UC San Diego

Purpose: Substance use is prevalent in U.S. criminal legal system (CLS) cases, yet court-ordered treatments rarely recommend effective treatments such as medications for addiction treatment (MAT). The stressful work coupled with lack of preparation among CLS professionals to support various pathways to recovery is theorized to drive and facilitate high rates of burnout, leading to stigma towards defendants with substance use disorder (DWSUD). This study aims to enhance our understanding of the connection between CLS occupational stress, substance use disorder (SUD) stigma, and to evaluate the impact of a tailored training on attitudes and practices concerning DWSUD within the CLS. Methodology: Using a mixed methods approach, we collected primary data. Qualitative data explored possible drivers, facilitators, and practices of substance use-related stigma among CLS professionals. We utilized various national trainings to collect pre-post-training survey data. Pre-training data assessed the relationship of burnout and attitudes towards DWSUD. Pre-post-training data assessed changes in behavioral intentions to refer to MAT for SUD-related cases, intentions to engage in self-care for managing occupational stress, and attitudes toward DWSUD. Findings: CLS professionals experience complex and intense occupational stress, leading to manifestations of emotional, mental, and physical symptoms; driving and facilitating SUD stigma. There was a significant relationship between 2 of the 3 occupational burnout dimensions and attitudes towards DWSUD. The adapted SHIELD training significantly improved attitudes and behavioral intentions related to SUD cases and promoting well-being behaviors among CLS professionals. Implications: These results highlight the urgent need for targeted interventions that provide resources increasing efficacy regarding SUD-related cases and addressing the demanding and stress-inducing nature of CLS professionals' work, as occupational stress contributes to SUD stigma. The adapted SHIELD training demonstrates the positive impact intervention has on attitudes and behavioral intentions, ultimately promoting well-being within the CLS profession. By identifying the nuanced relationships between burnout dimensions and attitudes, as well as the impact of an adapted training intervention, the study contributes valuable insights into improving the well-being of CLS professionals and promoting fair treatment for individuals with SUD. The study's findings advocate for enhanced curriculum, intervention strategies, and more resources to create a more empathetic and effective legal environment.