Booty: Dissertation: Examining the Impact of the Criminal Legal System on Opioid Use Disorder Treatment and Recovery: A Socioecological Perspective

Grants and Contracts Details


The proposed R36 dissertation project will advance scientific understanding of the criminal legal system’s influence on opioid use disorder (OUD) treatment and recovery. Many people access OUD treatment services through the criminal legal system, but the criminal legal system’s public safety role could have unintended consequences on an individual’s recovery post-release. The proposed mixed-methods study aligns with the NIDA Services Research Branch priority to better understand the impact of CLS involvement on substance use, service engagement, and recovery. Specifically, the aims will enhance knowledge of the community-, interpersonal-, and individual-level influence of the criminal legal system on language used to discuss opioid use disorder treatment, return to substance use, and mutual support group participation, respectively. The specific aims of the project are to: 1) examine the impact of the criminal legal system on the language used to discuss opioid use disorder treatment and recovery among people residing and working in communities highly impacted by the opioid epidemic, 2) analyze the effect of social network changes during reentry on return to use at 6 months post-release, and 3) evaluate the CLS-related predictors of individuals’ participation in mutual aid support groups (e.g., Alcoholic Anonymous or Narcotics Anonymous) post-release. Aim 1 will be achieved via qualitative thematic analysis of Photovoice group transcripts (N = 45 participants) from the Kentucky HEALing Communities Study Photovoice protocol. Aim 2 and Aim 3 will be achieved by conducting secondary data analyses using data from the Geographic variation in Addiction Treatment Environment study, a longitudinal cohort study examining medication use for OUD treatment and other recovery outcomes of individuals who participated in substance use disorder treatment programming while incarcerated (N = 250). The secondary analyses for Aim 2 and Aim 3 will use logistic regression to analyze the social network predictors of return to opioid and other substance use and negative binomial logistic regression to predict the number of mutual support groups attended in the 6-months after release, respectively. Results of this project will highlight the urgent need to view substance use as a medical issue rather than a criminal problem in order to combat disparities in treatment and recovery efficacy. Because opioid use recovery is not merely an individual process, barriers to recovery must be addressed at all levels of criminal legal system interaction to best effect change and have a sustained public health impact. The R36 dissertation project outlined in this application will launch the Principal Investigator on a path towards becoming an NIH independent investigator.
Effective start/end date6/1/245/31/26


  • National Institute on Drug Abuse: $53,357.00


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