Providers’ perspectives on the ‘best practices’ for employing medical-legal partnerships for women with co-occurring intimate partner violence and opioid use disorder

Abstract Purpose Co-occurring intimate partner violence and opioid use disorder (co-IPV/OUD) is an understudied public health issue which presents significant barriers to care for victims. Providers recognize that the complexities of these conditions require a more holistic, integrated approach to treatment; yet, devising co-located or coordinated care presents its own set of challenges. One potential pathway for improving care for women experiencing co-IPV/OUD is through medical-legal partnerships (MLPs), which have been shown to be an effective upstream intervention for addressing barriers to care. Method As part of a larger study on the barriers and facilitators for caring for women with co-IPV/OUD, we interviewed 40 individuals working across service domains (e.g., healthcare, criminal justice) to understand their perspectives on the best practices for employing an MLP in settings which serve this population. Results Participants discussed at length the “partners” who would need to be included in a medical-legal partnership for this population, including the need to have case managers and peer support involved. Participants identified other “practices” that needed to be considered when implementing a MLP for these women, including necessary training, considerations on where to house the partnership, and to a lesser extent how to refer patients into the partnership. Conclusions This study helps bridge two traditionally siloed literatures: research on MLPs and research on co-occurring IPV and substance use. In doing so, it offers a novel conceptual framework for considering how legal, clinical, and community-based supports can be integrated to better serve women with complex, intersecting needs.