The public health crisis surrounding opioid use is pronounced among justice-involved populations, who face high rates of overdose mortality as well as HIV, and hepatitis C due to injection drug use. The majority of opioid-related overdoses are due to polysubstance use (PSU), and a better understanding of the prevalence and patterns of PSU are necessary in order to inform interventions. This dissertation project has three aims: (1) understand the patterns of opioid PSU among a justice-involved population, (2) identify PSU patterns most at-risk for post-release relapse, and (3) examine engagement in post-release health service utilization. Post-release aims are guided by the Gelberg Behavioral Model of Vulnerable Populations.
This project utilizes secondary data from the Criminal Justice Kentucky Treatment Outcome Study, a Kentucky Department of Corrections funded two-wave longitudinal study of individuals who participated in substance abuse treatment programming while incarcerated. Latent profile analysis is used to determine the patterns of pre-incarceration opioid PSU in aim 1. Analyses for aims 2 and 3 examine PSU profiles, along with variables drawn from the Behavioral Model for Vulnerable Populations, in order to predict important reentry outcomes of relapse and health service utilization 12-months post-release in a series of logistic regressions.
Six unique profiles of opioid PSU were found among the current justice-involved population, which faced disproportionate risk of adverse outcomes at follow-up. Findings indicate heterogeneity of opioid use among a justice-involved population. The role of mental and physical health in PSU severity is also highlighted. Further, results from post-release analyses indicate that a continuum of risk exists among PSU such that PSU patterns are unique and important predictors of post-release outcomes which can be used to inform interventions during incarceration. The importance of accounting for vulnerability as conceptualized in the Behavioral Model for Vulnerable Populations is also discussed.
| Identifer | oai:union.ndltd.org:uky.edu/oai:uknowledge.uky.edu:sociology_etds-1045 |
| Date | 01 January 2019 |
| Creators | Bunting, Amanda Marie |
| Publisher | UKnowledge |
| Source Sets | University of Kentucky |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | Theses and Dissertations--Sociology |
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