Dissertation

Access to Injectable Naltrexone for Formerly Incarcerated Individuals During Community Reentry: Advancing the Role of Community Pharmacists in Wisconsin

Chladek, Jason Scott

2024

Overview

In Wisconsin, opioid use disorder (OUD) is highly prevalent among individuals impacted by the criminal justice system. Medications for opioid use disorder (MOUD), which includes injectable naltrexone, are a key component in the treatment of OUD and especially important for formerly incarcerated individuals as they transition out of correctional facilities and back into their communities. Unfortunately, few formerly incarcerated individuals are able to access MOUD upon community reentry. Wisconsin community pharmacists are a promising resource for providing injectable naltrexone, as they have the legal capacity to provide injections and are more accessible than other healthcare providers. However, utilization of community pharmacist-provided injectable naltrexone by formerly incarcerated individuals remains low. Additionally, research has not explored community pharmacist-provided injectable naltrexone for formerly incarcerated individuals. As a result, Aim 1 was used to identify the barriers and facilitators to community pharmacist-provided injectable naltrexone for formerly incarcerated individuals through semi-structured interviews with five different stakeholder groups. Content analysis was to summarize barriers and facilitators based on the Socioecological Model. Overall, participants identified barriers and facilitators across all levels of the Model. Aim 2 included a legal analysis of Wisconsin statutes and administrative codes with implications for community pharmacist-provided injectable naltrexone for formerly incarcerated individuals. Aim 2 also included an environmental scan of available injectable naltrexone services in Wisconsin. Both the analysis and scan emphasized the importance of increasing the number of MOUD providers and that community pharmacists can be an important resource for formerly incarcerated individuals. The legal analysis also highlighted several statues and codes that hinder or facilitate availability of or access to community pharmacist-provided injectable naltrexone. Finally, Aim 3 included three iterative focus groups with community pharmacists. Focus groups were used to inform an intervention that improves access to community pharmacist-provided injectable naltrexone for this patient population. The final intervention included pharmacist-led educational meetings with correctional staff about community pharmacist-provided injectable naltrexone. The participants also discussed specific components of the intervention, as well as anticipated challenges/barriers. The results of this project can increase access to injectable naltrexone for formerly incarcerated individuals and improve several health and social outcomes for this patient population.

• Publisher: ProQuest Dissertations & Theses
• Subject: Clinical psychology / Health sciences
• ISBN: 9798383001271