The Accessibility of Opioid Agonist Treatment and Its Forced Discontinuation in Swiss Prisons—Attitudes, Perceptions and Experiences of Defense Lawyers in Dealing With Detained Persons Using Opioids

Buadze, Anna; Baggio, Stéphanie; Schleifer, Roman; Aeberhard, Eveline; Wolff, Hans; Schneeberger, Andres R.; Liebrenz, Michael

doi:10.3389/fpsyt.2020.00395

Cited by 7 publications

(8 citation statements)

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“…The research team itself had gathered previous experience in employing qualitative research methodology on perceptions toward ADHD, SUD, and psychosis among the general population, medical and legal experts and affected individuals. Results have been reported elsewhere ( 22 , 35 – 38 ).…”

Section: Methodsmentioning

confidence: 53%

“…Since almost all respondents experienced the care of detainees with ADHD as labor- and time-intensive, energy-consuming and generally exhausting, and had adopted the view that inmates suffering from this disorder were in need of specific interventions, support and treatment, we are cautiously optimistic that at least in comparable penal institutions, staff may be open to the implementation of non-pharmacological treatments, offender psychoeducation and psychological treatment programs such as Reasoning and Rehabilitation 2 ADHD ( 88 ). In order to develop the understanding and acceptance of stimulant treatment for inmates with ADHD, it might be helpful to point to the successes of other pharmaceutical treatments for mental disorders, which were once considered highly controversial, but are generally better accepted today by prison staff ( 22 ). In addition, public opinion also seems to be changing regarding the use of psychotropic medications in cases of mental illness, as recently pointed out by Angermeyer et al who reported that attitudes toward pharmacological treatment have become noticeably more favorable over the last two decades ( 89 ).…”

Section: Discussionmentioning

confidence: 99%

“…The procedure regarding the content analysis differed only slightly in comparison to previous studies by our research group and has been described in detail before ( 22 ). Qualitative analysis of the interview data was done independently, initially by NF focusing on SUD, and subsequently for the purpose of this publication by AB and ML.…”

Section: Methodsmentioning

confidence: 99%

“…On the other hand, there are studies showing that the real possibilities of care for inmates with ADHD are very limited, both in terms of access to diagnostic assessment and initiation of multimodal treatment ( 19 – 21 ). In addition, it has been observed in everyday clinical practice that the continuation of pharmacological therapy for patients treated with stimulants before imprisonment is also extremely complicated and unlikely ( 22 ). This lack of care may reflect the challenges faced by those working in the prison system against the background of the comorbidities (conduct disorder, antisocial personality traits or disorder, comorbid substance use disorder) overlapping neurodevelopmental disorders (Autism Spectrum Disorder, Tic Disorder, Intellectual Disability) and emotional dysregulation frequently encountered among inmates with ADHD ( 11 , 20 , 23 ).…”

Section: Introductionmentioning

confidence: 99%

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Perceptions and Attitudes of Correctional Staff Toward ADHD—A Challenging Disorder in Everyday Prison Life

et al. 2021

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Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that is associated with risk-taking behaviors, poor self-control, and interpersonal difficulties. Affected individuals have an increased probability of involvement with the criminal justice system, contributing to a higher rate of arrest, and imprisonment compared with the general population; they are also inadequately treated once sentenced. Because prison staff play a central role in the identification of inmates with mental disorders, they could well be key to improving provision of care. There is however little knowledge of the conceptions, perceptions, and attitudes of prison staff toward ADHD. Such information could help to identify starting points for awareness training and further implementation of specific ADHD treatment. To bridge this gap, we undertook a study based on a qualitatively-driven mixed methods design, combining qualitative data collection in the form of narrative interviews with 19 prison staff from a Swiss correctional facility with quantitative data collection in the form of a survey that included the Attitudes toward Prisoners scale. The interviews were analyzed with QSR NVIVO 11 and a qualitative content analysis approach was used to evaluate findings. Prison staff were generally aware of ADHD and its symptomology, believing it to a be “real,” but “fashionable” disorder and favoring hereditary-genetic or biological explanatory models for its development. They viewed inmates with ADHD rather negatively, as complicating correctional efforts, and perceived them as sticking out, as tying up more resources and as frequently being involved in confrontations. Our findings suggest that difficulties in pragmatic aspects of communication and language comprehension may be perceived “as not listening or following instructions,” creating additional tensions. Consequently, inmates with ADHD are more often exposed to disciplinary sanctions, such as solitary confinement—an intervention deemed “necessary” by staff. Therefore, staff training on ADHD might need to cover evidence on adverse effects. Non-pharmacological interventions for treatment were preferred and considered to be highly efficacious. Skepticism toward pharmacological treatment prevailed, even when benefits from stimulant medication were described. Interestingly, this skepticism was not the result of negative experiences with the misuse and diversion of stimulants. Acceptance of multimodal treatment among prison staff may require customized strategies.

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Section: Methodsmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Perceptions and Attitudes of Correctional Staff Toward ADHD—A Challenging Disorder in Everyday Prison Life

et al. 2021

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“…On the other hand, there are studies that show that the real possibilities of care for inmates with ADHD are very limited, both in terms of access to diagnostic assessment and initiation of multimodal treatment (Berryessa, 2017; Hall & Myers, 2016; Susan Young, Gudjonsson, et al, 2018). In addition, it has been observed in everyday clinical practice that the continuation of pharmacological therapy for patients treated with stimulants before imprisonment is also extremely complicated and unlikely (Anna Buadze et al, 2020). This lack of care may reflect the challenges faced by those working in the prison system against the background of the comorbidities (conduct disorder, antisocial personality traits or disorder, comorbid substance use disorder) frequently encountered among inmates with ADHD (Hall & Myers, 2016).…”

Section: Introductionmentioning

confidence: 99%

Perceptions and Attitudes of Prison Staff towards ADHD – double jeopardy for inmates affected

Buadze

Friedl

Schleifer

et al. 2020

Preprint

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Background: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that is associated with risk-taking behaviors, poor self-control and interpersonal difficulties. Affected individuals have an increased probability of involvement in the criminal justice system, contributing to a higher rate of arrest and imprisonment compared with the general population. Current data on the prevalence of ADHD among prisoners reports rates of 26%, but finds them inadequately treated. Aims: Because prison staff play a central role in the identification of inmates with mental disorders, they could well be key to improving provision of care. There is however little knowledge of the conceptions, perceptions and attitudes of prison staff towards ADHD. Such information could help to identify starting points for awareness training and to further implementation of specific ADHD treatment. Methods: To bridge this gap, we employed a qualitatively driven mixed methods design combining qualitative data collection in the form of narrative interviews with 19 prison staff from a Swiss correctional facility with quantitative data collection in the form of a survey that included the Attitudes Toward Prisoners scale. The interviews were analyzed with QSR NVIVO 11 and a qualitative content analysis approach was used to evaluate findings. Results: Prison staff were generally aware of ADHD and its symptomology, believed it to a be real, but fashionable disorder and favored hereditary-genetic or biological explanatory models for its development. They viewed inmates with ADHD rather negatively, as complicating correctional efforts, perceived them as sticking out, as tying up more resources and as frequently being involved in confrontations. Our findings suggest that difficulties in pragmatic aspects of communication and language comprehension may be perceived as not listening or following instructions creating additional tensions. Consequently, inmates with ADHD are more often exposed to disciplinary sanctions, such as solitary confinement - an intervention deemed necessary by staff. Therefore, staff training on ADHD might need to cover evidence on adverse effects. Non-pharmacological interventions for treatment were preferred and considered to be highly efficacious. Skepticism towards pharmacological treatment prevailed, even when benefits from stimulant medication were described. Acceptance of multimodal treatment among prison staff may require customized strategies.

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Mal/adaptations: A qualitative evidence synthesis of opioid agonist therapy during major disruptions

Salamanca-Buentello

Cheng

Sabioni

et al. 2022

International Journal of Drug Policy

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The Accessibility of Opioid Agonist Treatment and Its Forced Discontinuation in Swiss Prisons—Attitudes, Perceptions and Experiences of Defense Lawyers in Dealing With Detained Persons Using Opioids

Cited by 7 publications

References 54 publications

Perceptions and Attitudes of Correctional Staff Toward ADHD—A Challenging Disorder in Everyday Prison Life

Perceptions and Attitudes of Correctional Staff Toward ADHD—A Challenging Disorder in Everyday Prison Life

Perceptions and Attitudes of Prison Staff towards ADHD – double jeopardy for inmates affected

Mal/adaptations: A qualitative evidence synthesis of opioid agonist therapy during major disruptions

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