Situational confidence and recovery capital among justice-involved adults receiving medications for opioid use disorder in a jail-based setting.

BACKGROUND

Justice-involved individuals with opioid use disorder (OUD) face heightened relapse risks during the reentry period. While medications for opioid use disorder (MOUD) are effective, long-term recovery also depends on psychological and structural supports, including situational confidence (perceived ability to resist substance use in high-risk situations) and recovery capital (the internal and external resources that support recovery).

METHODS

This cross-sectional study examined situational confidence and its association with recovery capital among 107 justice-involved adults receiving MOUD in an urban jail in Texas. Participants completed the Brief Situational Confidence Questionnaire (BSCQ) and the 10-item Brief Assessment of Recovery Capital (BARC-10). Mental health and substance use were assessed using the PHQ-9, GAD-7, AUDIT, and ASSIST. Bivariate associations were examined using chi-square and Fisher's exact tests, and a multivariable logistic regression model was used to assess factors associated with high situational confidence (BSCQ ≥ 80%).

RESULTS

Participants had a mean age of 38.9 years (SD = 0.4); most were male (74.0%), non-Hispanic Black or other race/ethnicity (58.0%), and had a high school education or less (59.8%). A majority (66.4%) reported unstable housing in the 30 days prior to incarceration. Fewer than half (44.9%) reported high situational confidence, with a mean score of 67.6 (SD = 26.9). Higher recovery capital was strongly associated with high situational confidence (aOR = 2.66; 95% CI: 1.52-4.96). Depression (aOR = 0.36; 95% CI: 0.16-0.78), sexual minority status (aOR = 0.14; 95% CI: 0.01-0.78), and reliance on informal income-generating activities ("hustling") (aOR = 0.30; 95% CI: 0.10-1.01) were associated with lower situational confidence.

CONCLUSIONS

Recovery capital is a strong predictor of situational confidence among justice-involved individuals receiving MOUD. Interventions that enhance recovery capital, including access to employment, housing, and social support, integrate mental health care, and provide tailored support for marginalized subgroups, may improve recovery outcomes during incarceration and reentry. Brief, validated tools like the BSCQ and BARC-10 may help identify individuals at greater relapse risk and guide more targeted, equity-informed reentry planning.