{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T09:06:48Z","timestamp":1778231208552,"version":"3.51.4"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,8,3]],"date-time":"2024-08-03T00:00:00Z","timestamp":1722643200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Addict"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Criminal\u2010legal (CL) referrals to addiction treatment have historically had low utilization of medications for opioid use disorder (MOUD). While state differences have been reported, an in\u2010depth longitudinal analysis of state\u2010by\u2010state differences is lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Substance Abuse and Mental Health Services Administration Treatment Episode Dataset\u2010Admissions 2000\u20132020 provided data for individuals entering their initial treatment with an opioid as their primary substance. Outcome was planned use of MOUD, assessing odds ratio (OR) of CL referrals relative to non\u2010CL referrals cumulatively over the 21\u2010year period and as incremental change (change in relative disparity) using effect sizes, stratified by each state.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>2,187,447 cases met the criteria. Planned MOUD occurred in 37.7% of non\u2010CL clients versus 6.5% of CL clients (OR\u2009=\u20090.11, 95% confidence interval\u2009=\u20090.11\u20130.12). For all clients, planned MOUD increased from 2000 (33.9%) to 2020 (44.8%). This increase was blunted within CL clients, increasing from 2000 (6.4%) to 2020 (13.3%). Rhode Island saw the greatest improvements in equity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusions<\/jats:title><jats:p>While rates of planned MOUD increased over the 21 years, a significant disparity persisted among CL clients in most states. As opioid use disorders and opioid\u2010related overdoses are more prevalent among those involved with the CL system, improving this has high impact.<\/jats:p><\/jats:sec><jats:sec><jats:title>Scientific Significance<\/jats:title><jats:p>Provides the most comprehensive analysis of state\u2010by\u2010state inequities in MOUD access for CL relative to non\u2010CL referrals over a 21\u2010year period through use of a national data set. Positive outliers are used as case examples for others to follow in pursuit of more equitable care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajad.13636","type":"journal-article","created":{"date-parts":[[2024,8,3]],"date-time":"2024-08-03T12:10:24Z","timestamp":1722687024000},"page":"60-68","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["State inequities: Gaps in planned treatment for criminal legal referrals with opioid use disorder across two decades of US treatment admissions"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8847-8727","authenticated-orcid":false,"given":"Nicholas L.","family":"Bormann","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7124-776X","authenticated-orcid":false,"given":"Andrea N.","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Iowa Iowa City Iowa USA"},{"name":"Department of Internal Medicine University of Iowa Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7363-8086","authenticated-orcid":false,"given":"Tyler S.","family":"Oesterle","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Miskle","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Iowa Iowa City Iowa USA"},{"name":"Department of Pharmacy University of Iowa Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison C.","family":"Lynch","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Iowa Iowa City Iowa USA"},{"name":"Department of Family Medicine University of Iowa Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Arndt","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Iowa Iowa City Iowa USA"},{"name":"Department of Biostatistics University of Iowa Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,8,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.3821"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.20622"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2018.05162"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2017.0890"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2021.108329"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.0558"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.josat.2023.208971"},{"key":"e_1_2_8_9_1","unstructured":"KluckowR ZengZ. 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