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- W4321236028 abstract "Adolescents with justice system involvement are significantly more likely to meet criteria for a substance use disorder (SUD) compared to the general adolescent population, with prevalence of SUD as high as 68%.3 Receiving SUD treatment has been found to reduce recidivism for justice-involved youth, yet only a small proportion (4.4-27.95%) receive SUD treatment4, 6–9. Our study aims to characterize current practices for SUD screening and treatment in the juvenile justice setting and elucidate best practices for those seeking to better address substance use for this vulnerable youth population. We identified and recruited medical and behavioral health providers with experience caring for justice-involved youth from the SAHM Juvenile Justice Special Interest Group. We conducted 30-60 minute semi-structured qualitative interviews, informed by the Capacity-Opportunity-Motivation-Behavior (COM-B) Model. Interviews were analyzed using thematic and content analysis. We identified current practices, facilitators and barriers affecting implementation, and themes that can inform implementation of evidence-based substance use screening and treatment moving forward. We interviewed 14 participants from twelve unique institutions and nine states. Current practices for addressing substance use varied widely. The majority of participants implemented a protocol for universal screening (83%) at their facilities, however there was notable variation in the timing and method of screening. Most facilities had some behavioral therapy available on-site (75%), although there was variation in the type, intensity, and administrators of behavioral therapy. There was also variation in the availability of evidence-based pharmacotherapy for SUD. Most described having provider(s) trained in buprenorphine prescribing (58%), although there was variation in whether MOUD was being actively prescribed and in what circumstances. Few facilities offered MAUD such as extended-release naltrexone (25%). Eight main themes emerged from analysis of the barriers and facilitators discussed by participants. These included importance of: (1) ensuring substance use-specific training for all team members, (2) integrating medical and behavioral healthcare, (3) addressing staff reticence and stigma, (4) building an institutional culture which supports screening and treatment, (5) dedicating adequate resources with respect to time, staffing, and funding, (6) formalizing and standardizing screening and treatment protocols, (7) engaging youth using trauma-informed approaches that emphasize youth strengths and autonomy, and (8) collaborating with multidisciplinary teams and community partners to maximize linkage to follow-up care after release. While the majority of participants screen justice-involved youth for substance use, they described variable implementation of behavioral health interventions and limited provision of on-site withdrawal management and treatment using medications for SUD. The present study identified common barriers and facilitators that arise during the implementation of evidence-based substance use care and key themes that can inform improvement of care." @default.
- W4321236028 created "2023-02-18" @default.
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- W4321236028 date "2023-03-01" @default.
- W4321236028 modified "2023-09-25" @default.
- W4321236028 title "151. Addressing Substance Use for Justice-Involved Youth: Where are We Now and Where are We Going?" @default.
- W4321236028 doi "https://doi.org/10.1016/j.jadohealth.2022.11.173" @default.
- W4321236028 hasPublicationYear "2023" @default.
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