背景:物质使用障碍(SUD),用药过量,在美国,与毒品使用有关的犯罪继续增加。逮捕前转移治疗计划可能会减少犯罪累犯和过量死亡。我们评估了一项全社区改治措施对犯罪的影响,监禁,和过量。
方法:本文报告了对执法部门主导的前瞻性评估,逮捕前的犯罪转移治疗方案,监禁,与未参与(未参与;n=103)的参与者之间的过量死亡相比,参与但未完成(非完成者;n=60)和完成(完成者;n=100)程序。参与者包括263名被警察逮捕的低级成年人,2017年9月1日至2020年8月31日期间与毒品使用有关的犯罪。该计划为符合条件的人提供了为期六个月的计划,该计划包括临床评估,根据每个人的需求推荐成瘾治疗服务,连接到恢复对等支持,和治疗参与监测。完成者最初的刑事指控无效,\'而未参与和未完成的参与者则向当地检察官提出了原始指控。该项目收集了参与者在计划注册前12个月和后12个月内的逮捕和监禁数据,以及计划注册后12个月内的致命过量数据。使用基线人口统计学(性别,年龄,种族,住房状况)和预指数犯罪逮捕和监禁指数作为协变量。
结果:在考虑了基线人口统计学和登记前逮捕/监禁史之后,逻辑回归模型发现,未参与和未完成组比完成组更有可能被逮捕(赔率比[OR]:3.9[95%CI,2.0-7.7]和3.6[95%CI,1.7-7.5],分别)和监禁(OR:10.3[95%CI,5.0-20.8]和21.0[95%CI,7.9-55.7],分别)在12个月的随访期间。在12个月的随访期间,未参与(6/103,5.8%)和未完成(2/60,3.3%)组的过量死亡率最高;完成者的死亡率最低(2/100,2.0%),所有死亡发生在完成6个月的治疗/监测计划后。
结论:执法部门之间的合作,临床医生,研究人员,以及更广泛的社区转移那些低层次的成年人,与吸毒有关的犯罪从刑事起诉到成瘾治疗可以有效减少犯罪的累犯,监禁,和过量死亡。
BACKGROUND: Substance use disorder (SUD), overdose, and drug use-related crime continue to increase in the U.S. Pre-arrest diversion-to-treatment programs may decrease crime recidivism and overdose deaths. We assessed the impact of a community-wide diversion-to-treatment initiative on crime, incarceration, and overdose.
METHODS: This article reports on the prospective evaluation of a law enforcement-led, pre-arrest diversion-to-treatment program on crime, incarceration, and overdose deaths compared between participants who did not engage (non-engaged; n = 103), engaged but did not complete (non-completers; n = 60) and completed (completers; n = 100) the program. Participants included 263 adults apprehended by police officers for low-level, drug use-related crimes between September 1, 2017 and August 31, 2020. The program offered eligible persons participation in a six-month program consisting of a clinical assessment, referral to addiction treatment services based on each individual\'s needs, connection to recovery peer support, and treatment engagement monitoring. Completers had their initial criminal charges \'voided,\' while non-engaged and non-Completer participants had their original charges filed with local prosecutors. The project collected participant-level data on arrests and incarceration within 12 months before and 12 months after program enrollment and data on fatal overdose within 12 months after program enrollment. Logistic regression predicted outcomes using baseline demographics (sex, age, race, housing status) and pre-index crime arrest and incarceration indices as covariates.
RESULTS: After accounting for baseline demographics and pre-enrollment arrest/incarceration history, logistic regression models found that the non-engaged and the non-Completer groups were more likely than completers to be arrested (odds ratios [ORs]: 3.9 [95 % CI, 2.0-7.7] and 3.6 [95 % CI, 1.7-7.5], respectively) and incarcerated (ORs: 10.3 [95 % CI, 5.0-20.8] and 21.0 [95 % CI, 7.9-55.7], respectively) during the 12-month follow-up. Rates of overdose deaths during the 12-month follow-up were greatest in non-engaged (6/103, 5.8 %) and non-Completer (2/60, 3.3 %) groups; completers had the lowest rate (2/100, 2.0 %), with all deaths occurring after completion of the six-month treatment/monitoring program.
CONCLUSIONS: Collaboration between law enforcement, clinicians, researchers, and the broader community to divert adults who commit a low-level, drug use-related crime from criminal prosecution to addiction treatment may effectively reduce crime recidivism, incarceration, and overdose deaths.