Davida M Schiff1, Mari-Lynn Drainoni2, Zoe M Weinstein3, Lisa Chan4, Megan Bair-Merritt5, David Rosenbloom6. 1. Department of Pediatrics, Boston University School of Medicine and Boston Medical Center, 88 E. Newton, Vose Hall 3rd Floor, Boston, MA 02118, United States; Division of General Academic Pediatrics, MassGeneral Hospital for Children, 125 Nashua St. Suite 860, Boston, MA 02114, United States. Electronic address: Davida.Schiff@mgh.harvard.edu. 2. Department of Health Law, Policy, and Management, Boston University School of Public Health, 715 Albany Street, T3W, Boston, MA, 02118, United States; Section of Infectious Disease, Boston University School of Medicine, United States; Center for Healthcare Organization and Implementation Research, ENRM VA Hospital, United States. 3. Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education (CARE) Unit, Boston Medical Center, 801 Massachusetts Ave, Boston, MA 02118, United States. 4. Sargent College of Health and Rehabilitation Services, Boston University, 635 Commonwealth Avenue, Boston, MA 02215, United States. 5. Department of Pediatrics, Boston University School of Medicine and Boston Medical Center, 88 E. Newton, Vose Hall 3rd Floor, Boston, MA 02118, United States. 6. Department of Health Law, Policy, and Management, Boston University School of Public Health, 715 Albany Street, T3W, Boston, MA, 02118, United States.
Abstract
BACKGROUND: The increasing rates of opioid use disorder and resulting overdose deaths are a public health emergency, yet only a fraction of individuals in need receive treatment. OBJECTIVE: To describe the implementation of and participants' experiences with a novel police-led addiction treatment referral program. METHODS: Follow-up telephone calls to participants in the Gloucester Police Department's Angel Program from June 2015-May 2016. Open-ended survey questionnaires assessed experiences of program participants and their close contacts, confirmed police-reported placement, and queried self-reported substance use and treatment outcomes. RESULTS: Surveys were completed by 198 of 367 individuals (54% response rate) who participated 214 times. Reasons for participation included: the program was a highly-visible entry point to the treatment system, belief that placement would be obtained, poor prior treatment system experiences, and external pressure to seek treatment. Most participants reported positive experiences citing the welcoming, non-judgmental services. In 75% (160/214) of the encounters, entry into referral placement was confirmed. Participants expressed frustration when they did not meet program entry requirements and had difficulty finding sustained treatment following initial program placement. At a mean follow-up time of 6.7months, 37% of participants reported abstinence since participation, with no differences between participants who entered referral placement versus those who did not. CONCLUSIONS: A police-led referral program was feasible to implement and acceptable to participants. The program was effective in finding initial access to treatment, primarily through short-term detoxification services. However, the program was not able to overcome a fragmented treatment system focused on acute episodic care which remains a barrier to long-term recovery.
BACKGROUND: The increasing rates of opioid use disorder and resulting overdose deaths are a public health emergency, yet only a fraction of individuals in need receive treatment. OBJECTIVE: To describe the implementation of and participants' experiences with a novel police-led addiction treatment referral program. METHODS: Follow-up telephone calls to participants in the Gloucester Police Department's Angel Program from June 2015-May 2016. Open-ended survey questionnaires assessed experiences of program participants and their close contacts, confirmed police-reported placement, and queried self-reported substance use and treatment outcomes. RESULTS: Surveys were completed by 198 of 367 individuals (54% response rate) who participated 214 times. Reasons for participation included: the program was a highly-visible entry point to the treatment system, belief that placement would be obtained, poor prior treatment system experiences, and external pressure to seek treatment. Most participants reported positive experiences citing the welcoming, non-judgmental services. In 75% (160/214) of the encounters, entry into referral placement was confirmed. Participants expressed frustration when they did not meet program entry requirements and had difficulty finding sustained treatment following initial program placement. At a mean follow-up time of 6.7months, 37% of participants reported abstinence since participation, with no differences between participants who entered referral placement versus those who did not. CONCLUSIONS: A police-led referral program was feasible to implement and acceptable to participants. The program was effective in finding initial access to treatment, primarily through short-term detoxification services. However, the program was not able to overcome a fragmented treatment system focused on acute episodic care which remains a barrier to long-term recovery.
Authors: Mari-Lynn Drainoni; Hannah K Knudsen; Kathy Adams; Shaquita A Andrews-Higgins; Vanessa Auritt; Sandi Back; Laura K Barkowski; Evan J Batty; Melika R Behrooz; Sydney Bell; Sadie Chen; Mia-Cara Christopher; Nicolette Coovert; Erika L Crable; Anindita Dasgupta; Michael Goetz; Dawn Goddard-Eckrich; Jeanie L Hartman; Holly Heffer; Pulwasha Iftikhar; Latasha Jones; Samantha Lang; Karsten Lunze; Anna Martin; Tara McCrimmon; Melissa K Reedy-Johnson; Carter Roeber; Ariel L Scalise; Cynthia J Sieck; Daniel M Walker; Galya Walt; Jennifer D Wood; Priscilla Zito; Ann Scheck McAlearney Journal: J Subst Abuse Treat Date: 2022-01-31
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