Dr. Megan O’Neil, Ohio State University, Research Scholar, Drug Enforcement and Policy Center
Title: Justice System Experiences and Health Risks among Medicaid and Uninsured Populations Receiving Treatment for Substance Use Disorder
Abstract: Our study, involving 401 adult uninsured or Medicaid recipients undergoing substance use disorder (SUD) treatment in Michigan, USA, with an oversampling of African American and American Indian Alaskan Native (AIAN) participants was conducted between 2021 and 2023. Premature mortality is an increasing issue for people who use drugs (PWUDs), with the fastest decrease in life expectancy among African American and AIAN populations, and a dearth of knowledge as to how best to improve these outcomes. We seek to fill this knowledge gap by focusing on systems involvement in SUD treatment, reentry, and high-risk health outcomes tied to premature mortality including: (1) overdose, (2) opioid use, (3) polysubstance use, and (4) multiple treatment admissions. Significantly, civil justice issues, particularly those concerning housing like homelessness and eviction emerged as robust correlates to high-risk health outcomes, above and beyond criminal justice involvement. These factors were major risk factors for opioid use, overdose, and polysubstance use. Additionally, we observed frequent interactions with family courts, child support enforcement, and traffic/administrative courts, alongside arrests and incarceration, impacting individuals’ life courses. Absent intervention, these extensive justice system experiences present significant barriers to successful reentry, affecting public health and safety.
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