Table 2 One-hundred factors within cluster map related to the criminal legal system, substance use, and overdose
Cluster: Societal impacts of criminal legal involvement | |
7 | There is fear and anxiety that comes about when consistently dealing with the legal system, damaging one’s mental health and leading to more substance use |
11 | Incarceration is destabilizing in that housing, jobs, and medical treatment all stop when charged |
52 | People lose access to resources while incarcerated |
55 | Increased criminal legal penalties perpetuate the stigma and the shame a person feels about their disease, which perpetuates continued use |
56 | Legal system does not help you feel more hopeful |
57 | Legal system makes it harder to get through to the other side |
73 | People are let out of jail at 3:30 a.m |
74 | People are going to get even sicker with more criminal legal contacts |
79 | Increased criminal legal penalties are not addressing the root issue |
80 | Some people have a lack of control and are unable to make an informed decision |
83 | Lack of control around available resources, which create hopelessness |
84 | Feelings of loneliness and lower tolerance post-incarceration |
87 | The justice system does not help people recover or connect them to resources |
89 | Jail has never helped |
96 | Increased criminal legal penalties make recovery from substance use more difficult |
97 | Services in jail are not focused on helping people be successful |
98 | There are no services post-release, or there are barriers to receiving services post-release |
99 | There are not a lot of services in jail |
100 | People have to go to jail to get services |
Cluster: Lifesaving benefits to decreased criminal legal penalties | |
21 | Trust the process, because not everyone has a family or a community to support them |
48 | Less criminal legal involvement decreases a person’s stress and trauma, which can prevent/reduce relapse and/or continued use |
49 | Less criminal legal involvement allows time to create consistency in one’s life, such as creating a community and connecting with more resources |
81 | Sometimes resources in jail can be very helpful |
Cluster: Environmental barriers to criminal legal involvement | |
4 | A lack of stability and potential to lose everything becomes the new stressor and reason to use |
8 | Overdose is a factor because health goes down in jail and prisons making a person frailer, and when you add that to their tolerance constantly changing, it is a dangerous combination |
9 | The more someone is incarcerated, the more community connections and resources they lose |
10 | Incarceration may lead to really quick blips of abstinence but then causes people to end up using more because of shame, stigma, and increased stress and lack of coping skills to deal with it all |
12 | The stress that comes along with being involved in the criminal legal system and being in a constant state of surveillance and crisis is a factor in people going to substances as a coping mechanism |
51 | The more often someone is incarcerated, the more trauma they accumulate |
53 | Increased criminal legal penalties increase drug use and death and will not decrease addiction or drug use |
59 | Prison takes away social and life skills |
76 | Mental health decreases over time |
77 | Increased criminal legal penalties cause people to lose their cars, house, job, and everything in between |
78 | Increased criminal legal penalties can lead to your kids being taken away |
85 | The risk of overdose is higher if people do not receive services in jail |
86 | The highest risk of overdose is after any period of abstinence (i.e., incarceration, treatment) |
90 | People are more likely to self-medicate post-release |
91 | It is harder to reintegrate into society post-release |
92 | Problems related to substance use continue and get worse in jail |
93 | Substance use and involvement in the criminal legal system is a repetitive cycle that does not set people up for success and is difficult to get away from once you are involved in it |
95 | It is more difficult for community service providers to locate people and provide necessary services post-release from the criminal legal system |
Cluster: Structural barriers to recovery services | |
6 | The less trauma associated with touches by the legal system, the less likely to encounter civil death, which would give people more opportunities to find treatment or access other resources to help improve their quality of life |
36 | There are a lot of negative interventions |
54 | Increased criminal legal penalties push some people to stay sober |
63 | Service options are very limited, and the waitlist is very long right now |
67 | Recovering from incarceration and recovering from substance use is similar |
82 | The substance is not the problem; it is a lack of coping skills for untreated mental health or other environmental factors post-release |
94 | People do not want to get in trouble for helping someone that has overdosed |
Cluster: Essential culturally aware community-based services | |
13 | Need for trauma-informed care |
24 | Need to change the laws, including decriminalizing drugs |
47 | Gives a person the opportunity to seek help and/or get treatment when they are not incarcerated |
50 | If criminal legal penalties were decreased, some people might do better for a few days by accessing MAT programs and being able to calm down and feel better after not being penalized |
61 | We need more opportunities to meet people where they are because a one-size-fits-all approach does not work for everyone |
62 | Important to have more programs that are culturally aware |
66 | There would be a better reason for recovering |
68 | Support systems help build trust |
70 | The more peers, the better |
71 | The sense of community is very important |
72 | Having peer support while incarcerated is so important |
75 | Having a support system in jail makes a big difference |
Cluster: Strategic allocation of funding | |
19 | There is a need for positive interventionists and harm reductionists |
25 | There need to be more crisis intervention teams instead of law enforcement responding to mental health crises |
38 | Instead of arresting, programs should evaluate if it is a mental health issue and connect people to resources (e.g., STAR Program) |
46 | More street outreach, even by police, can make a huge difference |
58 | Divert resources to help build up communities |
60 | We need opportunities to support people post-incarceration |
64 | Funding for thing other than jails and prisons would allow services to be individualized |
65 | Funding in the proper sectors would make it easier to get people into services and for people to seek services |
69 | Decreased criminal legal penalties would improve relationships with family and help families stay together |
88 | The money spent on jails could be better spent elsewhere |
Cluster: Strategies to improve law enforcement’s impact | |
2 | Police should have actual resources to make them educated, nonbiased, and have a nonjudgmental attitude toward those involved in a 911 call |
15 | Law enforcement needs more education on substance use disorder and more training in harm reduction |
17 | Instead of police coming to arrest, they address what is actually needed |
18 | Police should show up with a social worker or a peer who can connect people to resources and act as their backup |
27 | Law enforcement should be trained to be able to identify people that need to be connected to resources, be more compassionate, and not judgmental |
28 | Police should be a catalyst for mental health interventions |
29 | Police should build bridges with the community |
31 | Law enforcement needs to be part of the community |
45 | Police can help by connecting people to resources |
Cluster: Changing policies to keep law enforcement accountable and better educate law enforcement on community culture | |
1 | Police should act with information that is reality based, not all based on old information or outdated attitudes |
14 | The role of the police and the criminal legal system should be to connect people to resources that will improve their condition |
16 | There should be a harm reduction model for police officers |
20 | There is a benefit to not having the police be involved in most cases |
22 | There should be more responsibility on the legal system to change the laws, not the police |
23 | Police and the criminal legal system should not punish people for having a disease |
30 | Police should want to save lives |
44 | Police presence can be important, but not increased arrests |
Cluster: Community issues with law enforcement to prioritize | |
3 | Police are using the overdose crises as entertainment and boredom killing |
5 | Police are a paramilitary organization searching for war |
26 | Right now, police know about harm reduction programs, but do not know how or cannot get people connected to help |
32 | Law enforcement should prioritize violent crimes |
33 | Police suffer from compassion fatigue |
34 | It is hard for police to handle mental health crises |
35 | Law enforcement is overworked |
37 | Police are being asked to be something that is not possible (i.e., a clinician and a soldier at the same time) |
39 | The police aim to teach a lesson |
40 | The police do not understand addiction, substance use, or MAT |
41 | There is nothing law enforcement can do |
42 | Law enforcement’s hands are tied in regard to helping people |
43 | Police enforce the law they are told to enforce |