The impact of drug court participation on mortality: 15-year outcomes from a randomized controlled trial
| Autor: | Brook W. Kearley, John A. Cosgrove, Denise C. Gottfredson, Alexandra S. Wimberly |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Population 030508 substance abuse Medicine (miscellaneous) Poison control Suicide prevention Heroin law.invention Drug Users 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Naloxone Injury prevention medicine Humans 030212 general & internal medicine Mortality education education.field_of_study Jurisprudence business.industry Drug court Heroin Dependence Psychiatry and Mental health Clinical Psychology Family medicine Baltimore Female Pshychiatric Mental Health 0305 other medical science business medicine.drug |
| Zdroj: | Journal of substance abuse treatment. 105 |
| ISSN: | 1873-6483 |
| Popis: | Aim To test the effects of drug court participation on long-term mortality risk. Methods During 1997–98, 235 individuals charged with a non-violent offense were randomly assigned to Baltimore City Drug Treatment Court (BCDTC) or traditional adjudication. Heroin was the predominant substance of choice among the sample. Participant mortality was observed for 15 years following randomization. Results Over 20% of participants died during the study, at an average age of 46.6 years, and 64.4% of deaths were substance-use related. Survival analyses estimated that neither mortality from any cause nor from substance use-related causes significantly differed between BCDTC and traditional adjudication. Conclusions Frequent and premature death among the sample indicates that this is a high-risk population in need of effective substance use treatment. Roughly half of drug treatment courts are now estimated to offer medication assisted treatment (MAT), which is currently the most effective treatment for opioid use disorders. In this study of BCDTC implemented over 15 years ago, only 7% of participants received MAT, which may explain the lack of program impact on mortality. Historical barriers to providing MAT in drug court settings include access, concerns about diversion, negative attitudes, blanket prohibitions, and stigma. Drug treatment courts should implement best practice standards for substance use treatment and overdose prevention, including increased access to MAT and naloxone, and training to reduce stigmatizing language and practice. |
| Databáze: | OpenAIRE |
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