Organizational-level correlates of the provision of detoxification services and medication-based treatments for substance abuse in correctional institutions

Abstract

In recent years, there has been an increased examination of organizational-level innovation adoption in substance abuse treatment organizations. However, the majority of these studies have focused on community-based treatment centers. One understudied area of the substance abuse treatment system is correctional institutions. This study uses the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) cooperative's National Criminal Justice Treatment Practices survey (NCJTP) to examine the adoption of detoxification services and pharmacotherapies for the treatment of substance abuse across a nationally representative sample of correctional institutions (n=198). There were significant differences between jails and prisons in the percentage of organizations offering detoxification services and medications. Specifically, detoxification services were offered by 5% of prisons and 34% of jails; and, medications were offered by 6% of prisons and 32% of jails. Binary logistic regression models were used to examine the associations between these services and organizational characteristics, including context, resources, previously introduced practices, culture, and systems integration. Variables measuring organizational context and previously introduced practices were significant correlates of the provision of both detoxification services and medications. Multivariate results indicated that the differences between jails and prisons remained significant after controlling for other organizational factors. Although the adoption of detoxification services and pharmacotherapies may be a controversial topic for correctional institutions, these services have the potential to improve offender well-being and reduce public health risks associated with substance abuse.

Barriers to Substance Abuse Treatment in Rural and Urban Communities: Counselor Perspectives

“…A continuum of care is a tailored, tiered approach in which a client may seamlessly move through the treatment levels based on their progress (Oser, Knudsen, Staton-Tindall, Taxman, &Leukefeld, 2009; McKay et al, 2002). For example, a client may receive detoxification services (if needed) followed by an appropriate level of care (e.g., residential or outpatient) with subsequent aftercare services (e.g., participation in support groups such as AA or NA).…”

Challenges to implementing opioid substitution therapy in Ukrainian prisons: Personnel attitudes toward addiction, treatment, and people with HIV/AIDS

“…The introduction and adoption of OST has been historically slow and difficult, but has been especially problematic in CJS populations (Friedmann et al, 2012; Jurgens et al, 2009; Oser et al, 2009) despite existing evidence supporting it (Stallwitz and Stover, 2007), with both patient and organizational issues impeding OST introduction and expansion. Research shows that such factors as the lack of knowledge, misinformation about, and negative attitudes toward OST have an impact on its use even in the US, where opioid-dependence has been treated with methadone for over 40 years.…”

Attitudes Toward Addiction, Methadone Treatment, and Recovery Among HIV-Infected Ukrainian Prisoners Who Inject Drugs: Incarceration Effects and Exploration of Mediators

“…The adoption of OAT has been historically arduous and slow, but has been especially problematic in criminal justice populations (28–30) with both patient- and organizational-level hurdles impeding OAT introduction and expansion. Research shows that such factors as lack of knowledge, misinformation about, and negative attitudes toward OAT limits its uptake and expansion even in the US, where opioid-dependence has been treated with methadone for over 45 years (31–34).…”