Faculty Bibliography

OBJECTIVE:Justice-involved populations are at increased risk of overdose following release from prison and jail. This risk is exacerbated by polysubstance use, including the use of opioids with other substances. This study explored pre-incarceration polysubstance use involving opioids as a unique risk factor for postrelease return to substance use. METHODS:The study examined data from a cohort of 501 justice-involved persons who were enrolled in a therapeutic community treatment program while incarcerated. Latent profile validation identified profiles of polysubstance use involving opioids prior to incarceration. Multivariate logistic regression examined return to substance use, defined as self-reported relapse, and a time series model examined time in the community until a relapse event occurred. RESULTS:A latent profile validation found six unique polysubstance opioid patterns prior to incarceration. Two of these profiles, primarily alcohol and primarily buprenorphine, were at increased and accelerated risk for relapse postrelease relative to a less polysubstance use profile. Both profiles at increased risk had pre-incarceration co-use of marijuana (≈45% of month) and nonmedical use of opioids (≈40% of month) but were unique in their respective near daily use of alcohol and nonmedical buprenorphine. CONCLUSIONS:Among persons who use opioids returning to the community, return to substance use occurs along a continuum of risk. Providers' consideration of polysubstance use patterns during treatment may assist in mitigating adverse outcomes for patients postrelease.

BACKGROUND:Big events (i.e., unique historical disruptions) like the COVID-19 epidemic and its associated period of social distancing can transform social structures, social interactions, and social norms. Social distancing rules and the fear of infection have greatly reduced face-to-face interactions, increased loneliness, reduced ties to helping institutions, and may also have disrupted the opioid use behaviors of people who use drugs. This research used Reddit to examine the impact of COVID-19 on the social networks and social processes of people who use opioids. METHODS:Data were collected from the social media forum, Reddit.com. At the beginning of the COVID-19 pandemic in the U.S. (March 5, 2020, to May 13, 2020), 2,000 Reddit posts were collected from the two most popular opioid subreddits (r/OpiatesRecovery, r/Opiates). Posts were reviewed for relevance to COVID-19 and opioid use resulting in a final sample of 300. Thematic analysis was guided by the Big Events framework. RESULTS:The COVID-19 pandemic was found to create changes in the social networks and daily lives among persons who use opioids. Adaptions to these changes shifted social networks leading to robust social support and mutual aid on Reddit, including sharing and seeking advice on facing withdrawal, dealing with isolation, managing cravings, and accessing recovery resources. CONCLUSIONS:Reddit provided an important source of social support and mutual aid for persons who use opioids. Findings indicate online social support networks are beneficial to persons who use opioids, particularly during big events where isolation from other social support resources may occur.

BACKGROUND:The COVID-19 pandemic poses significant challenges to people with opioid use disorder (OUD). As localities enforce lockdowns and pass emergency OUD treatment regulations, questions arise about how these changes will affect access and retention in care. In this study, we explore the influence of COVID-19 on access to, experiences with, and motivations for OUD treatment through a qualitative analysis of public discussion forums on Reddit. METHODS:We collected data from Reddit, a free and international online platform dedicated to public discussions and user-generated content. We extracted 1000 of the most recent posts uploaded between March 5th and May 13th, 2020 from each of the two most popular opioid subreddits "r/Opiates" and "r/OpiatesRecovery" (total 2000). We reviewed posts for relevance to COVID-19 and opioid use and coded content using a hybrid inductive-deductive approach. Thematic analysis identified common themes related to study questions of interest. RESULTS:Of 2000 posts reviewed, 300 (15%) discussed topics related to the intersection of opioid use and COVID-19. Five major themes related to OUD treatment were identified: Concern about closure of OUD treatment services; transition to telehealth and virtual care; methadone treatment requirements and increased exposure to COVID-19; reactions to changing regulations on medications for OUD; and influences of the pandemic on treatment motivation and progress. CONCLUSION/CONCLUSIONS:In the face of unprecedented challenges due to COVID-19, reactions of Reddit opioid forum users ranged from increased distress in accessing and sustaining treatment, to encouragement surrounding new modes of treatment and opportunities to engage in care. New and less restrictive avenues for treatment were welcomed by many, but questions remain about how new norms and policy changes will be sustained beyond this pandemic and impact OUD treatment access and outcomes long-term.

Black women are disproportionately involved in the child welfare system. This state-level intervention occurs at two levels-a higher likelihood of being (i) screened for drug use during pregnancy and (ii) reported to child welfare authorities after delivery. Consequently, they face further enmeshment in state-systems, including custody loss and lower reunification odds. Using evidence from the past forty years of research and media reports, we argue that systemic forces and policies largely contribute to racial disproportionality in the child welfare system, and assert this state intervention serves as a mechanism to control black reproduction.

In response to the opioid epidemic, there have been several national and state-level policies enacted. Consideration of how criminal justice-involved individuals are affected by such policies has received limited attention, despite disproportionately higher use among this population. Bivariate statistics examined yearly trends and logistic regressiosns examined demographic correlates of nonmedical prescription opioid and heroin use among Kentucky inmates over an eight-year time-span of important national and local policy changes (n=34,542). Results indicate that among incarcerated individuals, prior use of heroin increased 204% from 2008 to 2016, with increases possibly linked to key policy changes associated with OxyContin reformulation and state implementation of a prescription drug monitoring program. The current incarcerated population had more severe use patterns when considering general population research. Consideration of criminal justice-involved populations is crucial to understanding and treating the opioid epidemic.

Despite advances in research into minority sexual identities, bisexual identity research has been limited. Studies conducted to date suggest that bisexuality is often perceived as a 'transitional' identity and bisexual individuals in relationships are often perceived to be either straight, lesbian, or gay based on the gender of their relationship partner. The current couple-based study focuses on the experiences of bisexual individuals in mixed-sex relationships and how bisexual identity may impact sexual and relationship satisfaction of both members of the couple. Cross-sectional data were analyzed from both members of 142 mixed-sex couples (N = 284). Analyses indicated that feelings of illegitimacy of bisexuality and outness to family were negatively associated with sexual and relationship satisfaction of both partners whereas intimacy was positively associated with sexual satisfaction for both partners. The results highlight the importance of acknowledging bisexual identity even in the context of long-term relationships and addressing issues surrounding bisexual identity in its function for sexual and relationship satisfaction with couples. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

AIM:: Findings indicate the heterogeneity of opioid use among a justice-involved population. More diverse polysubstance patterns may serve as a proxy to identifying individuals with competing physical and mental health needs. Future interventions could be tailored to polysubstance patterns during the period of justice-involvement.

In Asia, Mitragyna speciosa (e.g., "kratom") has been used to mitigate alcohol and drug dependence. Some preliminary findings suggest kratom's potential use as an informal harm-reduction method in the United States, such as an opioid substitute or as a means of lessening opioid withdrawal symptoms. To determine correlates of past-year kratom use among a sample of polysubstance users enrolled in residential recovery programs in Kentucky, an anonymous survey was completed by clients in April 2017. Logistic regression was used to identify significant associations with past-year kratom use. Of the final sample (N = 478), 10.4% reported past-year kratom use. Past-year heroin use, but not past-year prescription opioid (e.g., oxycodone, hydrocodone) use, was significantly associated with kratom use, such that individuals who reported past-year heroin use were 2.5 times more likely to also report past-year kratom use. Non-prescribed buprenorphine (i.e., Suboxone) use partially mediated the relationship between past-year heroin and kratom use by explaining 36% of the association between the two drugs. Though amphetamines were highly preferred, past-year use was negatively correlated with past-year kratom use. Rates of past-year kratom use were lower than rates of alcohol and illicit drug use. Kratom was not preferred over heroin or prescription opioids.

The purpose of this exploratory study was to establish the prevalence of disability as measured by self-reported Social Security Disability Insurance (SSDI) receipt among a sample of women on probation and parole who have experienced interpersonal victimization in childhood and/or adulthood. Women receiving SSDI were more likely to be older, White, to live alone, and to score lower on measures of social support compared to women not receiving SSDI. SSDI recipients were also more likely to report poorer health, chronic pain, and more frequent health care service utilization. High rates of adverse childhood experiences, rape, adult victimization, and an overall greater severity of post-traumatic stress disorder symptomatology were observed for women receiving SSDI. Groups had similar overall mental health profiles and diverged primarily on trauma variables. Findings support the need for trauma-informed care and highlight the possibility that some criminal justice system-involved women likely qualify for SSDI, yet are not receiving it.

Criminological research has tended to consider employment in a dichotomy of employed versus unemployed. The current research examines a sample of individuals 1-year post-release to assess the extent to which four distinct employment categories (full-time, part-time, disabled, and unemployed) are associated with reincarceration and days remaining in the community. Findings indicate disabled individuals remain in the community longer and at a higher proportion compared with other employment categories. Furthermore, unique protective and risk factors are found to be associated with each employment category while some risk factors (e.g., homelessness) highlight the importance of addressing reentry barriers regardless as to employment status.