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Background <p>Over 600,000 individuals are released from correctional institutions annually in the United States. Substance use disorders (SUDs) are highly prevalent in this population, and only a small proportion receive adequate treatment during incarceration. Post-incarceration, substance use increases considerably, and the risk of drug overdose is higher among formerly incarcerated individuals than among their counterparts in the general population, especially among individuals who use illicit opioids. However, significant gaps exist in our understanding of individual- and environment-level pathways of post-incarceration substance use, limiting treatment effectiveness. For those who receive substance use treatment services post-incarceration, research suggests that these services are not medically appropriate and/or responsive to their unique needs – thereby jeopardizing substance use outcomes.</p> Objectives <p>The Addiction Treatment Adequacy Post-Incarceration (ATAP) Study aims to examine individual and environmental factors associated with changes in substance use and substance use treatment adequacy over a one-year period post-incarceration among formerly incarcerated individuals in New York City (NYC). We will examine the extent to which participants receive appropriate substance use treatment services, as recommended by their scores on the American Society of Addiction Medicine patient placement criteria (ASAM PPC).</p> Methods <p>We will use innovative spatially informed multi-level modeling strategies to investigate individual- and environment-level factors that influence substance use among individuals released from correctional institutions and residing in the NYC metropolitan area. Guided by social ecological theory, this study will address the following specific aims: 1) Characterize substance use over a 12-month period (every three months) among 350 formerly incarcerated individuals who have been released in NYC during the past three years; 2) Identify individual (e.g., race, gender, income, mental health) and environmental (e.g., proximity to drug purchasing sites, neighborhood characteristics, residential mobility, access to treatment services) risk factors for drug use among formerly incarcerated individuals; and 3) Investigate discrepancies between ASAM PPC composite scores (a measure of addiction severity) generated and levels of substance use treatment.</p> Potential implications <p>The proposed research will identify substance use treatment gaps and influential factors that are amenable to intervention in the interest of informing effective responses to the current opioid crisis.</p>

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Examining predictors of substance use and treatment adequacy among formerly incarcerated individuals with a history of opioid and cocaine use: research protocol

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月24日

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  • Tawandra Rowell-Cunsolo,
  • Meghan Bellerose,
  • George Musa,
  • Katherine Curtis,
  • David Long,
  • Elwin Wu,
  • Keely Cheslack-Postava,
  • Carl Hart

摘要

Background

Over 600,000 individuals are released from correctional institutions annually in the United States. Substance use disorders (SUDs) are highly prevalent in this population, and only a small proportion receive adequate treatment during incarceration. Post-incarceration, substance use increases considerably, and the risk of drug overdose is higher among formerly incarcerated individuals than among their counterparts in the general population, especially among individuals who use illicit opioids. However, significant gaps exist in our understanding of individual- and environment-level pathways of post-incarceration substance use, limiting treatment effectiveness. For those who receive substance use treatment services post-incarceration, research suggests that these services are not medically appropriate and/or responsive to their unique needs – thereby jeopardizing substance use outcomes.

Objectives

The Addiction Treatment Adequacy Post-Incarceration (ATAP) Study aims to examine individual and environmental factors associated with changes in substance use and substance use treatment adequacy over a one-year period post-incarceration among formerly incarcerated individuals in New York City (NYC). We will examine the extent to which participants receive appropriate substance use treatment services, as recommended by their scores on the American Society of Addiction Medicine patient placement criteria (ASAM PPC).

Methods

We will use innovative spatially informed multi-level modeling strategies to investigate individual- and environment-level factors that influence substance use among individuals released from correctional institutions and residing in the NYC metropolitan area. Guided by social ecological theory, this study will address the following specific aims: 1) Characterize substance use over a 12-month period (every three months) among 350 formerly incarcerated individuals who have been released in NYC during the past three years; 2) Identify individual (e.g., race, gender, income, mental health) and environmental (e.g., proximity to drug purchasing sites, neighborhood characteristics, residential mobility, access to treatment services) risk factors for drug use among formerly incarcerated individuals; and 3) Investigate discrepancies between ASAM PPC composite scores (a measure of addiction severity) generated and levels of substance use treatment.

Potential implications

The proposed research will identify substance use treatment gaps and influential factors that are amenable to intervention in the interest of informing effective responses to the current opioid crisis.