Qualitative study uncovers multilevel barriers to addiction medication engagement among justice-involved women, highlighting the need for continuous care across carceral and community settings.
Criminal legal system (CLS)-involved women who use opioids experience substantial challenges engaging in medications for opioid use disorder (MOUD). This qualitative study examined multilevel determinants of MOUD engagement across carceral, reentry, and community contexts. We conducted a secondary analysis of semi-structured interviews with 12 CLS-involved women with histories of opioid use and MOUD treatment. Reflexive thematic analysis, informed by the social ecological model, identified individual, interpersonal, and institutional/structural determinants. Medication experiences, treatment preferences, recovery motivation, and interpersonal relationships shaped engagement, while institutional/structural determinants included treatment costs, inconsistent jail-based MOUD access, inadequate discharge planning, and availability of low-barrier community services. Notably, jails emerged as sites of both treatment disruption and opportunity. Findings highlight the dynamic, multilevel nature of MOUD engagement and support patient-centered, harm-reduction approaches that preserve treatment choice, facilitate reengagement, and strengthen continuity of care across incarceration, reentry, and community settings.
No takes yet. Share an insight, caveat, or question.
Ciraldo et al. (2026) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: