Abstract

Objectives

This study aimed to classify the factors that were correlated with injection drug use (IDU) and with medications for opioid use disorder (MOUD) treatment engagement among individuals who were recently released from prison.

Methods

Data for this study were obtained from a Midwestern reentry program for incarcerated individuals with co-occurring opioid use and a mental health disorder between May 1, 2017, and April 30, 2020. CHAID decision tree modeling was utilized to classify IDU and MOUD treatment engagement.

Results

Those most likely to report IDU were individuals with a Hepatitis C diagnosis and a history of overdose, and those least likely to report IDU were not diagnosed with Hepatitis C, identified as a person of color, and never overdosed on opioids. The subgroup of that were most likely to report MOUD treatment engagement were individuals taking psychiatric medication and who had a history of IDU. The subgroup of participants least likely to report MOUD treatment engagement were individuals prescribed psychiatric medication, without had a history of IDU, and were not participating in substance-use treatment.

Conclusion

Our findings indicate that, to protect vulnerable populations and to flatten the overdose mortality curve, an increased focus is required within criminal/legal systems to facilitate linkages to care at reentry.

中文翻译：

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应用机器学习分析：与阿片类药物使用障碍治疗参与注射吸毒和出狱后药物相关的因素

摘要

目标

本研究旨在对最近出狱的个人中与注射吸毒 (IDU) 和阿片类药物使用障碍 (MOUD) 治疗参与度相关的因素进行分类。

方法

本研究的数据来自中西部重返计划，该计划针对 2017 年 5 月 1 日至 2020 年 4 月 30 日期间同时使用阿片类药物和精神健康障碍的被监禁者。CHAID 决策树模型用于对 IDU 和 MOUD 治疗参与度进行分类。

结果

最有可能报告IDU的人是被诊断出丙型肝炎且有过量用药史的人，而最不可能报告IDU的人是未诊断出患有丙型肝炎、被确定为有色人种且从未过量服用阿片类药物的人。最有可能报告 MOUD 治疗参与的亚组是服用精神药物且有 IDU 病史的个体。最不可能报告参与 MOUD 治疗的参与者亚组是接受过精神科药物治疗、没有注射吸毒史且没有参与药物滥用治疗的个体。

结论

我们的研究结果表明，为了保护弱势群体并拉平服药过量死亡率曲线，需要在刑事/法律系统中更加关注，以促进与重返社会护理的联系。