Adults incarcerated following arrest for drug misuse are a vulnerable population. Historically, the role of courts in drug arrest cases is to impose sanctions and protect society from future harm. Problem solving courts (PSCs) are a public health intervention that refer arrested individuals with opioid use disorder (OUD) to treatment as a pre-trial diversionary strategy. The research outcome of the proposed project will rigorously evaluate the implementation and impact of an existing strategy in response to Research Objective 4: strategies for evaluation that infuse public health approaches into public safety and response. Although previous studies have examined the effect of PSCs on recidivism, characteristics of individual PSC policies, procedures, and practices and their impact on morbidity and mortality rates have not been rigorously evaluated. Specifically, the proposed project will address the following research question: Do PSCs promote health and wellness of individuals and their communities by impacting subsequent morbidity and mortality rates? There are 5 Specific Aims of the proposed project to evaluate both the implementation and impact of PSCs: 1) Quantitatively coding policies and procedures of individual PSCs and traditional correctional facilities; (2) qualitatively evaluating the development and implementation of policies and procedures adopted by individual PSCs and traditional correctional facilities; (3) analyzing the effect of individual PSC and traditional correctional facility policies and procedures on opioid- related morbidity and mortality; (4) integrating impactful PSC and/or correctional facility protocols revealed from Aims 1-3 into a synthetic OUD population framework; and, (5) developing and disseminating to public health agencies, the judiciary, and other key stakeholders evidence-based recommendations and tools. The proposed project is a partnership between the University of Pittsburgh Graduate School of Public Health (a previously funded Injury Control Research Center), Indiana State Department of Health (ISDH), Indiana Management Performance Hub (MPH), and Indiana University Purdue University Indianapolis (IUPUI). Pitt Public Health?s partner, ISDH, received programmatic funding through the Prevention for States Program and an Enhanced State Opioid Overdose Surveillance grant, and is currently applying to the Overdose Data to Action Program. This project will be the first to systemically evaluate the impact of PSCs on health and wellness and will lead to changes to the judicial system that will improve public health and lower fatal and non-fatal overdose rates.

Public Health Relevance

Problem solving courts (PSCs) are an existing public health intervention that refer arrested individuals with opioid use disorder (OUD) to treatment instead of prison. However, their impact on health has not been evaluated. The proposed project will evaluate whether being sentenced to a PSC leads to fewer overdoses and death than being sentenced to prison in Indiana.

National Institute of Health (NIH)
National Center for Injury Prevention and Control (NCIPC)
Research Project (R01)
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Special Emphasis Panel (ZCE1)
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University of Pittsburgh
Public Health & Prev Medicine
Schools of Public Health
United States
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