Multilevel determinants of medication preferences for opioid use disorder among criminal-legal-involved populations: Insights from a scoping review.

Abstract

<h4>Background</h4>Individuals with opioid use disorder (OUD) hold varying perceptions of the three medications to treat OUD (MOUD). Data on these perceptions among those with criminal-legal involvement is limited. To optimize MOUD service delivery, especially in criminal-legal settings, it is essential to explore the preferences and attitudes of those with legal involvement.<h4>Methods</h4>We conducted a scoping review of literature published via PubMed, Embase, Web of Science, Scopus, PsycInfo, and SocINDEX (January 1, 2014-September 17, 2024). Three-stage screening process was employed by two reviewers: title/abstract (n = 2085 articles), full-text (n = 88), and data extraction of 44 articles included in the final sample. Content analysis was used to understand preferences/attitudes toward MOUD and related influential factors.<h4>Results</h4>Factors that influenced MOUD preferences/attitudes were clustered in positive (n = 39 articles; i.e., like), negative (n = 38; i.e., dislike), or mixed (n = 20; both positive and negative) valences. Methadone was the most referenced (n = 30), with more articles noting negative attitudes than positive. Fewer studies focused on oral buprenorphine (n = 18), with balanced positive and negative views. Seven articles on injectable MOUD highlighted mostly positive attitudes. Factors shaping preferences/attitudes spanned from individual to structural levels. Common factors associated with negative preferences included MOUD program rules, side or adverse effects, and drug-free ideology. Positive preferences were often engendered by flexible MOUD delivery and beliefs about MOUD. Influential factors differed by MOUD type.<h4>Conclusions</h4>Preferences/attitudes toward MOUD among criminal-legal-involved populations are shaped by intersecting multilevel determinants and differ by MOUD type. Identified factors might serve as intervention targets to better meet individuals' needs.