Use Of Medication Assisted Treatment For Opioid Use Disorder In Criminal Justice Settings Evidence Based Resource Guide Series

Treatment and recovery of individuals with opioid use disorder (OUD) can vary. These individuals may have co-occurring disorders, live in diverse parts of the country, and face a variety of socio-economic factors that help or hinder their treatment. All these factors bring complexities to evaluating the effectiveness of services, treatments, and supports.Despite variations, substantial evidence is available to understand the types of services, treatments, and supports that reduce substance use, lessen mental health symptoms, and improve individuals' quality of life. Communities are eager to take advantage of what has been learned to help individuals in need.

The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already existâ€"like evidence-based medicationsâ€"are not being deployed to maximum impact. To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.

Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.

This textbook provides an overview of the overlap between the criminal justice system and mental health for students of criminology and criminal justice. It provides an accessible overview of basic signs and symptoms of major mental illnesses and size of scope of justice-involved individuals with mental illness. In the United States, the law enforcement and the criminal justice system is often the first public service to be in contact with individuals suffering from mental illness or in mental distress. Those with untreated mental illnesses are often at higher risk for committing criminal acts, and due to a lack of mental health facilities, resources, and pervasive misconceptions about this population, those with mental illness often end up in the corrections system. This timely work covers the roles of each part of the criminal justice system interacting with mentally ill individuals, from law enforcement and first responders, social services, public health services, sentencing and corrections, to release and re-entry. It also addresses the crucial need of mental healthcare for criminal justice professionals, who suffer from high rates of job stress, PTSD, and other mental health issues. With new chapters on stigma, mental illness during and after disaster and crisis, and updates and new supplementary materials throughout, this book will be of interest to students of criminology and criminal justice, sociology, psychology, and public health. It will also be of interest to policy-makers and practitioners already working in the field, interacting with and addressing the needs of mentally ill individuals.

The Federal Guidelines for Opioid Treatment Programs (Guidelines) describe the Substance Abuse and Mental Health Services Administration's (SAMHSA) expectation of how the federal opioid treatment standards found in Title 42 of the Code of Federal Regulations Part 8 (42 CFR � 8) are to be satisfied by opioid treatment programs (OTPs). Under these federal regulations, OTPs are required to have current valid accreditation status, SAMHSA certification, and Drug Enforcement Administration (DEA) registration before they are able to administer or dispense opioid drugs for the treatment of opioid addiction.

Motivation is key to substance use behavior change. Counselors can support clients' movement toward positive changes in their substance use by identifying and enhancing motivation that already exists. Motivational approaches are based on the principles of person-centered counseling. Counselors' use of empathy, not authority and power, is key to enhancing clients' motivation to change. Clients are experts in their own recovery from SUDs. Counselors should engage them in collaborative partnerships. Ambivalence about change is normal. Resistance to change is an expression of ambivalence about change, not a client trait or characteristic. Confrontational approaches increase client resistance and discord in the counseling relationship. Motivational approaches explore ambivalence in a nonjudgmental and compassionate way.

All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.