. 2024 Sep 19;2(1):64.

doi: 10.1186/s44263-024-00093-y.

Influences of the criminal justice system on use of medications for opioid use disorder: a qualitative study

Emmeline Taylor^{1

2}, Caroline Gray¹, Matthew Stimmel³, Ingrid A Binswanger^{4

5

6

7}, Erica Morse⁴, Christine Timko^{1

8}, Alex H S Harris^{1

9}, David Smelson¹⁰, Andrea K Finlay^{11

12

13}

Affiliations

¹ Center for Innovation to Implementation (Ci2i), VA Palo Alto Healthcare System, 795 Willow Road (MPD-152), Menlo Park, CA, 94025, USA.
² Department of Clinical Psychology, University of Colorado, Colorado Springs, CO, USA.
³ Veterans Justice Programs, U.S. Department of Veterans Affairs, Washington, D.C., USA.
⁴ Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA.
⁵ Colorado Permanente Medical Group, Denver, CO, USA.
⁶ Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
⁷ Department of Health Systems Science, Bernard J Tyson Kaiser Permanente School of Medicine, Pasadena, CA, USA.
⁸ Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA.
⁹ Department of Surgery, Stanford University School of Medicine, Palo Alto, CA, USA.
¹⁰ Center for Organization and Implementation Science, Edith Nourse Rogers VA Medical Center, Bedford, MA, USA.
¹¹ Center for Innovation to Implementation (Ci2i), VA Palo Alto Healthcare System, 795 Willow Road (MPD-152), Menlo Park, CA, 94025, USA. Andrea.Finlay@va.gov.
¹² Department of Veterans Affairs, National Center On Homelessness Among Veterans, Washington, D.C., USA. Andrea.Finlay@va.gov.
¹³ Schar School of Policy and Government, George Mason University, Arlington, VA, USA. Andrea.Finlay@va.gov.

PMID: 39681954
PMCID: PMC11622969
DOI: 10.1186/s44263-024-00093-y

Influences of the criminal justice system on use of medications for opioid use disorder: a qualitative study

Emmeline Taylor et al. BMC Glob Public Health. 2024.

. 2024 Sep 19;2(1):64.

doi: 10.1186/s44263-024-00093-y.

Authors

Affiliations

¹ Center for Innovation to Implementation (Ci2i), VA Palo Alto Healthcare System, 795 Willow Road (MPD-152), Menlo Park, CA, 94025, USA.
² Department of Clinical Psychology, University of Colorado, Colorado Springs, CO, USA.
³ Veterans Justice Programs, U.S. Department of Veterans Affairs, Washington, D.C., USA.
⁴ Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA.
⁵ Colorado Permanente Medical Group, Denver, CO, USA.
⁶ Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
⁷ Department of Health Systems Science, Bernard J Tyson Kaiser Permanente School of Medicine, Pasadena, CA, USA.
⁸ Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA.
⁹ Department of Surgery, Stanford University School of Medicine, Palo Alto, CA, USA.
¹⁰ Center for Organization and Implementation Science, Edith Nourse Rogers VA Medical Center, Bedford, MA, USA.
¹¹ Center for Innovation to Implementation (Ci2i), VA Palo Alto Healthcare System, 795 Willow Road (MPD-152), Menlo Park, CA, 94025, USA. Andrea.Finlay@va.gov.
¹² Department of Veterans Affairs, National Center On Homelessness Among Veterans, Washington, D.C., USA. Andrea.Finlay@va.gov.
¹³ Schar School of Policy and Government, George Mason University, Arlington, VA, USA. Andrea.Finlay@va.gov.

PMID: 39681954
PMCID: PMC11622969
DOI: 10.1186/s44263-024-00093-y

Abstract

Background: Legal-involved veterans with opioid use disorder (OUD) have lower receipt of medications for opioid use disorder (MOUD) than other veterans served at the Veterans Health Administration (VHA). This qualitative study examined the influence of the criminal justice system on access to MOUD for legal-involved veterans in the U.S.

Methods: VHA facilities (n = 14) that varied in their provision of MOUD to legal-involved veterans were selected for qualitative interviews. Interviewees included legal-involved veterans (n = 18), VHA Veterans Justice Programs Specialists (n = 15), substance use disorder treatment providers (n = 5), and criminal justice staff (n = 12). Team members applied codes to meaningful units of analysis (quotations) in the transcribed interviews. Using a matrix approach, team members created a spreadsheet matrix with codes, facility rate of MOUD, and relevant quotations summarized for each participant. Themes and connections between individual participants and cross-interview concepts were explored. Participants were not asked to provide feedback on the findings.

Results: Themes identified were as follows: (1) Veterans Treatment Court policies both enhanced and limited MOUD treatment access and utilization among participants; (2) cross-system collaboration strengths and challenges existed; and (3) criminal justice system treatment preferences and policies both enhanced and limited MOUD in jails and prisons.

Conclusions: The influence of the criminal justice system on MOUD has led to variable access to MOUD for legal-involved veterans. Our findings can help inform recommendations to enhance access to MOUD for veterans within the criminal justice system, including the development of a national database of MOUD education materials for Veterans Treatment Courts, strengthening community-court relationships, allowing individuals to use their own healthcare coverage within jails and prisons and extend Medicaid coverage into criminal justice settings, and applying national quality measures for MOUD to criminal justice settings and develop a national system for tracking these quality measures.

Keywords: Criminal Justice; Opioid Use Disorder; Qualitative Research; Veteran.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by Stanford University’s Institutional Review Board (eprotocol #40213) and the VA Palo Alto Research & Development committee. Consent for publication: Not applicable. Competing interests: IB is a Guest Editor for the article collection; however, peer review of any submissions for which the Guest Editors have competing interests is handled by another Editor or Editorial Board Member who has no competing interests. The authors have no other conflicts of interest or disclosures to report.

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John-Schuster G. John-Schuster G. BMC Glob Public Health. 2025 Aug 20;3(1):71. doi: 10.1186/s44263-025-00192-4. BMC Glob Public Health. 2025. PMID: 40836351 Free PMC article. No abstract available.

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Influences of the criminal justice system on use of medications for opioid use disorder: a qualitative study

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Influences of the criminal justice system on use of medications for opioid use disorder: a qualitative study

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