عنوان انگلیسی مقاله:
A Scoping Review of Barriers and Facilitators to Implementation of Medications for Treatment of Opioid Use Disorder within the Criminal Justice System
ترجمه فارسی عنوان مقاله:
مروری گسترده از موانع و تسهیل کننده های اجرای داروها برای درمان اختلال استفاده از مواد افیونی در سیستم عدالت کیفری
Sciencedirect - Elsevier - International Journal of Drug Policy, 81 (2020) 102768. doi:10.1016/j.drugpo.2020.102768
Christine E. Grellaa, Erika Ostileb, Christy K Scottc, Michael Dennisd, John Carnavalee
Background: Policies aimed at addressing the high rates of opioid overdose have prioritized increasing access to
medications for treatment of opioid use disorder (MOUD). Numerous barriers exist to providing MOUD within
the criminal justice system and/or to justice-involved populations. The aim of this study was to conduct a
scoping review of the peer-reviewed literature on implementation of MOUD within criminal justice settings and
with justice-involved populations.
Methods: A systematic search process identified 53 papers that addressed issues pertaining to implementation
barriers or facilitators of MOUD within correctional settings or with justice-involved populations; these were
coded and qualitatively analyzed for common themes.
Results: Over half of the papers were published outside of the U.S. (n = 28); the most common study designs
were surveys or structured interviews (n = 20) and qualitative interviews/focus groups (n = 18) conducted
with correctional or treatment staff and with incarcerated individuals. Four categories of barriers and facilitators
were identified: institutional, programmatic, attitudinal, and systemic. Institutional barriers typically limited
capacity to provide MOUD to justice-involved individuals, which led to programmatic practices in which MOUD
was not implemented following clinical guidelines, often resulting in forcible withdrawal or inadequate treatment.
These programmatic practices commonly led to aversive experiences among justice-involved individuals,
who consequently espoused negative attitudes about MOUD and were reluctant to seek treatment with MOUD
following their release to the community. Facilitators of MOUD implementation included increased knowledge
and information from training interventions and favorable prior experiences with individuals being treated with
MOUD among correctional and treatment staff. Few systemic facilitators to implementing MOUD with justiceinvolved
individuals were evident in the literature.
Conclusion: Barriers to implementing MOUD in criminal justice settings and/or with justice-involved populations
are pervasive, multi-leveled, and inter-dependent. More work is needed on facilitators of MOUD implementation.
Keywords: opioid use disorder | medication | criminal justice system | implementation | barriers | facilitators