{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T14:43:37Z","timestamp":1792421017730,"version":"4.5.0"},"reference-count":40,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Correct Health Care"],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:p>Opioid use disorder (OUD) is highly prevalent in correctional settings, where assessment occurs under conditions of stress, surveillance, and timeconstraint. Under these conditions, fluctuating or inconsistent self-report is common and is frequently interpreted as deception, with consequences for documentation, treatment access, and patient safety. This article develops a conceptual framework for interpreting such response variability without presuming intentional dishonesty, and operationalizes it into a structured interpretive tool for real-time clinical use. The framework draws on three literatures: correctional health and OUD assessment, forensic work on malingering, and quantum cognition research on judgment under uncertainty. Constructs from this synthesis were mapped to recurring patterns observed in correctional OUD assessment. Four quantum cognition constructs (order effects, contextuality, superposition, and interference) account for commonly observed patterns, including environment-dependent disclosure, shifts in withdrawal reporting, and ambivalence toward opioid agonist therapy (OAT). These constructs are translated into a structured interpretive tool that prompts clinicians to consider nondeceptive mechanisms (order, context, motivation, and emotional state) before attributing variability to malingering. Applied at the point of care, the framework supports safer withdrawal management, clearer documentation, and more equitable OAT access in correctional environments.<\/jats:p>","DOI":"10.1177\/10783458261454828","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T12:44:46Z","timestamp":1782218686000},"page":"301-311","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["What if Patients Aren't Lying? A Quantum Cognition-Informed Approach to Interpreting Clinical Variability in Correctional Opioid Use Disorder Assessment"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4814-235X","authenticated-orcid":false,"given":"Ovie Martin","family":"Albert","sequence":"first","affiliation":[{"name":"VODP Addiction and Mental Health, Centennial Centre for Mental Health and Brain Injury, Recovery Alberta\/Alberta Health Services, Ponoka, Alberta, Canada."},{"name":"Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-24971-6_12"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmp.2009.04.005"},{"key":"e_1_3_2_4_1","volume-title":"First Peoples, second class treatment: The role of racism in the health and well-being of Indigenous peoples in Canada","author":"Allan B.","year":"2015","unstructured":"Allan B., , & Smylie J. (2015). First Peoples, second class treatment: The role of racism in the health and well-being of Indigenous peoples in Canada. Wellesley Institute: Toronto, ON."},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1257\/aer.20181446"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2019.305486"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511997716"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0963721414568663"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-071867"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40352-023-00209-w"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/jchc.24.06.0048"},{"key":"e_1_3_2_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/amajethics.2025.277"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.1151\/ascp074145"},{"issue":"1","key":"e_1_3_2_14_1","first-page":"98","article-title":"Clinical and conceptual problems in the attribution of malingering in forensic evaluations","volume":"37","author":"Drob S. L.","year":"2009","unstructured":"Drob S. L., , Meehan K. B., , & Waxman S. E. (2009). Clinical and conceptual problems in the attribution of malingering in forensic evaluations. J Am Acad Psychiatry Law, 37(1), 98\u2013106. 19297641","journal-title":"J Am Acad Psychiatry Law"},{"key":"e_1_3_2_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12910-017-0179-8"},{"key":"e_1_3_2_16_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2013.00173"},{"key":"e_1_3_2_17_1","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9781139003261"},{"key":"e_1_3_2_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2015.03.003"},{"key":"e_1_3_2_19_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1516047113"},{"key":"e_1_3_2_20_1","doi-asserted-by":"publisher","DOI":"10.3758\/s13423-025-02675-9"},{"key":"e_1_3_2_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-05101-2"},{"key":"e_1_3_2_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(16)00104-8"},{"key":"e_1_3_2_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11065-023-09601-7"},{"key":"e_1_3_2_24_1","volume-title":"Motivational Interviewing: Helping People Change","author":"Miller W. R.","year":"2013","unstructured":"Miller W. R., , & Rollnick, S. (2013). Motivational Interviewing: Helping People Change, 3rd ed. Guilford Press: New York.","edition":"3"},{"key":"e_1_3_2_25_1","doi-asserted-by":"publisher","DOI":"10.1086\/338631"},{"key":"e_1_3_2_26_1","volume-title":"Medications for Opioid Use Disorder save Lives","author":"National Academies of Sciences, Engineering, and Medicine","year":"2019","unstructured":"National Academies of Sciences, Engineering, and Medicine. (2019). Medications for Opioid Use Disorder save Lives. National Academies Press: Washington, DC; 10.17226\/25310"},{"key":"e_1_3_2_27_1","unstructured":"National Commission on Correctional Health Care. (2021). Opioid Use Disorder Treatment in Correctional Settings. Position Statement."},{"key":"e_1_3_2_28_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0140525X12001525"},{"key":"e_1_3_2_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0193-953X(05)70066-6"},{"key":"e_1_3_2_30_1","volume-title":"Clinical Assessment of Malingering and Deception","author":"Rogers, R.","year":"2018","unstructured":"Rogers, R., Bender, S.D. (Eds). (2018). Clinical Assessment of Malingering and Deception, 4th ed. Guilford Press: New York.","edition":"4"},{"key":"e_1_3_2_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-12685-0"},{"key":"e_1_3_2_32_1","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1441.030"},{"key":"e_1_3_2_33_1","doi-asserted-by":"publisher","DOI":"10.1176\/ps.2009.60.6.761"},{"issue":"4","key":"e_1_3_2_34_1","first-page":"502","article-title":"The case for medication for opioid use disorder during incarceration as standard of care","volume":"50","author":"Tamburello A","year":"2022","unstructured":"Tamburello A. (2022). The case for medication for opioid use disorder during incarceration as standard of care. J Am Acad Psychiatry Law, 50(4), 502\u2013508. 10.29158\/JAAPL.220080-22","journal-title":"J Am Acad Psychiatry Law"},{"key":"e_1_3_2_35_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.80.6.663"},{"key":"e_1_3_2_36_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002969"},{"key":"e_1_3_2_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40352-021-00141-x"},{"key":"e_1_3_2_38_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsr1706626"},{"key":"e_1_3_2_39_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1407756111"},{"key":"e_1_3_2_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmp.2015.11.005"},{"key":"e_1_3_2_41_1","doi-asserted-by":"publisher","DOI":"10.1098\/rsta.2015.0100"}],"container-title":["Journal of Correctional Health Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10783458261454828","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10783458261454828","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10783458261454828","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T14:21:16Z","timestamp":1792419676000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10783458261454828"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,23]]},"references-count":40,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,10,1]]}},"alternative-id":["10.1177\/10783458261454828"],"URL":"https:\/\/doi.org\/10.1177\/10783458261454828","relation":{},"ISSN":["1078-3458","1940-5200"],"issn-type":[{"value":"1078-3458","type":"print"},{"value":"1940-5200","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,23]]}}}