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Community Correctional Agents' Views of Medication-Assisted Treatment: Examining Their Influence on Treatment Referrals and Community Supervision Practices

NCJ Number
Substance Abuse Volume: 37 Issue: 1 Dated: January 2016 Pages: 127-133
S. G. Mitchell; J. Willet
Date Published
January 2016
7 pages
This study examined how community correctional agents' understanding of addiction and views of medically-assisted treatment (MAT) influence their professional actions regarding addiction medications.
Alcohol and opioid use disorders are common among adults under community supervision. Although several medications have been approved by the Food and Drug Administration (FDA) to treat such disorders, they are underused with this population despite established effectiveness at decreasing substance use. For the current study, 118 semi-structured qualitative interviews were conducted with community correctional agents participating in the CJ-DATS MATICCE implementation study across 20 parole/probation offices in nine U.S. States. Using grounded theory methodology and an iterative analytic approach, issues of role perception, views of MAT, current treatment referral, and community supervision practices were explored. Agents often had limited autonomy to make direct treatment referrals, regardless of their views of MAT, as they were required to follow court orders and their organization's policies and procedures. Within some organizations, community correctional agents held sufficient autonomy to make direct treatment referrals, with agents struggling to reconcile their desire to support their clients who needed MAT with concerns about the abuse potential of opioid agonist medications. Viewing MAT as a "treatment of last resort" was counterbalanced by the view that it was an effective evidence-based practice. Agents described how MAT impacted their ability to supervise clients and how their knowledge and understanding of MAT was directly influenced by watching their clients who were successful or unsuccessful on MAT. Even those agents who were more accepting of MAT were largely unsupportive of its long-term use. The study concludes that community correctional agents' views of MAT were influenced by their understanding of addiction as well as their experiences in supervising clients receiving treatment with medications, but whether or not MAT referrals were made was not always within their control. (Publisher abstract modified)