Pre-Arrest Diversion-To-Treatment for Adults with Substance Use Disorder: Health Outcomes and Predictors of Program Completion.

Abstract

Untreated addiction is often associated with criminal justice involvement. Pre-arrest diversion programs are increasingly popular, despite limited evidence. We implemented Madison Addiction Recovery Initiative (MARI), a law enforcement-led diversion-to-treatment program, for adults with eligible, drug use-related crime, and evaluated MARI’s impact on health outcomes. One-hundred-sixty participants completed clinical assessments at baseline, with 100 completing the six-month program (“Completers”) and clinical assessments, and 60 not completing the program (“Non-Completers”). One-way ANOVA and chi-square tests compared baseline characteristics between Completers and Non-Completers, with differing characteristics entered into a logistic regression model assessing the baseline predictors of program completion. At baseline, 75.0% reported opioid use, and 34.9% were involved in addiction treatment. Compared to baseline, Completers reduced depression, anxiety, and addiction severity scores, and increased their rate of treatment with medications for opioid use disorder (p < 0.001). Significant predictors of program completion (p < 0.05) included treatment engagement, and higher depression and lower anxiety symptom scores at baseline, fewer incarceration episodes within 12 months pre-enrollment, and shorter “lifetime” maximum sobriety duration. These findings suggest pre-arrest diversion programs can effectively connect adults who committed drug-use related crimes to addiction treatment, and improve health outcomes among engaged participants.