report screening tools, diagnostic interviews, review of pre-incarceration medical records, and urine drug screening, all of which may lead to false positive and false negative results. In this essay, we apply a common framework from epidemiology and other fields to conceptualize OUD assessment in carceral settings: individuals assessed for OUD can be those with OUD who are correctly offered MOUD ("true positives"), those without OUD who are offered MOUD ("false positives"), those with OUD who are not offered MOUD ("false negatives"), and those without MOUD who are not offered MOUD ("true negatives"). We discuss these assessment and treatment outcomes from the perspectives of people who are incarcerated, security staff, and healthcare staff. This framework may inform discussions between medical staff and security personnel on the implementation of MOUD programs.
Competing Interests: Declaration of competing interest JB reports providing paid medical expert testimony reports related to non-addiction related healthcare services in a jail setting. The other authors have no conflicts of interest.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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