Evaluating the effectiveness of problem-solving courts at preventing fatal and non-fatal opioid events: preliminary findings from Indiana

Article Details

Authors
Elizabeth Van Nostrand, Alyssa Johnston, Steven M Albert, Andre L Brown, Jeanine M Buchanich, Brad Ray, Mark S Roberts

Article Type
Original Research

DOI
10.7573/dic.2021-8-1

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Abstract

Background: Fatal and non-fatal events associated with drug misuse are skyrocketing in most United States jurisdictions, including Indiana. Historically, the role of the judiciary is to arrest, impose sanctions and protect society from harm. Adults arrested for drug abuse in Indiana can be sentenced to 1 of 17 correctional facilities. As an alternative, they may be eligible to participate in a problem-solving court (PSC) programme that refers individuals to treatment as a pretrial diversionary strategy. The aim of the study is to determine which interventions offered by PSCs and correctional facilities impact morbidity and mortality. The study began in 2019 and will end in 2023; therefore, the results in this manuscript are preliminary.

Methods: The study cohort included two populations arrested for drug misuse: (1) adults sentenced to Indianan correctional facilities (1 January 2018 to 30 June 2021) and (2) adults participating in an Indiana PSC programme (1 January 2018 to 30 June 2021). The study used a mixed-methods design that integrated qualitative interviews of deputy wardens, PSC team members and service providers with the following quantitative datasets: sentencing information, emergency department visits, inpatient hospitalization admissions, prescription drug monitoring programme data and death records. The individuals will be followed at 2-week, 4-week, 6-month and 1-year intervals post-release. Difference-in-difference and time-toevent analyses will identify impactful interventions. A model will be created to show the effect of impactful interventions in Indiana counties that do not have PSCs.

Results: Findings are preliminary. There is variability amongst correctional facilities regarding programme eligibility, provided services and provision of medication-assisted treatment. All correctional facilities were severely impacted by the COVID-19 pandemic.

Conclusion: It is anticipated that the adoption of impactful interventions will lower opioid-related morbidity and mortality rates.

Keywords: correctional facility, courts, drug misuse, law enforcement, morbidity, substance-related disorders.

Citation: Van Nostrand E, Johnston A, Albert SM, Brown AL, Buchanich JM, Ray B, Roberts MS. Evaluating the effectiveness of problem-solving courts at preventing fatal and non-fatal opioid events: preliminary findings from Indiana. Drugs Context. 2021;10:2021-8-1. https://doi.org/10.7573/dic.2021-8-1

Contributions: AJ contributed to the research and data analysis portions of the paper and results. She also edited the final manuscript. SMA contributed to the writing of the qualitative methods portion of the paper. AB contributed to the writing of the qualitative methods portion of the paper. JB contributed to the writing of the data linkage and data analyses portions of the paper. BR contributed to the writing of the data linkage and analyses portions of the paper. He also edited portions of the final manuscript. MSR contributed to the writing of the modelling portion of the paper. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: None of the authors have any relevant conflicts of interest. None of the authors have any patents broadly relevant to the work. None of the authors has any relationships/conditions/circumstances that present a potential conflict of interest. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2021/11/dic.2021-8-1-COI.pdf

Acknowledgements: It takes a talented, multidisciplinary team to tackle a project as complex and multifaceted as this study. The students at the University of Pittsburgh Graduate School of Public Health are enthusiastic, dedicated contributors who make working together so rewarding: Ozge Burget, Adam Kruchen, Patrick O’Toole, Jordan Perkins, Ethan Rosentel and Devin Strynkowski. Also, the study’s stakeholder committee members are nationally recognized innovators and we greatly appreciate their advice regarding the project’s overall aims, design, and methods: Barbara Andraka-Christou, JD, PhD (University of Central Florida College of Community Innovation and Education); Donald Burke, MD (University of Pittsburgh/Epistemix); Jonathan Cleary, JD (Indiana Problem Solving Court Committee/Dearborn Superior Court No.1); Laura Hollowell, MA, LMHC (Indiana State Department of Health); Mary Kay Hudson (Indiana Office of Court Services); James Hut (Indiana Department of Correction); Michael A Kaufmann, MD, FACEP, FAEMS (Indiana Department of Homeland Security); Douglas B Marlowe, JD, PhD (National Association of Drug Court Professionals; Ross Silverman, JD, MPH (Indiana University Richard M Fairbanks School of Public Health); Alexa Ward, BA (Student); and David B Wilson, PhD (George Mason University College of Humanities and Social Sciences). This study would not be possible without each of your contributions. Many, many thanks.

Funding declaration: This project is supported by Grant No. 1 R01CE003152-01-00, funded by the Centers for Disease Control and Prevention. The manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services. No funds were provided for writing assistance.

Copyright: Copyright © 2021 Van Nostrand E, Johnston A, Albert SM, Brown AL, Buchanich JM, Ray B, Roberts MS. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2021 Van Nostrand E, Johnston A, Albert SM, Brown AL, Buchanich JM, Ray B, Roberts MS. https://doi.org/10.7573/dic.2021-8-1. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/evaluating-the-effectiveness-of-problem-solving-courts-at-preventing-fatal-and-non-fatal-opioid-events-preliminary-findings-from-indiana

Correspondence: Elizabeth Van Nostrand, Department of Health Services, Administration and Policy, Temple University College of Public Health, Philadelphia, PA, USA. Email: evannostrand@temple.edu

Provenance: Invited; externally peer reviewed.

Submitted: 1 August 2021; Accepted: 22 October 2021; Publication date: 15 December 2021.

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