Offending, custody and opioid substitution therapy treatment utilisation among opioid-dependent people in contact with the criminal justice system: comparison of Indigenous and non-Indigenous Australians.

BACKGROUND: Although Indigenous Australians are over-represented among heroin users, there has been no study examining offending, time in custody, and opioid substitution therapy (OST) treatment utilisation among Indigenous opioid-dependent (including heroin) people at the population level, nor comparing these to non-Indigenous opioid-dependent people. The aims of this study were to compare the nature and types of charges, time in custody and OST treatment utilisation between opioid-dependent Indigenous and non-Indigenous Australians in contact with the criminal justice system. METHODS: This was a population-based, retrospective data linkage study using records of OST entrants in New South Wales, Australia (1985-2010), court appearances (1993-2011) and custody episodes (2000-2012). Charge rates per 100 person-years were compared between Indigenous and non-Indigenous Australians by sex, age and calendar year. Statistical comparisons were made for variables describing the cumulative time and percentage of follow-up time spent in custody, as well as characteristics of OST initiation and overall OST treatment utilisation. RESULTS: Of the 34,962 people in the cohort, 6,830 (19.5%) were Indigenous and 28,132 (80.5%) non-Indigenous. Among the 6,830 Indigenous people, 4,615 (67.6%) were male and 2,215 (32.4%) female. The median number of charges per person against Indigenous people (25, IQR 31) was significantly greater than non-Indigenous people (9, IQR 16) (p < 0.001). Overall, Indigenous people were charged with 33.2% of the total number of charges against the cohort and 44.0% of all violent offences. The median percentage of follow-up time that Indigenous males and females spent in custody was twice that of non-Indigenous males (21.7% vs. 10.1%, p < 0.001) and females (6.0% vs. 2.9%, p < 0.001). The percentage of Indigenous people who first commenced OST in prison (30.2%) was three times that of non-Indigenous people (11.2%) (p < 0.001). Indigenous males spent less time in OST compared to non-Indigenous males (median percentage of follow-up time in treatment: 40.5% vs. 43.1%, p < 0.001). CONCLUSIONS: Compared to non-Indigenous opioid-dependent people, Indigenous opioid-dependent people in contact with the criminal justice system are charged with a greater number of offences, spend longer in custody and commonly initiate OST in prison. Hence, contact with the criminal justice system provides an important opportunity to engage Indigenous people in OST.

Factors affecting criminal recidivism among participants in the Magistrates Early Referral Into Treatment (MERIT) program in New South Wales, Australia.

INTRODUCTION AND AIMS: The Magistrates Early Referral Into Treatment (MERIT) program is a diversionary program for people with substance use (primarily illicit drug) problems, based in New South Wales, Australia. The aim of this study was to assess factors relevant to recidivism among MERIT participants. DESIGN AND METHODS: A longitudinal study utilising administrative data was conducted. MERIT participants entering the program after 1 August 2004 and with a finalisation date of prior to 31 December 2005 were included in the study. Recidivism records for this cohort were obtained for the period 1 August 2004 and 31 December 2007 and linked to MERIT administrative data. Cox proportional hazards modelling was used to identify predictors of recidivism. RESULTS: A total of 1160 MERIT participants were included in the analysis. Compared to non-completers, completion of the MERIT program was associated with a 30% reduction in risk of recidivism. Factors associated with increased risk of recidivism following MERIT included principal drug other than cannabis and higher number of prior convictions. Discussion and Conclusions. Although the design of this study does not permit causal conclusions, these results suggest the MERIT program may be associated with reduced criminal offending. The identification of factors associated with increased risk of recidivism may be helpful in identifying participants in need of higher intensity interventions.[Larney S, Martire KA. Factors affecting criminal recidivism among participants in the Magistrates Early Referral Into Treatment (MERIT) program in New South Wales, Australia.