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CORK Bibliography: Criminal Justice System

67 citations. October 2007 to present

Prepared: September 2008

[Anon]. Drug addiction: a view from the law enforcement field. (editorial). Asian Biomedicine 1(1): 109-110, 2007. (0 refs.)

Arfken CL; Kubiak SP. Characteristics of facilities with specialized programming for drinking drivers and for other criminal justice involved clients: analysis of a national database. Substance Abuse Treatment, Prevention, and Policy 2: article 26, 2007. (26 refs.)

Background: Offering specialized programming at substance abuse treatment facilities can help diversify clientele and funding sources, potentially enhancing the facilities' ability to survive and/or expand. Past research has shown that facilities only offering specialized programming for driving under the influence/driving while intoxicated offenders (DUI) are predominately private-for-profit owned. As criminal justice populations, both DUI and other criminal justice offenders, comprise a large proportion of those in community-based substance abuse treatment knowing facilities' characteristics would be important for administrators and policymakers to consider when updating programming, training staff or expanding capacity to ensure efficient use of scarce resources. However, while such characteristics are known for DUI programs, they are not known for facilities offering specialized programming for other criminal justice offenders. Methods: Analysis of the 2004 US National Survey of Substance Abuse Treatment Facilities. Results: Almost half the facilities (48.2%) offered either DUI or other criminal justice specialized programming. These facilities were divided between those offering DUI specialized programming (17.7%), other criminal justice specialized programming (16.6%) and both types of programming (13.9%). Certain characteristics were independently associated with offering DUI specialized programming (private ownership, rural location, for profit status) or other criminal justice specialized programming (receiving public funds, urban location, region of country). Conclusion: Offering specialized programming for DUI or other criminal justice offenders was common and associated with distinct characteristics. These observed associations may reflect the positioning of the facility to increase visibility, or diversify clientele and possibly funding streams or the decision of policymakers. As the criminal justice populations show no sign of decreasing and resources are scarce, the efficient use of resources demands policymakers recognize the prevalence of these specialized programming, join forces to examine them for efficacy, and explicitly incorporate these characteristics into strategies for workforce training and plans for treatment expansion.

Bjerre B; Kostela J; Selen J. Positive health-care effects of an alcohol ignition interlock programme among driving while impaired (DWI) offenders. Addiction 102(11): 1771-1781, 2007. (14 refs.)

Aims: To compare the costs of hospital care and sick leave/disability pensions between two groups of driving while impaired (DWI) offenders: participants in an alcohol ignition interlock programme (AIIP) and controls with revoked licences, but with no comparable opportunity to participate in an AIIP. Setting: As an alternative to licence revocation DWI offenders can participate in a voluntary 2-year AIIP permitting the offender to drive under strict regulations entailing regular medical check-ups. The participants are forced to alter their alcohol habits and those who cannot demonstrate sobriety are dismissed from the programme. Participants are liable for all costs themselves. Design: Quasi-experimental, with a non-equivalent control group used for comparison; intent-to-treat design. Based on the number of occasions/days in hospital and on sick leave/disability pension, the health-care costs for public insurance have been calculated. Finding: Average total health-care costs were 25% lower among AIIP participants (1156 individuals) than among controls (815 individuals) during the 2-year treatment period. This corresponds to over 1000 (SEK9610) less annual costs per average participant. For those who complete the 2-year programme the cost reduction was more pronounced; 37% during the treatment and 20% during the post-treatment period. Conclusions: The positive health-care effects were due apparently to reduced alcohol consumption. The social benefit of being allowed to drive while in the AIIP may also have contributed. The reduction in health-care costs was significant only during the 2-year treatment period, but among those who completed the entire AIIP sustained effects were also observed in the post-treatment period. The effects were comparable to those of regular alcoholism treatment programmes.

Boles SM; Young NK; Moore T; DiPirro-Beard S. The Sacramento dependency drug court: Development and outcomes. Child Maltreatment 12(2): 161-171, 2007

Dependency Drug Courts are a growing method of addressing the functional status and reunification success of families involved in child welfare and affected by substance use disorders. Despite widespread interest in them, few evaluations have appeared in the literature to help inform the discussion about their effectiveness. This article provides a description of various types of dependence drug courts and reports 24-month reunification rates from the Sacramento Dependency Drug Court. Results indicated that the participants had higher rates of treatment participation than did comparison participants. In addition, at 24 months 42% of the Dependency Drug Court children had reunified vers 27.2% of the comparison children. There were no differences in treatment completion or child reunification rates by parent's primary drug problem. Rates of recidivism were extremely low, for both the court and comparison groups and did not differ significantly. The results of the present study are encouraging and suggest that rigorous, controlled studies are merited to further evaluate the effectiveness of the Dependency Drug Courts.

Bond JW; Sheridan L. The relationship between the detection of acquisitive crime by forensic science and drug-dependent offenders. Journal of Forensic Sciences 52(5): 1122-1128, 2007. (23 refs.)

Drug- and nondrug-related acquisitive crime offences such as burglary, theft, and motor vehicle theft, were compared to assess whether drug abusers were more likely to be apprehended via forensic science techniques. Data were all acquisitive offences committed over a 6-year period within a police force area in England. Drug-dependent offenders committed a wider range of offence types than nondependent offenders, and they were significantly more likely to be detected via their DNA or fingerprints (p < 0.01). A logistic regression (n > 14,000) revealed a number of predictors that influence the detection of the crime by forensic techniques. The results indicate that a number of these predictors are of statistical significance; the most significant of these being drug use by the offender with sex, ethnicity, and employment status also being relevant. Age of the offender and number of offences committed were found not to be significant. Of the four hypotheses considered to explain this, the most likely was thought to be the physical and mental impact of drug use on crime scene behavior. Consideration is given to the disciplines of forensic science and forensic psychology working closely together to distinguish factors that influence crime scene behavior.

Bray JW; Zarkin GA; Miller WR; Mitra D; Kivlahan DR; Martin DJ; Couper DJ; Cisler RA. Measuring economic outcomes of alcohol treatment using the economic form 90. Journal of Studies on Alcohol and Drugs 68(2): 248-255, 2007. (35 refs.)

Objective: This article assesses the ability of the economic outcome measures in the Economic Form 90 to detect differences across levels of alcohol dependence as measured by the Alcohol Dependence Scale. Method: We used baseline data from the Combining Medications and Behavioral Interventions (COMBINE) Study, a large, multisite clinical trial, to assess the extent to which the economic items on the Economic Form 90 instrument can detect differences across levels of alcohol dependence. Results: After adjusting for differences in demographic characteristics, the Economic Form 90 can detect significant differences across a range of dependence severity levels for the economic outcomes of inpatient medical care, emergency-department medical care, behavioral health care, being on parole or probation, and missed workdays, conditional or being employed. We did not detect significant differences across dependence severity for employment status, outpatient medical care, other criminal justice involvement, or motor vehicle accidents. Conclusions: The Economic Form 90 can identify differences in many economic outcomes associated with differing levels of alcohol dependence. This suggests that the Economic Form 90 may be useful in assessing changes in economic outcomes that result from changes in alcohol dependence.

Brocato J; Wagner EF. Predictors of retention in an alternative-to-prison substance abuse treatment program. Criminal Justice and Behavior 35(1): 99-119, 2008. (82 refs.)

This longitudinal study examines predictors of retention among alternative-to-prison substance abuse treatment clients. The roles of motivational factors and the client-therapist relationship are examined. The sample was composed of 141 male felony offenders who were legally mandated to a community-based, long-term residential drug treatment program. Results support the following conclusions: (a) retention in treatment is positively related to motivation to change; (b) motivation to change, particularly recognition of a drug problem, is positively related to the therapeutic alliance; and (c) changes in motivation in response to treatment are positively related to the therapeutic alliance. Implications of these findings for treatment and research are discussed.

Burke C. Methamphetamine use among San Diego County arrestees. Journal of Psychoactive Drugs Supplement 4: 337-345, 2007. (17 refs.)

Between 1987 and 2003, an objective measure of recent drug use from a high-risk group was collected as part of a federally-funded program called ADAM (Arrestee Drug Abuse Monitoring). The information collected as part of this project supplemented other self-report data collected across the country with the general population. San Diego County was one of the original ADAM sites, and with local funding support was able to maintain the essential aspects of the program uninterrupted when national support was discontinued. In May 2006, the results of data collected in calendar year 2005 as part of a standard interview with adult and juvenile arrestees, urinalysis, as well as a methamphetamine (meth) addendum were presented at the Substance Abuse Research Consortium (SARC) meeting in Pasadena, California. This article provides a summary of these descriptive data, including a profile of recent meth users, reasons for initiating and continuing use, patterns of use, and trends in use over time. Additionally, information regarding juveniles' perceived risk of meth use and the potential effects meth has on communities is highlighted. Potential policy implications and areas for further research are also discussed.

Butts JA; Roman J, eds. Changing System: Outcomes for the RWJF Futures Initiative on Juvenile Justice and Substance Abuse. A National Evaluation Report. Portland OR: Reclaiming Futures National Program Office, Portland State University, 2007. (0 refs.)

This is the summary of a portion of the evaluation conducted of a ten-site demonstration project to improve outcomes for drug-involved youth in the juvenile justice system. The intervention relied upon organizational change and system reform, with each community adopting its own model. Biannual surveys were conducted between December 2003 and June 2006, and provide the basis of the report. It was found that most quality indicators in each community had improved significantly over the course of the effort. Among the factors assessed were things such as waiting lists, availability of transportation, availability of bilingual staff, use of standardized screening and assessment protocols, ability of agencies to provide the range of services needed, and inclusion of family. In the process communities found themselves having to deal with improvement of administrative procedures, coordination of policy,

Campbell KM; Deck D; Krupski A. Impact of substance abuse treatment on arrests among opiate users in Washington State. American Journal on Addictions 16(6): 510-520, 2007. (24 refs.)

Administrative data from Washington State's Division of Alcohol and Substance Abuse drive this three-year prospective study of the impact of substance abuse treatment on arrests among 12,962 opiate users receiving publicly funded substance abuse services. Using survival analysis, the risk of arrest among opiate users who receive substance abuse treatment is compared to those who do not receive treatment. Propensity scores control for client characteristics associated with admission to substance abuse treatment. Overall, a reduction in the risk of arrest was found among subjects in treatment (Hazard Ratio = 0.59 - 0.78, p < .05) and subjects successfully completing treatment (Hazard Ratio = 0.75, p < .05). Risk of arrest was elevated among those with a negative outcome to treatment (Hazard Ratio = 1.23, p < .05).

Clough AR; Lee KKS; Conigrave KM. Promising performance of a juvenile justice diversion programme in remote Aboriginal communities, Northern Territory, Australia. Drug and Alcohol Review 27(4): 433-438, 2008. (9 refs.)

Introduction and Aims. Diversion from court and prison has been recommended for Indigenous Australian youth who commit offences. As no evaluations of such programmes have been published, we describe processes and early outcomes of a diversion programme in the Northern Territory. Design and Methods. From 2003 to 2006, among 1700 remote Indigenous community residents, 35 young people (aged 11-18 years, median 15 years) committed offences. They were diverted from criminal justice and referred to a community-based diversion initiative. Client assessment records and staff interviews furnished data to examine clients' diversion pathways and early programme results. Results. Eighteen clients were reportedly using a substance at the time of their offence; cannabis (n=9), petrol (n=5), alcohol (n=4). The remaining 17 had histories of using one or more of these. Two clients could not complete local diversion programs because they moved to other regions; one case was not pursued for legal reasons, leaving 32 clients exposed to the local programme. By July 2006, four clients were continuing in their programmes, three had breached them, but 25 had completed them in periods ranging from 2 to 60 weeks (median=26 weeks), a completion rate of 89% (25/28). Just one client re-offended after completing diversion. Discussion and Conclusions. A high completion rate was achieved despite: a dearth of locally available drug and alcohol treatment services and diversion options; shifts in police approaches; heavy administrative burdens to meet legal requirements; and difficulties communicating across cultural barriers.

Copeland J; Maxwell JC. Cannabis treatment outcomes among legally coerced and non-coerced adults. BMC Public Health 7: article 111, 2007. (24 refs.)

Background: Treatment seeking for cannabis dependence in general, and particularly the number of criminal justice referrals to cannabis treatment, has increased over the past decade. This study aims to compare the characteristics, psychosocial functioning and treatment outcome of those legally coerced into cannabis treatment compared to those entering treatment without legal coercion. Methods: This study is a retrospective audit of the administrative clinical records of 27,198 adults presenting to public Texas treatment programs with cannabis as their primary drug problem between 2000 and 2005. Results: Of the 69% legally coerced into treatment, there was less psychological distress and greater likelihood of having completed treatment compared with non-coerced clients. Participants who were legally coerced into treatment were also more likely to have received less intensive forms of treatment and to have not used cannabis in the month prior to 90-day post-treatment follow-up. Conclusion: More public health information is needed on cannabis dependence and increased availability of subsidised early and brief interventions in a variety of primary health care settings would reduce the late presentations of the more severely impaired voluntary clients. The limitations of this dataset are discussed.

Cropsey KL; Linker JA; Waite DE. An analysis of racial and sex differences for smoking among adolescents in a juvenile correctional center. Drug and Alcohol Dependence 92(1/3): 156-163, 2008. (43 refs.)

The purpose of this study was to investigate racial and sex differences on the risk factors for smoking initiation and daily smoking among juvenile justice adolescents, a population that is traditionally ignored in school-based epidemiological samples. This study used archival data collected by juvenile justice authorities for a large sample of juvenile justice adolescents (N = 4381), examining interaction terms to determine race and sex differences for risk factors. About 70% of juvenile justice adolescents reported ever having smoked cigarettes while almost half reported daily smoking. Overall predictors of ever and daily smoking included older age, being female, White, use of alcohol, cannabis, and cocaine in the past year, affiliation with smoking peers, not living with at least one parent, and a diagnosis of ADHD. While differences were seen between individual predictor models for both race and sex, the interaction terms did not add significantly to the overall model. These important racial and gender differences in this study suggest that tailored prevention messages and interventions may be needed to be most effective with adolescents in the juvenile justice system. While this study provides a basic foundation of risk factors for smoking among juvenile justice adolescents, future research is needed to assess the efficacy of treatment and prevention interventions with this high risk group of adolescent smokers.

Cropsey KL; Weaver MF; Dupre MA. Predictors of involvement in the juvenile justice system among psychiatric hospitalized adolescents. Addictive Behaviors 33(7): 942-948, 2008. (17 refs.)

Objective: Several risk factors for juvenile justice involvement have been identified in previous research among delinquents and include mental illness, substance use, trauma and abuse, family dysfunction, poor parenting, school problems, and aggressive behavior. However, most of these predictors resulted from studies among adolescents incarcerated in the juvenile justice system. We were interested in finding out the prevalence rates of juvenile justice involvement among psychiatric inpatient adolescents and determining predictors of juvenile justice involvement in this high-risk group. Methods: Six hundred and thirty-six medical records from adolescents ages 12-17 years who were consecutively admitted to one of two psychiatric inpatient units between July 1, 2003 and June 30, 2004 were examined. Results: Almost half (43.6%) of hospitalized adolescents had a history of juvenile justice involvement. Logistic regression analysis was conducted to determine predictors of juvenile justice involvement. Significant predictors of juvenile justice involvement included being male, parental legal history, family substance abuse history, disruptive disorder, cocaine use, being sexually active, and having a history of aggressive behavior. Conclusions: Adolescents in mental health or substance abuse treatment settings should be screened for juvenile justice involvement and appropriate referrals made to prevent worsening problems for at-risk youth.

Curtis R; Wendel T. "You're always training the dog": Strategic interventions to reconfigure drug markets. Journal of Drug Issues 37(4): 867-892, 2007. (42 refs.)

Based on ethnographic observation of the changes in drug markets and violence in New York City over the past 20 years, this paper compares and contrasts three distinct types of drug markets and the types of systemic violence that are characteristic of each and argues that knowing which kinds of markets and contexts are associated with what kinds of violence can be valuable for policy makers and professionals. Further, evolving drug markets and different forms of violence associated with particular market types are, in part, responses to law enforcement interventions intended to eliminate drug markets. Police interventions alter the character of drug markets -- either for better or for worse -- as they adapt, and these interventions can produce markedly different outcomes with regard to violence and crime. Comparatively brief interventions of limited scope can effectively control violence and reconfigure markets by "training" them to act in ways less likely to produce violence and social disorder.

Daughters SB; Stipelman BA; Sargeant MN; Schuster R; Bornovalova MA; Lejuez CW. The interactive effects of antisocial personality disorder and court-mandated status on substance abuse treatment dropout. Journal of Substance Abuse Treatment 34(2): 157-164, 2008. (48 refs.)

The present study sought to examine the interactive effects of court-mandated (CM) treatment and antisocial personality disorder (ASPD) on treatment dropout among 236 inner-city male substance users receiving residential substance abuse treatment. Of the 236 participants, 39.4% (n = 93) met criteria for ASPD and 72.5% (n = 171) were mandated to treatment through a pretrial release-to-treatment program. Results indicated a significant interaction between ASPD and CM status, such that patients with ASPD who were voluntarily receiving treatment were significantly more likely to drop out of treatment than each of the other groups. Subsequent discrete time survival analyses to predict days until dropout, using Cox proportional hazards regression, indicated similar findings, with patients with ASPD who were voluntarily receiving treatment completing fewer days of treatment than each of the other groups. These findings suggest the effectiveness of the court system in retaining patients with ASPD, as well as the role of ASPD in predicting treatment dropout for individuals who are in treatment voluntarily. Implications, including the potential value of the early implementation of specialized interventions aimed at improving adherence for patients with ASPD who are receiving treatment voluntarily, are discussed.

Dave D. Illicit drug use among arrestees, prices and policy. Journal of Urban Economics 63(2): 694-714, 2008. (29 refs.)

Prior studies, by relying on nationally representative surveys, have overlooked the important fact that use of addictive substances is not uniformly distributed; subgroups of hardcore users account for most of the drug consumption. This study employs the Arrestee Drug Abuse Monitoring system to analyze the demand for cocaine and heroin by urban arrestees, employing objective indicators of use based on urinalysis. The data are repeated city cross sections, and panel data methodology is employed to account for endogeneity. Cocaine and heroin prices have a negative effect on the probability of use even among this group of heavy users. Results indicate that subjective, self-reported measures of participation are likely to be under-reported, which may impart bias to estimates of the price elasticity. The own-price cocaine participation elasticity is about -0.15, and the own-price heroin participation elasticity is about -0.10 for arrestees. This contemporaneous elasticity understates the full effect, and the long-run price elasticity is about twice the magnitude. The magnitude of the price response is substantially smaller relative to the estimates in the prior literature, and calculations suggest that further enforcement and interdiction-driven increases in drug prices may not be cost-effective.

Dembo R; Wareham J; Schmeidler J. A longitudinal study of cocaine use among juvenile arrestees. Journal of Child & Adolescent Substance Abuse 17(1): 83-109, 2007. (64 refs.)

We report the results of latent growth model analyses examining the continuity of cocaine use among adolescents. This study examined a sample of 278 justice-involved juveniles completing at least one of three follow-up interviews as part of a National Institute on Drug Abuse funded study. Latent growth models were analyzed examining (1) changes in cocaine use over time; (2) the effects of sociodemographic characteristics on cocaine use over time; and (3) the effects of family problem characteristics, deviant peer associations, physical abuse, sexual victimization, and emotional/psychological functioning on cocaine use,over time. The results of our analyses indicated that cocaine use among these youths continued over time. Further, consistent with findings from existing literature, cocaine use was significantly related to drug using and delinquent peer associations, and marginally related to family problems with the justice system. Implications for policy and intervention service needs are discussed.

Doherty EE; Green KM; Ensminger ME. Investigating the long-term influence of adolescent delinquency on drug use initiation. Drug and Alcohol Dependence 93(1/2): 72-84, 2008. (64 refs.)

Prior research has found a positive relationship between delinquency and early onset of drug use. However, little is known about the influence of delinquency on drug initiation through mid-adulthood. This paper investigates the long-term relationship between serious adolescent delinquency and the onset of marijuana and cocaine use among an epidemiologically defined community sample of African American males and females followed from first grade through age 42. Using propensity score methods we match individuals on several etiological variables that may explain both delinquency and drug use in an attempt to examine the extent to which there may be a causal link between delinquency and drug use initiation. Through a comparison of survival curves on the unmatched and matched samples of serious delinquents and non-serious delinquents, we find that serious adolescent delinquency has at least some causal influence on drug use initiation that extends into mid-life. We discuss how these results can inform future research and delinquency and drug prevention and intervention initiatives.

Dula CS; Dwyer WO; LeVerne G. Policing the drunk driver: Measuring law enforcement involvement in reducing alcohol-impaired driving. Journal of Safety Research 38(3): 267-272, 2007. (49 refs.)

Introduction: With many thousands of deaths still annually attributable to driving under the influence (DUI), it remains imperative that we continually address the problem of producing and sustaining effective countermeasures, and that we subject these efforts to empirical scrutiny. This article presents relevant findings from state-wide datasets. Results: A formula generating a potentially useful metric for assessing aspects of the DUI prosecutorial chain is presented, focusing on the rate of proactive DUI arrests. While in need of cautious interpretation due to issues of inherent inaccuracies in large databases, small numbers of crashes and/or arrests in multiple jurisdictions, and the lack of replication in other states, the analyses show no relationship between the level of DUI arrest activity and DUI-related crashes. This finding brings into question the efficacy of the many millions of dollars devoted each year to targeted DUI enforcement, as it is currently being implemented. Conclusions: Results are discussed in terms of developing adequate disincentives to DUI so as to raise general deterrence via dramatic increases in proactive DUI enforcement and then engaging in pervasive and persistent social marketing of such efforts to maximize the perception that arrest and punishment for DUI is always imminent, that penalties will be swift, certain, and severe. It is echoed that accurate data need to be collected at all levels of the DUI arrest and prosecution process in every jurisdiction within a state, so as to facilitate the empirical assessment of countermeasure efficacy in reducing alcohol-related crashes. Impact on Industry: Given that this work needs to be replicated, the impact on the traffic safety industry is potentially huge. The present data indicate that law enforcement efforts to further abate DUI-related crashes are apparently ineffective, though likely necessary to maintain reductions achieved in the 80s and early 90s. Thus, to attain additional systematic reductions, a dramatic increase in enforcement will be necessary as will a diversification of abatement efforts, including an increase in aggressive social marketing tactics to positively impact our traffic safety culture by making DUI universally unacceptable (for a discussion of this latter issue and on the use of positive reinforcement to change driver behavior, see Dula & Geller, 2007).

Epperson M; El-Bassel N; Gilbert L; Orellana ER; Chang M. Increased HIV risk associated with criminal justice involvement among men on methadone. AIDS and Behavior 12(1): 51-58, 2008. (38 refs.)

This paper examines the relationship between HIV risk and criminal justice involvement among a random sample of 356 men enrolled in methadone maintenance treatment programs in New York City. Bivariate and logistic regression analyses were performed to estimate the associations between measures of criminal justice involvement and participant HIV risk, controlling for socio-demographic variables. A lifetime history of incarceration was significantly associated with being HIV positive (Adjusted OR = 5.08). Recent arrest was associated with unprotected vaginal sex and having multiple female sexual partners. Sex trading was associated with both arrest and incarceration, and the strongest association was found between selling sex and recent incarceration (Adjusted OR = 5.69). Results suggest that recent criminal justice involvement among men with substance abuse histories is associated with increased HIV risk behaviors. Findings underscore the need for targeted HIV prevention efforts for men on methadone with a recent history of arrest or incarceration.

Erickson SK; Rosenheck RA; Trestman RL; Ford JD; Desai RA. Risk of incarceration between cohorts of veterans with and without mental illness discharged from inpatient units. Psychiatric Services 59(2): 178-183, 2008. (41 refs.)

Objective: This study examined the risk of incarceration among cohorts of veterans treated in the Department of Veterans Affairs (VA) Connecticut Healthcare System. Incarceration rates of persons with and without mental illness were compared and adjusted for various clinical and service utilization variables. Data were compared before and after the closure of over 80% of the Connecticut VA psychiatric inpatient beds in 1996. Methods: Data from five annual cohorts of patients (1993-1997) treated in an inpatient unit in the VA Connecticut Healthcare System (N= 36,385) were merged with state Department of Correction data. Logistic regression models were used to identify risk factors for incarceration. Results: Bivariate analysis showed that incarceration rates were higher for VA patients with psychiatric disorders and with substance use disorders than for those without such diagnoses, but there were no significant increases in likelihood of incarceration over these years of extensive closures. In multiple logistic regression analysis only diagnoses of substance use disorders and major depression were independently associated with an increased likelihood of incarceration, whereas schizophrenia, personality disorders, and co-occurring psychiatric and substance use disorders were not independently associated with increased likelihood in multivariate analysis. Conclusions: Alcohol and drug problems appeared to account for much of the risk of incarceration among hospitalized veterans during the study period. Unlike in previous studies, schizophrenia and related psychotic disorders were not independently associated with an increased risk of incarceration.

Faller-Marquardt M; Pollak S; Schmidt U. Cigarette burns in forensic medicine. Forensic Science International 176(2-3): 200-208, 2008. (50 refs.)

Skin lesions suspected to have been caused by a burning cigarette require thorough diagnostic evaluation as to the mode of infliction. Accidental cigarette bums must be differentiated from injuries due to self-infliction or maltreatment. The typical categories are presented on the basis of the literature and exemplary cases from the authors' own study material. An intentional infliction must be taken into consideration when a body region is involved which does not normally come into contact with a cigarette by chance. Full thickness bums from glowing cigarettes require an exposure time of more than 1 s. One should also keep in mind the possibility of confusion with local skin infections or thermal effects by traditional medical practices (e.g. moxibustion). In unclear cases, repeated inspection of the lesion is recommended in order to facilitate its classification as to causation and age. The courses of healing in first- to third-degree cigarette bums are demonstrated by means of continuous photographic documentation. The discussion deals with different kinds of accidental and intentional cigarette bums, e.g. in drug addicts, psychiatric patients, victims of child abuse, maltreatment and torture, but also in persons feigning a criminal offence.

Fisher WH; Wolff N; Grudzinskas AJ; Roy-Bujnowski K; Banks SM; Clayfield J. Drug-related arrests in a cohort of public mental health service recipients. Psychiatric Services 58(11): 1448-1453, 2007. (20 refs.)

Objectives: The excessive prevalence of comorbid substance abuse among persons with severe mental illness has been well established and identified as the source of numerous negative outcomes. An overlooked aspect of illicit drug use in this population is its illegality and the potentially dire criminal sanctions. This study examined the prevalence of drug arrests in a cohort of persons receiving services from a state mental health agency who were followed for roughly ten years. Methods: Data on arrest spanning from 1991 to 2000 were obtained for all individuals receiving inpatient, case management, or residential services from July 1991 to June 1992 (N=13,816). Reports of prevalence were based on the number with at least one drug-related arrest in the observation period. Results: Five percent of individuals in the cohort experienced at least one drug-related arrest (N=720). These included simple possession as well as manufacturing and distribution. The prevalence was much higher (15%) among persons aged 18 to 25 years than in other age groups. Roughly 95% of persons with a drug arrest also had an arrest for another type of offense. This pattern is similar to that observed among persons with a drug-related arrest in the general population. Conclusions: Convictions on drug charges can void access to Section Eight housing and other benefits and are associated with other patterns of offending that also carry significant criminal sanctions. State mental health agencies may wish to target interventions toward youthful clientele by focusing specifically on the risks associated with involvement with illicit drugs.

Garner BR; Knight K; Simpson DD. Burnout among corrections-based drug treatment staff - Impact of individual and organizational factors. IInternational Journal of Offender Therapy and Comparative Criminology 51(5): 510-522, 2007. (33 refs.)

As a result of limited budgets, many treatment programs are forced to operate for extended periods at or beyond their capacity. The resulting pressure and stress on treatment staff can be taxing and lead to serious problems, including job burnout. Although the concept of burnout within other social service professions has been broadly researched, less attention has been given to burnout among drug abuse treatment staff, especially among corrections-based drug treatment staff. The goal of this article is to extend this area of research by exploring the impact of individual factors and organizational factors on burnout. Findings revealed that although a number of factors were related to staff burnout, younger counselor age, lower adaptability, poorer clarity of agency mission, and higher stress were most significant. Ways in which treatment programs might address these issues affecting staff burnout are discussed.

Gjersing LR; Butler T; Caplehorn JRM; Belcher JM; Matthews R. Attitudes and beliefs towards methadone maintenance treatment among Australian prison health staff. Drug and Alcohol Review 26(5): 501-508, 2007. (23 refs.)

Introduction and Aims. Justice Health NSW has one of the most extensive prison-based methadone programmes in the world. We examine prison health staff attitudes towards methadone treatment and compare these with community methadone staff. Design and Methods. A cross-sectional survey of 202 staff employed by Justice Health New South Wales was undertaken in 2003. Results. The mean scores on the various sub-scales were: abstinence-orientation (AO) 2.9 (95% CI 2.8- 3. 0); disapproval of drug use (DDU) 3.3 (95% CI 3.2 - 3.4); knowledge (1, now) 2.7 (95% CI 2.4 - 2.9); and toxicity 4.6 (95 % CI 4.2 - 5. 0). Both the A 0 and DD U score were correlated negatively with the 1, now score (r = - 0. 3 7 and r = - 0. 13, respectively). Prison health staff had higher A 0 (2.9 vs. 2.6, p < 0. 00 1) and DDU (3.3 vs. 2.6, p < 0. 00 1) scores, and lower 1; now (2.7 vs. 7. 0, p < 0. 001) scores than methadone staff working in the Australian community. They were more knowledgeable than US community methadone staff about the toxicity of methadone (4.6 vs. 0. 0, p < 0.001). Discussion and Conclusions. This is the first survey to examine prison health staff attitudes to methadone treatment. Correctional health staff tend to be more abstinence-orientated, more likely to disapprove of drug use, and less knowledgeable about the risks and benefits of methadone than Australian community methadone staff. The findings have important implications for training health staff working in the prison environment with regard to client retention on methadone treatment.

Greenberg GA; Rosenheck RA. Jail incarceration, homelessness, and mental health: A national study. Psychiatric Services 59(2): 170-177, 2008. (43 refs.)

Objective: This study sought to investigate the rates and correlates of homelessness, especially mental illness, among adult jail inmates. Methods: Data from a national survey of jail inmates (N= 6,953) were used to compare the proportion of jail inmates who had been homeless in the previous year with the proportion of persons in the general population who had been homeless in the previous year, after standardization to the age, race and ethnicity, and gender distribution of the jail sample. Logistic regression was then used to examine the extent to which homelessness among jail inmates was associated with factors such as symptoms or treatment of mental illness, previous criminal justice involvement, specific recent crimes, and demographic characteristics. Results: Inmates who had been homeless (that is, those who reported an episode of homelessness anytime in the year before incarceration) made up 15.3% of the U. S. jail population, or 7.5 to 11.3 times the standardized estimate of 1.36% to 2.03% in the general U. S. adult population. In comparison with other inmates, those who had been homeless were more likely to be currently incarcerated for a property crime, but they were also more likely to have past criminal justice system involvement for both nonviolent and violent offenses, to have mental health and substance abuse problems, to be less educated, and to be unemployed. Conclusions: Recent homelessness was 7.5 to 11.3 times more common among jail inmates than in the general population. Homelessness and incarceration appear to increase the risk of each other, and these factors seem to be mediated by mental illness and substance abuse, as well as by disadvantageous sociodemographic characteristics.

Hakansson A; Schlyter F; Berglund A. Factors associated with history of non-fatal overdose among opioid users in the Swedish criminal justice system. Drug and Alcohol Dependence 94(1/3): 48-55, 2008. (62 refs.)

Background: Overdose (OD) is a common cause of death in opioid users. Also, many current opioid users report a history of non-fatal OD. The present study aimed to identify factors associated with a history of non-fatal OD. Methods: A sample of 7085 Swedish criminal justice clients with alcohol or drug misuse was assessed, using the Addiction Severity Index. Subjects reporting use of opioids during the 30 days prior to incarceration were included (n = 1113). Relevant variables of misuse pattern, heredity, psychiatric symptoms and previous criminal charges were analysed in a logistic regression model. Results: A history of non-fatal OD was reported by 55% (n =604). The estimated contribution to the variance in OD history was 25% for variables describing misuse pattern, compared to 10% for psychiatric symptoms, 8% for heredity, and 8% for previous criminal charges. The final model included the following variables: history of injection drug use (OR 3.28), history of heroin use (OR 2.87), history of suicide attempt (OR 1.92), history of tranquilliser use (OR 1.91), being born in Sweden or other Nordic countries (OR 1.74), difficulty in controlling violent behaviour (OR 1.68). and paternal alcohol problems (OR 1.57). Conclusions: Suicide attempts and difficulty in controlling violent behaviour were associated with history of non-fatal OD, independent of variables of misuse pattern. This may indicate a possible association with impulse control disturbances, and may have clinical applications. Country of birth and heredity of alcohol problems also had some influence. As expected, severity of misuse most strongly contributed to history of non-fatal OD.

Hammond A; Sloboda Z; Tonkin P; Stephens R; Teasdale B; Grey SF et al. Do adolescents perceive police officers as credible instructors of substance abuse prevention programs? Health Education Research 23(4): 682-696, 2008. (36 refs.)

Although program recipients' attitudes toward instructors are crucial to program outcomes, they have not been adequately examined in the substance abuse prevention literature. This study uses survey data to explore attitudes toward instructors of prevention programming held by students from a national longitudinal evaluation of a school-based substance abuse prevention program delivered by Drug Abuse Resistance Education (D.A.R.E.) officers. Our analyses indicated that students who had police officers as instructors evaluated program instructors significantly higher than students who had non-police officers as instructors. The evaluation of police instructors varied according to students' sociodemographic characteristics. Implications for future research and practice are considered.

Hartley RD; Maddan S; Spohn CC. Prosecutorial discretion: An examination of substantial assistance departures in federal crack-cocaine and powder-cocaine cases. Justice Quarterly 24(3): 382-407, 2007. (64 refs.)

Recently there has been a call for research that explores decision-making at stages prior to sentencing in the criminal justice process. Particularly research is needed under a determinate sentencing system where judicial dispositions are usually restricted by guidelines, which increases the importance of earlier decision-making stages. As an answer to this call, and in an attempt to build on currents studies on the effects of departures as an intervening mechanism, and a source of unwarranted disparity, this study explores federal sentencing data on offenders convicted of crack-cocaine and powder-cocaine offenses. Although decision-making of all criminal justice actors generally, and prosecutors specifically, has been the subject of much research, studies have yet to resolve the nature and outcome of their "autonomous" discretion. This autonomy becomes especially salient regarding prosecutorial decisions for substantial assistance departures. In deciding who receives a substantial assistance departure, the prosecutor has carte blanche power.

Henderson CE; Taxman FS; Young D. A Rasch model analysis of evidence-based treatment practices used in the criminal justice system. Drug and Alcohol Dependence 93(1/2): 163-175, 2008. (73 refs.)

This study used item response theory (IRT) to examine the extent to which criminal justice facilities and community-based agencies are using evidence-based substance abuse treatment practices (EBPs), which EBPs are most commonly used, and how EBPs cluster together. The study used data collected from wardens, justice administrators, and treatment directors as part of the National Criminal Justice Treatment Practices survey (NCJTP; Taxman et al., 2007a), and includes both adult criminal and juvenile justice samples. Results of Rasch modeling demonstrated that a reliable measure can be formed reflecting the extent to which juvenile and adult correctional facilities, and community treatment agencies serving offenders, have adopted various treatment practices supported by research. We also demonstrated the concurrent validity of the measure by showing that features of the facilities' organizational contexts were associated with the extent to which facilities were using EBPs, and which EBPs they were using. Researchers, clinicians, and program administrators may find these results interesting not only because they show the program factors most strongly related to EBP use, but the results also suggest that certain treatment practices cluster together, which may help stakeholders plan and prioritize the adoption of new EBPs in their facilities. The study has implications for future research focused on understanding the adoption and implementation of EBPs in correctional environments.

Ho CH; Kingree JB; Thompson M. Demographic differences in substance use problems among juvenile delinquents. American Journal of Drug and Alcohol Abuse 33(5): 747-754, 2007. (14 refs.)

This article presents two studies that used community-based, national samples of adolescents to compare demographic differences between delinquent and nondelinquent respondents. Results indicated that ethnic differences in alcohol problems were similar in the delinquent and nondelinquent groups, with whites reporting higher levels of alcohol problems. In contrast, age differences were smaller among delinquents than nondelinquents, which pointed to a heightened risk for both alcohol and marijuana problems among younger delinquents. Future research can explore biological and psychosocial factors that increase risk for substance problems among younger delinquents.

Hussey DL; Drinkard AM; Falletta L; Flannery DJ. Understanding clinical complexity in delinquent youth: Comorbidities, service utilization, cost, and outcomes. Journal of Psychoactive Drugs 40(1): 85-95, 2008. (49 refs.)

This study describes the extent and severity of multiple comorbidities in a juvenile detention center population, and explores how these numerous problems impact the utilization of treatment services, costs, and outcomes including those for substance abuse, mental illness, and criminal activity. Cluster analyses of the outcome scales at intake yielded two groups: youth high (42%) and youth lower (58%) on all factors. Girls experienced the most significant impairments across emotional problems, behavior complexity, internal mental distress, and victimization domains, utilized significantly more units of residential treatment, individual counseling and case management, and had the highest treatment costs. The total cost of services ($1,171,290, N = 114) was significantly related to substance problems in the past year (r = .219, p <.05), emotional problems (r = .237, p <.05), behavior complexity (r = .318, p <.05), internal mental distress (r = .263,p <.05), environmental risk (r = .205,p <.05), and conflict tactics (r =.240, p <.05). Despite initial differences in measures of baseline severity, high and low cluster youth, and boys and girls in general, achieved similar results on the key outcome variables 12 months later. Study implications include a need for co-occurring, integrated treatment efforts that address family, emotional, and mental health problems of delinquent youth (especially females) in order to improve their ability to successfully attend to substance abuse problems and interpersonal conflicts.

Johnson BD; Golub A; Dunlap E; Sifaneck SJ. An analysis of alternatives to New York City's current marijuana arrest and detention policy. Policing 31(2): 226-250, 2008. (67 refs.)

Purpose - During the 1990s, the New York City Police Department (NYPD) instituted a policy of arresting and detaining people for minor offenses that occur in public as part of their quality-of-life (QOL) policing initiative. The purpose of this paper is to examine the pros and cons of the current policy and compare it with possible alternatives including: arrest and issuing of a desk appearance ticket (DAT); issuing of a non-criminal citation (violation); street warnings; and toleration of public marijuana smoking. Design/methodology/approach - The paper reviews several studies of QOL policing and examines the pros and cons of the current NYPD policy, compared to possible alternatives. Findings - The number of NYPD arrests for marijuana in public view (MPV) (with most detained for one or two days) increased from 3,000 in 1994 to over 50,000 in 2000, and have been about 30,000 in the mid-2000s. Most of these arrestees (84 percent) were minority; Blacks were 2.7 more likely and Hispanics 1.8 times more likely to be detained than Whites for an MPV arrest. Minorities received more severe dispositions, even controlling for demographics and prior arrest histories. Originality/value - The paper recommends that the NYPD change to routinely issuing DATs to reduce detention for marijuana violators. Drug policy reformers might wish to further pursue changing statutes regarding smoking MPV into a violation (non-criminal) or encourage the wider use of street warnings, as in Britain. Any of these policy changes would help reduce the number detained and the disproportionate burden on minorities associated with the current arrest and detention policy. These policies could help maintain civic norms against smoking marijuana in public.

Keene J; Stenner K; Connor M; Fenley S. A case-study of substitute opiate prescribing for drug-using offenders. Drugs: Education, Prevention and Policy 14(5): 443-456, 2007. (24 refs.)

This paper presents a case study of a Criminal Justice Intervention Programme (DIP) for drug-using offenders in the UK. Of 180 offenders offered the scheme, 103 (57%) successfully engaged and 59 (32%) stayed six weeks or more. The majority of referrals (94%) were for heroin misuse and 45% also reported crack use. Less than a third (27%) of all referrals reported injecting. Those who engaged initially were more likely to be injectors (70% compared to 30% of those who did not engage), females, polydrug users, and older clients. But those who stayed in treatment for at least six weeks were more likely to be non-injectors (60% stayed in treatment compared to 40% who did not), male and ethnic minority groups. Qualitative analysis of 40 semi-structured interviews with clients emphasized the benefits of fast access and friendly helpful staff. However, clients believed that drug use itself was interlinked with social, economic and psychological problems and identified a need for comprehensive 'wrap-around services' and help with housing and employment. The complexity of the relationship between drug use and crime was seen as reflecting the complexity of these underlying problems. The opportunities and limitations of combining individual treatment and public safety objectives are discussed.

Krebs CP; Lindquist CH; Koetse W; Lattimore PK. Assessing the long-term impact of drug court participation on recidivism with generalized estimating equations. Drug and Alcohol Dependence 91(1): 57-68, 2007. (31 refs.)

Drug courts are one of the most common strategies for dealing with the large proportion of criminal offenders who are drug-involved, yet methodological limitations limit the conclusions that can be drawn from many existing evaluations of their effectiveness. The current study 41 examined the long-term impact of drug court participation compared to regular probation on the recidivism of 475 drug-involved offenders under supervision in Hillsborough County, Florida. Using a combination of self-reported data (collected through in-person interviews at baseline, i.e., the beginning of supervision) and administrative records, the study employed a repeated measures framework (examining five 6-month time periods from baseline to 30 months post-baseline) and generalized estimating equations to compare the likelihood of being arrested between drug court participants and a matched sample of comparison offenders. The results indicate that participation in drug court was associated with a significant decrease in the likelihood of being arrested in the 12-18 months post-baseline time period. Although the drug court effect was somewhat delayed (it was not significant prior to 12 months) and short-lived (it was not significant after 18 months), the fact that significant program effects were observed during a time period that coincides with the conclusion of drug court participation for graduates and a time period well beyond initial program exposure, suggests that drug court participants are more likely than comparable offenders not exposed to drug court to remain arrest free when no longer under community supervision.

Kubiak SP; Arfken CL; Swartz JA; Koch AL. Treatment at the front end of the criminal justice continuum: The association between arrest and admission into specialty substance abuse treatment. Substance Abuse Treatment, Prevention, and Policy 1(e-article 20), 2006. (45 refs.)

Background: To reduce criminal recidivism and drug use, it has been proposed that the substance abuse treatment delivery system cut across different components of the criminal justice continuum. Arrest, at the front end of this continuum, may represent a critical moment to motivate people with substance use disorders (SUD) to seek treatment but is often over looked as an intervention point. We used data from the 2002 National Survey on Drug Use and Health (NSDUH) to compare treatment need and recent treatment admission for participants with no criminal justice (CJ) involvement in the past year, past-year arrest, and CJ supervision (i.e., probation or parole status). Results: Of those arrested, 44.8% met criteria for an SUD. However, only 14% of those arrested with an SUD received treatment in the year of their arrest. In multivariate modelling, arrest was an independent predictor of treatment admission (odds ratio (OR) = 8.74) similar in magnitude to meeting criteria for an SUD (OR = 8.22). Those further along the continuum - under supervision - were most likely to receive treatment (OR = 22.62). Conclusion: Arrest involves the largest number of individuals entering the criminal justice system. The NSDUH suggests that nearly 6 million individuals in the US experience an arrest annually and that nearly half meet criteria for an SUD. Although arrest involves the largest number of individuals entering the criminal justice system, it is also the most fleeting point as individuals can move in and out rather quickly. Minimally, arrest imposes contact between the individual and a law enforcement person and can be an opportunity for early intervention strategies such as pre-arraignment diversion into treatment or brief intervention strategies. Using brief intervention at this early point in the continuum may motivate a greater number of individuals to seek treatment or decrease drug and alcohol use. Training and procedural shifts at this point of contact could have important policy implications in reducing the number of subsequent arrests or preventing individuals moving further along the criminal justice continuum, as well as decreasing the fiscal and resource burdens associated with criminal justice processing and confinement.

Lapham SC; Baca JC; Lapidus J; McMillan GP. Randomized sanctions to reduce re-offense among repeat impaired-driving offenders. Addiction 102(10): 1618-1625, 2007. (30 refs.)

Aims: This study, conducted within a driving under the influence (DUI) court intervention, evaluated the degree to which removing electronic monitoring (EM) and/or mandatory vehicle sales requirements increased rates of post-sentence traffic violations among repeat DUI offenders. Design: Randomized trial. Setting and participants A total of 477 repeat DUI offenders entering the Driving under the Influence of Intoxicants (DUII) Intensive Supervision Program (DISP), Multnomah County, Oregon. Intervention: Subjects were randomized into four intervention groups. Group 1: standard DISP with EM and vehicle sales requirements; group 2: standard DISP with mandatory vehicle sale, but without EM; group 3: standard DISP with EM, but without mandatory vehicle sale; and group 4: standard DISP without EM or mandated vehicle sale. Standard DISP includes treatment for alcohol abuse and dependence, polygraph testing, regular court appearances, and probation or court-based monitoring. Measurements: The risk of re-arrest for traffic violations was compared among the four groups using hazard ratio estimates from complementary log-log regression models. Findings: Compared with group 1, subjects in group 2 initially had increased re-arrest risks, but this effect dissipated within 3 years of entering DISP. Group 3 subjects had a 96% increase in re-arrest rates. Group 4 subjects had smaller increased risks than predicted, with re-arrest rates similar to those of group 1 at the end of the follow-up period. Conclusions: Although some of the findings suggest that mandatory vehicle sales may deter future traffic violations, inconsistent results across groups make this finding equivocal. Positive effects of EM, while large in the short term, appear to have a relatively small long-term value in reducing traffic arrest rates.

Larney S; Mathers B; Dolan K. Illicit Drug Treatment in Prison: Detoxification, drug-free units, therapeutic communities and opioid substitution treatment. NDARC Technical Report No. 266. Sydney: National Drug and Alcohol Research Centre (Australia), 2007. (59 refs.)

While it is recognized that providing drug treatment to drug-using offenders may contribute to reducing re-offending, treatment availability is often limited. However, prisoners retain the right to adequate healthcare, including access to effective treatment for drug dependence, and treatment equivalent to the care available in the community. This is of particular importance as prisons are important sites of HIV transmission due to sharing of injecting equipment and unprotected sexual activity. This report summarizes the published literature on illicit drug detoxification and treatment interventions in prisons. The first topic discussed is detoxification with attention to opiates and psychostimulants, and discussion of pharmacotherapies, symptomatic treatment, psychiatric complications, and the need for psychological support. Discussion then turns to drug-free wings, therapeutic communities and their impact on drug use, criminal recidivism, and factors associated with treatment completion. It concludes with consideration of opioid substitution treatment, in the community and prison setting, its rationale, and the use of methadone maintenance, buprenorphine maintenance and LAAM.

Levinson AH; Mickiewicz T. Reducing underage cigarette sales in an isolated community: The effect on adolescent cigarette supplies. Preventive Medicine 45(6): 447-453, 2007. (31 refs.)

Objective. The current study explored the practicality of preventing underage retail cigarette sales and the relationship to cigarette supplies among adolescents. Method. In Fort Morgan, Colorado, an isolated rural community with below-average socioeconomic status and a large Latino population, supervised teenaged employees repeatedly attempted to buy cigarettes from every store over a 9-month period in 2005. Repeated violations were penalized. Cigarette acquisition and exchange among community adolescents were assessed before and after intervention using a high school student survey. Results. The measured violation rate declined from 47% in the first week to 3.4% during the final three months, and high school student reliance on retail cigarette purchases declined. Adolescent cigarette supplies declined by approximately 15%. Conclusion. Isolated rural communities can reduce adolescent cigarette supplies by conducting consistent enforcement against retail cigarette sales to minors. Previous research suggests that reducing these sales may help reduce adolescent smoking. The current study demonstrates that enforcement is practical and effective.

Maxwell JC; Freeman J; Davey J. A large-scale study of the characteristics of impaired drivers in treatment in Texas. Journal of Addiction Medicine 1(4): 173-179, 2007. (41 refs.)

Purpose: This is a study of individuals entering treatment who had been arrested for DUI in the past year or who entered treatment while on probation for DUI to determine their levels of impairment and the factors that predict treatment completion and abstinence at follow-up. Methods: Secondary data analysis was performed on an administrative dataset of 29,566 adult Texans who entered publicly funded substance abuse treatment between 2000 and 2005. Multivariate logistic regressions predicted multiple past-year arrests, treatment completion, and abstinence at follow-up. Results: Being older, homeless, having more problems with peer or social relationships, using daily, and having more public intoxication arrests predicted entering treatment with more than 1 DUI arrest in the past year. Individuals with multiple arrests in the past year were more impaired and the least likely to complete treatment or be abstinent in their last month of treatment. The strongest predictor of completing treatment was having been treated in a residential environment (odds ration [OR], 3.35; 95% confidence interval [CI], 2.44-4.6; P < 0.0001), the strongest predictor of past-month abstinence at follow-up was completing treatment (OR, 2.18. 95% CI, 1.83-2.59; P < 0.0001), and the strongest risk factor was living in a situation in which the individual was exposed to alcohol abuse or drug use (OR, 0.13; 95% CI, 0.1-0.17; P < 0.0001). Conclusions: This study provides evidence of the extent of abuse and dependence among DUI arrestees and their need for treatment not only for their substance abuse problems but also for other problems, including co-occurring mental health problems. Closer supervision by probation during follow-up could reinforce abstinence and prevent recidivism.

Mistral W; Wilkinson S; Mastache C; Midgley S; Law F. Efficacy of naltrexone treatment with combined crack and opiate users: A descriptive study of a new treatment service in Bristol, UK. Drugs: Education, Prevention and Policy 15(1): 107-119, 2008. (34 refs.)

Naltrexone has been shown to be clinically effective in treating opioid dependence, although there are reports that it may be unsafe in treatment of unselected cases. Although there are no generally accepted pharmacological treatments for crack cocaine addiction alone, there is evidence that naltrexone can be useful in cases of concurrent cocaine and heroin use. In 2005 Bristol Specialist Drug Service initiated a naltrexone treatment programme targeted at pre-release offenders using both crack cocaine and heroin. Of 172 referrals, only 51 (30%) were inducted into treatment, and only 16% of these were retained at 3 months, and 4% at 9 months. There was evidence to support induction in prison, as 90% of those who were inducted there continued treatment on release. An integrated approach between criminal justice and community services is of primary importance in getting users into treatment. Interviews highlighted that the environment outside of prison can trigger relapse, and that community clinics need to separate clients on an abstinence programme from those who continue to use. Of clients interviewed, 52% reported that they use heroin to mitigate severe come down from crack, and it is suggested that naltrexone may be of use for these specialized combined users.

Moore TJ. The size and mix of government spending on illicit drug policy in Australia. Drug and Alcohol Review 27(4): 404-413, 2008. (43 refs.)

Aim. To estimate how much governments in Australia spend on reducing and dealing with illicit drug problems. Methods. Government documents and supplementary information sources were used to estimate drug-related expenditure for the financial year 2002-03, in Australian dollars. Public sector expenditure on reducing drug problems ('proactive expenditure') was classified into four policy functions: prevention, treatment, harm reduction and enforcement. Expenditure related to the consequences of drug use ('reactive expenditure') was included as a separate category. Results. Spending by Australian governments in financial year 2002-03 on all drug-related activities was estimated to be $3.2 billion. Proactive expenditure was estimated to be $1.3 billion, comprising 55% on enforcement, 23% on prevention, 17% on treatment, 3% on harm reduction and 1% on activities that span several of these functions. Expenditure on dealing with the consequences of drug use was estimated to be $1.9 billion, with the majority the result of crime-related consequences. Conclusion. Several insights result from estimating these expenditures. First, law enforcement is the largest drug policy component, with Australian governments also spending significant amounts on treatment and prevention programmes. Secondly, apart from the prevention component, Australia's drug policy mix is strikingly similar to recent international estimates. Finally, expenditures associated with dealing with the consequences of illicit drugs are large and important for assessing drug-related public sector expenditure.

O'Brien CP. Modern treatment for prisoners. (editorial). Addiction 103(8): 1343-1343, 2008. (1 refs.)

Office of Applied Studies, Substance Abuse and Mental Health Services Administration. The DASIS Report: Primary Methamphetamine/Amphetamine Admissions to Substance Abuse Treatment: 2005. (February 7, 2008). Rockville MD: Substance Abuse and Mental Health Services Administration, 2008. (9 refs.)

From 1995 to 2005, the percentage of substance abuse treatment admissions for primary abuse of methamphetamine /amphetamine more than doubled from 4% to 9%. In 2005, about 1.8 million substance abuse treatment admissions were reported to SAMHSA's Treatment Episode Data Set (TEDS). Of these, 169,500 were for primary methamphetamine /amphetamine abuse and 80,000 admissions were for secondary or tertiary methamphetamine/ amphetamine abuse. The duration of use of their primary drug before admission to treatment was, on average, six years less for persons admitted to treatment for primary methamphetamine /amphetamine abuse than it was for persons admitted for abuse of other primary substances. The criminal justice system was the principal source of referral for 49% of primary methamphetamine/amphetamine treatment admissions compared with 34% of admissions for other primary substances.

Public Domain

Palk G; Davey J; Freeman J. Prevalence and characteristics of alcohol-related incidents requiring police attendance. Journal of Studies on Alcohol and Drugs 68(4): 575-581, 2007. (22 refs.)

Objective: The purpose of this study was to examine the prevalence of alcohol-related incidents attended by operational police within three of the largest cities in Queensland (i.e., Brisbane, Gold Coast, and Townsville; n = 7,398). There have been only a relatively small proportion of Australian studies that have examined the prevalence and characteristics of alcohol-related incidents requiring police attention, and most are based on small sample sizes that are representative of specific populations. Method: Participants in the current study were first-response operational police officers who completed a modified activity log during a 5-week period, identifying the type, prevalence, and characteristics of alcohol-related incidents that were attended (n = 31,090). Results: Overall, approximately one in four incidents attended by police during the study period involved alcohol, whereas only 3% were drug related. The most common incidents police attended were ve- hicle and/or traffic matters, disturbances, and offenses against property. A closer examination revealed that disturbances and vehicle/traffic-type incidents were almost twice as likely to be alcohol related as compared with the overall percentage of incidents. Similar findings were evident between metropolitan and nonmetropolitan areas, which highlights the consistent impact of alcohol on police resources. Offenders were more likely to be young males, whereas victims consisted of a relatively even number of males and females. Conclusions: The findings highlight the pervasive nature of alcohol across a range of criminal incidents, demonstrating the tremendous impact alcohol-related incidents have on police resources and can potentially contribute to the development of more effective, problem-oriented strategies to address alcohol-related crime.

Perron BE; Bright C. The influence of legal coercion on dropout from substance abuse treatment: Results from a national survey. Drug and Alcohol Dependence 92(1/3): 123-131, 2008. (38 refs.)

Legal coercion is frequently used to leverage substance abuse treatment upon persons who would otherwise not seek it voluntarily. Various methodological and conceptual problems of the existing research have prevented a clear understanding of its effectiveness. The influence of legal coercion on retention in substance abuse treatment was examined using a national survey of programs in the public sector of care and three different treatment modalities including short-term residential (N = 756), long-term residential (N = 757), and outpatient treatment (N = 118 1). Legal coercion was found to reduce the risk of dropout across all three treatment modalities. The greatest effect was among persons in short-term residential treatment. The smallest effect was observed in outpatient treatment. This study shows that legal coercion significantly reduces the risk of dropout in substance abuse treatment. However, the differential effects across treatment conditions must be carefully considered when using coercion to involve individuals in treatment.

Rey GN; Garcia FJ; Icaza MEMM; Sainz MT. Alcohol and drug consumption, depressive features, and family violence as associated with complaints to the prosecutor's office in Central Mexico. Substance Use & Misuse 42(10): 1485-1504, 2007. (46 refs.)

The article is aimed at reporting the characteristics of the population detected at State Prosecutors' Offices including the two such offices that existed in the city selected for the study, one located in a general hospital for the inspection of violence- related cases (n = 156); and the second in the facility where all detainees are taken when arrested (n = 129), and where victims can file a complaint (n = 186). A household survey undertaken among the population 18 to 65 years of age (n = 887) was used as a group of reference. Both studies were undertaken in Pachuca City, the capital of Hidalgo, located 100 km from Mexico City during the second half of 1996. Face- to- face questionnaires were used to obtain sociodemographic data, drug use and drinking patterns, depressive symptomatology, and family violence. Discriminant and logistic regression analysis were undertaken. The age group from 18 to 24 displayed the highest number of legal complaints and arrests (OR = 1.773). The likelihood for appearing at a State Prosecutor's Office was higher for those living in an atmosphere of threats and injuries within the family (OR = 19) and for those that reported alcohol consumption on the day of the event (OR = 14). Extremely high rates of family violence were obtained in this sample, increasing the likelihood of arriving at the Prosecutor's Office either because arrested or for being a victim. Results confirm the relationship between alcohol use, depression, and violence, reinforcing the need to prevent alcohol abuse, 1 especially among youth.

Rowe M; Bellamy C; Baranoski M; Wieland M; Connell MJO; Benedict P et al. A peer-support, group intervention to reduce substance use and criminality among persons with severe mental illness. Psychiatric Services 58(7): 955-961, 2007. (40 refs.)

Objective: This study compared the effectiveness of two interventions in reducing alcohol use, drug use, and criminal justice charges for persons with severe mental illnesses: first, a community-oriented group intervention with citizenship training and peer support that was combined with standard clinical treatment, including jail diversion services, and second, standard clinical treatment with jail diversion services alone. Methods: A total of 114 adults with serious mental illness participated in a 2 x 3 prospective longitudinal, randomized clinical trial with two levels of intervention (group and peer support for the experimental condition and standard services for the control) and three interviews (baseline, six months, and 12 months). Self-report questionnaires assessed alcohol and drug use, and program databases assessed criminal justice contacts. The authors used a mixed-models analysis to assess alcohol and drug use, repeated-measures analysis of covariance to assess criminal justice charges, and correlational analyses to assess the relation between intervention participation and outcome variables. Results: The experimental group showed significantly reduced alcohol use in comparison with the control group. Further, results showed a significant group-by-time interaction, where alcohol use decreased over time in the experimental group and increased in the control group. Drug use and criminal justice charges decreased significantly across assessment periods in both groups. Conclusions: Of the outcomes, only decreased alcohol use was attributable to the experimental intervention. Although this may be a chance finding, peer-and community-oriented group support and learning may facilitate decreased alcohol use over time.

Saum CA; O'Connell DJ; Martin SS; Hiller ML; Bacon GA; Simpson DD. Tempest in a TC: Changing treatment providers for in-prison therapeutic communities. Criminal Justice and Behavior 34(9): 1168-1178, 2007. (20 refs.)

Corrections officials frequently use private contractors to operate in-prison, therapeutic community (TC) treatment programs. However, the recurrent competitive bidding process inherent in state agencies contracting for services sometimes results in a treatment-provider change. Few studies have focused on whether this change leads to better or worse treatment motivation and engagement for clients and how it might be evaluated. Using data collected during the larger Criminal Justice Drug Abuse Treatment Studies Performance Indicators for Corrections study, quantitative assessments of client functioning were made at two points in time. Changing to new treatment providers in three in-prison TC treatment facilities caused significant disruptions, leading to decreased client-counselor rapport and peer support as well as lower levels of treatment readiness, participation, and satisfaction of clients. Qualitative client and staff interviews provided further insight relevant for correctional administrators and treatment providers who may be considering similar changes. General recommendations for provider transition planning are offered.

Schwartz J. Gender differences in drunk driving prevalence rates and trends: A 20-year assessment using multiple sources of evidence. Addictive Behaviors 33(9): 1217-1222, 2008. (11 refs.)

This research tracked women's and men's drunk driving rates and the DUI sex ratio in the United States from 1982-2004 using three diverse sources of evidence. Sex-specific prevalence estimates and the sex ratio are derived from official arrest statistics from the Federal Bureau of Investigation, self-reports from the Centers for Disease Control and Prevention, and traffic fatality data from the National Highway and Transportation Safety Administration. Drunk driving trends were analyzed using Augmented Dickey Fuller time series techniques. Female DUI arrest rates increased whereas male rates declined then stabilized, producing a significantly narrower sex ratio. According to self-report and traffic data, women's and men's drunk driving rates declined and the gender gap was unchanged. Women's overrepresentation in arrests relative to their share of offending began in the 1990s and accelerated in 2000. Women's arrest gains, contrasted with no systematic change in DUI behavior, and the timing of this shift suggest an increased vulnerability to arrest. More stringent laws and enforcement directed at less intoxicated offenders may inadvertently target female offending patterns.

Shannon L; Logan T; Cole J; Walker R. An examination of women's alcohol use and partner victimization experiences among women with protective orders. Substance Use & Misuse 43(8/9): 1110-1128, 2008. (60 refs.)

This study examined associations of women's alcohol use with self-reported experiences of male-perpetrated intimate partner violence among a sample of women with protective orders. Participants were 676 women with a protective order against a male intimate partner from three rural areas and one urban area. Multivariate analyses indicated that women's substance use was associated with psychological abuse tactics and severity of physical and sexual victimization in the last year of the relationship. Women's alcohol use was associated with the severity of physical violence within the last year of the relationship, whereas illegal drug use had associations with the number of verbal abuse, degradation and jealousy/control tactics. There was a significant interaction of women's alcohol and drug use with the severity of sexual assault.

Shannon K; Rusch M; Shoveller J; Alexson D; Gibson K; Tyndall MW. Mapping violence and policing as an environmental-structural barrier to health service and syringe availability among substance-using women in street-level sex work. International Journal of Drug Policy 19(2): 140-147, 2008. (60 refs.)

Background: Within street-based sex work and substance-using populations, there is growing evidence to support the role of place, both physical setting and social meanings attached to place, in mediating the effectiveness and reach of health and harm reduction services. Methods: Social mapping was used to explore how health service and syringe availability maybe impacted at the geographic level by avoidance of physical settings due to violence and policing among women in street-level sex work. Through a community-based research partnership and extensive peer-led outreach over a 6-month period, women were invited to participate in interview-questionnaires and mapping of their community, working conditions, and access to resources. Results were compiled used ArcGIS software and GIS street maps. In secondary analysis, logistic regression was used to model the geographic association (using likelihood ratio and significance at p < 0.05) and stratified models were run to assess differential patterns of avoidance based on age, ethnicity and drug use. Results: The findings reveal a significant geographic relationship between a heavily concentrated core area of health and syringe availability and avoidance of physical settings due to violence and policing by 198 women in street-level sex work in Vancouver, Canada. Of particular concern, this correlation is significantly elevated among younger and Aboriginal women, active injection drug users, and daily crack cocaine smokers, suggesting significant environmental-structural barriers to interventions among these vulnerable populations. Conclusions: The resultant displacement of sex work to primarily industrial settings and side streets pushes women further from health and social supports and reduces access to safer injection and drug use paraphernalia. This study offers important evidence for environmental-structural level prevention and safer environment interventions, supported by legal reforms, that facilitate safer sex work environments, including spatial. programming, peer-based prevention, outreach and mobile resources, and peer-supervised safer sex work settings.

Shepard EM; Blackley PR. The impact of marijuana law enforcement in an economic model of crime. Journal of Drug Issues 37(2): 403-424, 2007. (46 refs.)

U.S. law enforcement against the sale and possession of marijuana has been estimated to cost close to $8 billion a year in criminal justice resources. Current enforcement is justified if it provides net benefits greater than alternatives such as a legal, regulated market for marjuana. Prior research suggests that current levels of drug enforcement may increase nondrug crime and hard drug use. Here, local rates of property crime, homicide, and nonmarijuana drug possession are estimated as a function of economic conditions, enforcement effectiveness, and arrests for possession or sale of marijuana. The data consists of a pooled sample of over 1300 U.S. counties (1994-2001). The results suggest that marijuana arrests are associated with increases in homicides, burglaries, motor vehicle thefts, and larcenies along with subsequent increases in hard drug arrests. These results raise significant questions about the merits of policies that focus on criminal justice approaches to marijuana control.

Staton-Tindall M; Garner BR; Leukefeld C; Saum CA; Oser CB. Gender differences in treatment engagement among a sample of incarcerated substance abusers. Criminal Justice and Behavior 34(9): 1143-1156, 2007. (50 refs.)

This article examines gender differences in treatment engagement, psychosocial variables, and criminal thinking among a sample of male and female substance abusers (N = 2,774) enrolled in 20 prison-based treatment programs in five different states as part of the National Institute on Drug Abuse-funded Criminal Justice Drug Abuse Treatment Studies cooperative agreement. Results indicate that inmates in female treatment programs report more psychosocial dysfunction, less criminal thinking, and higher engagement than in male facilities, and there is a more negative relationship between psychosocial variables and treatment engagement (compared to male programs). Only one subscale of criminal thinking had a significant gender interaction, with males having a significantly stronger relationship between cold-heartedness and low treatment engagement. Implications for treatment interventions with a gender-specific focus are discussed.

Sterud T; Hem E; Ekeberg O; Lau B. Occupational stress and alcohol use: A study of two nationwide samples of operational police and ambulance personnel in Norway. Journal of Studies on Alcohol and Drugs 68(6): 896-904, 2007. (53 refs.)

Objective: Police and ambulance personnel are widely believed to have a high prevalence of excessive alcohol consumption. However, the empirical basis for this assumption is scant or nonexistent. We assessed the association of alcohol use with burnout and job stressors, with drinking to cope and neuroticism as two possible moderating factors in two occupations, the police and ambulance services. Method: We undertook a comprehensive nationwide questionnaire survey of police (n = 2,372) and ambulance (n = 1,096) personnel in operational duty. The questionnaire encompassed the Alcohol Use Disorders Identification Test (AUDIT), the Maslach Burnout Inventory, the Job Stress Survey, and the Basic Character Inventory. Results: With a modified AUDIT score of 6 or more, the prevalence for men was 17.7% (police personnel) versus 16.6% (ambulance personnel). The prevalence for women was 9.1% versus 7.4%, respectively. Personnel who were male, were younger, and had higher levels of neuroticism reported higher levels of alcohol-related problems. Drinking to cope was most strongly associated with higher levels of alcohol-related problems (standardized P =.29, p <.001) and was found to moderate the effect of depersonalization (e.g., cynical and distant attitude toward one's work and the people with whom one works) and gender. Conclusions: In general, the present study does not support the notion of a strong relationship between occupational stress and alcohol use in these emergency service occupations. However, drinking to cope may be a risk factor for alcohol-related problems, particularly among male personnel and those experiencing higher levels of depersonalization.

Sullivan CJ; Veysey BM; Hamilton ZK; Grillo M. Reducing out-of-community placement and recidivism: Diversion of delinquent youth with mental health and substance use problems from the justice system. International Journal of Offender Therapy and Comparative Criminology 51(5): 555-577, 2007. (52 refs.)

For a number of reasons, researchers and policy makers are now focusing on diversion of youth from the juvenile justice system. This study examines New York State's diversion efforts focused on youth with mental health and substance abuse problems who are at risk of out-of-community placement (N = 2,309). Twelve counties participated in the Mental Health Juvenile Justice (MH/JJ) Diversion Project. Overall, the initiative was successful in reducing out-of-community placement and recidivism for diverted youth. In regression analysis site, services received, and problem-profile variables were important predictors of out-of-community placement. Prior record, prior placement, and significant mental health problems were statistically significant predictors of recidivism. This suggests some contrasts in explaining the results of two important goals of the MH/JJ project. Study results and implications for future research and intervention are discussed.

Sung HE; Richter L. Rational choice and environmental deterrence in the retention of mandated drug abuse treatment clients. International Journal of Offender Therapy and Comparative Criminology 51(6): 686-702, 2007. (60 refs.)

Length of treatment stay is consistently associated with positive posttreatment outcomes in the rehabilitation of drug-abusing offenders. However, past retention research centered on the examination of individual-level determinants to the exclusion of environmental predictors. In this study, the authors propose a rational choice framework in which treatment retention is viewed as a decision-making process that involves calculation of costs and benefits of remaining in treatment. Environmental factors not directly related to the treatment process are theorized to either reward or punish the course of action taken by each treatment client. Retention data from 1,984 drug-abusing felons diverted for longterm residential treatment were analyzed to test the hypotheses that criminal sanctions against drug offenses, violence in local drug markets, and lack of legitimate job opportunities act as deterrents against premature termination of treatment. Results corroborated the criminal sanction and unemployment hypotheses, but not the violence hypothesis. These findings highlight the necessity of reinforcing perceptions of arrest risks and job prospects during treatment. The study concludes with some clinical recommendations.

Swartz JA; Lurigio AJ. Serious mental illness and arrest - The generalized mediating effect of substance use. Crime & Delinquency 53(4): 581-604, 2007. (62 refs.)

Past studies of the mediating effects of substance use on the criminal justice involvement of the mentally ill have tended to focus on a single disorder, schizophrenia, and on violent crimes. This study examined the generality of the relationships among psychiatric disorders, substance use, and arrests for violent, nonviolent, and drug-related offenses using data collected for the 2001 and 2002 National Survey on Drug Use and Health. Logistic regression models showed that for violent offenses, the statistical association between serious mental illness (SMI) and arrest across psychiatric diagnoses was substantially but only partially mediated by substance use. For nonviolent offenses and for drug-related offenses, the relationship between SMI and arrest was almost completely mediated by substance use and reduced to statistical nonsignificance. These findings suggest that co-occurring substance use increases the chances a person with any SMI, not just schizophrenia, will be arrested for any offense, not just violent offenses, but that the magnitude of this relationship varies by offense type and, to a lesser extent, by disorder.

Thompson KM. Alcohol-related legal infractions and student retention. Journal of Studies on Alcohol and Drugs 68(5): 689-696, 2007. (39 refs.)

Objective: The present study employed municipal alcohol-related arrest reports to determine if being arrested/cited reduced the probability of academic retention. Method: Alcohol-related legal infraction data implicating 1,3 10 college students was gathered during a 4-year period. First- through third-year students were identified in the database by cross-checking names in the campus directory. A random sample of nonarrested students functioned as the comparison group (n = 856). Students not appearing in the directory the following year were defined as nonretained students. Results: Retention was not affected by the experience of one alcohol-related legal infraction. Retention odds were 3 1 % lower for students experiencing multiple arrests, however, than for nonarrested or single-arrested students. Gender moderated the association between arrest and retention, with women who had been arrested more likely to return to school than those who had not been arrested. Retention odds were higher for arrested/cited students if they were in their second or third year of college, a fraternity/sorority member, or charged with an offense other than driving under the influence. Conclusions: Multi-arrested college students are at risk for attrition. Immersion in college life may reduce the odds of attrition among arrested college students.

Voisin DR; Crosby R; Yarber WL; Salazar LF; DiClemente RJ; Staples-Home M. Witnessing community violence and health-risk behaviors among detained adolescents. American Journal of Orthopsychiatry 77(4): 506-513, 2007. (43 refs.)

This study examines whether witnessing community violence, in the 12 months prior to juvenile detention, is related and health-related outcomes in the 2 months prior to being detained among 550 youth. Participants answered survey questions using audio-computer assisted self-interviewing procedures, which assessed demographic, problem, and drug and sexual risk behaviors. Multiple logistic regression analyses, controlling for significant covariates, indicated that adolescents, in the last 12 months, who reported witnessing community violence, relative to their peer witnessing no violence, were in the last 2 months prior to being detained, twice more likely to have suicidal threats, 2 times more likely to use marijuana and alcohol, 2 times more likely to get high on alcohol or other drugs during sexual intercourse, and 2 times more likely to have sex with a partner who was high on alcohol or other drugs. Finding suggest that detained youth, many of whom may not access traditional health care, should be offered prevention and intervention services dring detention, which provides a critical window of opportunity for needed services.

Wagenaar AC; Maldonado-Molina MM; Erickson DJ; Ma L; Tobler AL; Komro KA. General deterrence effects of US statutory DUI fine and jail penalties: Long-term follow-up in 32 states. Accident Analysis and Prevention 39(5): 982-994, 2007. (47 refs.)

Introduction: We examined effects of state statutory changes in DUI fine or jail penalties for firsttime offenders from 1976 to 2002. Methods: A quasi-experimental time-series design was used (n = 324 monthly observations). Four outcome measures of drivers involved in alcohol-related fatal crashes are: single-vehicle nighttime, low BAC (0.01-0.07 g/dl), medium BAC (0.08-0.14g/dl), high BAC (>= 0.15 g/dl). All analyses of BAC outcomes included multiple imputation procedures for cases with missing data. Comparison series of non-alcohol-related crashes were included to efficiently control for effects of other factors. Statistical models include state-specific Box-Jenkins ARIMA models, and pooled general linear mixed models. Results: Twenty-six states implemented mandatory minimum fine policies and 18 states implemented mandatory minimum jail penalties. Estimated effects varied widely from state to state. Using variance weighted meta-analysis methods to aggregate results across states, mandatory fine policies are associated with an average reduction in fatal crash involvement by drivers with BAC >= 0.08 g/dl of 8% (averaging 13 per state per year). Mandatory minimum jail policies are associated with a decline in single-vehicle nighttime fatal crash involvement of 6% (averaging 5 per state per year), and a decline in low-BAC cases of 9% (averaging 3 per state per year). No significant effects were observed for the other outcome measures. Conclusions: The overall pattern of results suggests a possible effect of mandatory fine policies in some states, but little effect of mandatory jail policies.

Waters JA; Ussery W. Police stress: History contributing factors, symptoms, and interventions. Policing 30(2): 169-188, 2007. (33 refs.)

Purpose - The purpose of this paper is to highlight the stressors involved in an occupation at potential risk - the profession of law enforcement. Design/methodology/approach - The paper reviews the history of police stress studies. It describes prevention and treatment programs that have unfortunately not been sufficiently utilized because of the police culture. Findings - The documented symptoms of stress include digestive orders, cardiovascular diseas, alcoholism, domestic violence, post-traumatic stress disorder, depression and suicide. While some police officers start their careers in excellent physical health, some retire early or even die from job-related stress disorders if the cumulative impact of stress exacts its toll. Originality/value - The paper offers a description of COP.2.COP a confidential hotline for officers and their families staffed by retired officers and licensed professionals.

Weir BW; Bard RS; O'Brien K; Casciato CJ; Stark MJ. Violence against women with HIV risk and recent criminal justice system involvement - Prevalence, correlates, and recommendations for intervention. Violence Against Women 14(8): 944-960, 2008. (57 refs.)

This research note examines the prevalence and correlates of intimate partner violence (IPV) and other violence (OV) among women (N = 529) at risk for HIV and with histories of criminal justice system involvement. The 3-month prevalences of IPV and OV were 31.2% and 18.7%, respectively. IPV was associated with having a current main partner, substance use, sexual risk behavior, trading sex, anxiety, depression, and lower self-esteem. OV was associated with no current employment or schooling, unstable housing, drug use, trading sex, anxiety, depression, and lower self-esteem. The high prevalence of violence demonstrates the need for intervention in this population; the correlates show that effective interventions must address the complex issues in these women's lives.

Werb D; Kerr T; Marsh D; Li K; Montaner J; Wood E. Effect of methadone treatment on incarceration rates among injection drug users. European Addiction Research 14(3): 143-149, 2008. (45 refs.)

Background: Methadone maintenance treatment (MMT) has been shown to dramatically reduce illicit opioid use and criminal activity among injection drug users (IDU). However, questions remain concerning the effect of MMT in reducing rates of incarceration among IDU. We therefore sought to investigate the long-term effect of MMT on rates of incarceration. Methods: We performed a generalized estimating equation longitudinal analysis of factors associated with incarceration among participants in the Vancouver Injection Drug Users Study (VIDUS). We also recorded whether participants reported having difficulty accessing drug treatment during the study period. Results: Among 1,247 active IDU, 624 (50.0%) reported being incarcerated at least once during the 6-year study period. In multivariate analysis, there was a strong negative association between methadone treatment and incarceration (adjusted odds ratio = 0.64, 95% CI: 0.54-0.76, p < 0.001) despite intensive covariate adjustment. Conclusions: Given our findings concerning the strong negative association between MMT and incarceration, and the reported high-risk injection practices of incarcerated IDU, limiting the availability of MMT has the potential to further exacerbate the high levels of HIV transmission found among IDU who are in need of treatment both in their communities and in correctional facilities.

Witter RZ; Martyny JW; Mueller K; Gottschall B; Newman LS. Symptoms experienced by law enforcement personnel during methamphetamine lab investigations. Journal of Occupational and Environmental Hygiene 4(12): 895-902, 2007. (22 refs.)

This study was conducted to determine if law enforcement personnel experience symptoms associated with methamphetamine lab investigation and to assess those factors that may result in more symptoms. A total of 258 standardized, self-administered surveys were distributed to law enforcement personnel attending national/regional training classes, between June 2004-February 2005. Ninety-three percent of the surveys were returned and used to determine symptoms experienced while investigating clandestine methamphetamine labs, as well as the job duties of the respondent and the personal protective equipment used. More than 70% of respondents reported headaches, central nervous system symptoms, respiratory symptoms, sore throat, and other symptoms. Unadjusted and adjusted risk of symptoms was higher for those who investigated more than 30 labs. Other significant risk factors included time spent in the lab, phase of investigation, presence of active chemical processes, and coexistent disease. Respirator use was not independently associated with the likelihood of reporting symptoms. It was concluded that methamphetamine lab investigation is positively associated with symptom reporting in a high percentage of law enforcement personnel involved in these tasks. For most individuals, the reported symptoms were transitory and diminished in a short time, but some individuals reported needing to seek medical attention with symptoms that persisted.

Wood DM; Warren-Gash C; Ashraf T; Greene SL; Shather Z; Trivedy C et al. Medical and legal confusion surrounding gamma-hydroxybutyrate (GHB) and its precursors gamma-butyrolactone (GBL) and 1,4-butanediol (1,4BD). QJM. An International Journal of Medicine 101(1): 23-29, 2008. (33 refs.)

Background: Gamma-hydroxybutyrate (GHB) is used as a recreational drug, with significant associated morbidity and mortality; it is therefore a class C drug under the Misuse of Drugs Act (1971). However, its precursors gamma-butyrolactone (GBL) and 1,4-butanediol (1,4BD) remain legally available despite having similar clinical effects. Aim: The aim of this study was to determine whether the relative proportions of self-reported ingestions of GHB or its precursors GBL and 1,4BD were similar to those seen in analysis of seized drugs. Design and methods: Retrospective review of our clinical toxicology database to identify all cases of self-reported recreational GHB, GBL and 1,4BD use associated with ED presentation in 2006. Additionally all seized substances on people attending local club venues were analysed by a Home Office approved laboratory to identify any illicit substances present. Results: In 2006, there were a total of 158 ED presentations, of which 150 (94.9) and 8 (5.1) were GHB and GBL self-reported ingestions respectively; 96.8 (153) were recreational use. Of the 418 samples seized, 225 (53.8) were in liquid form; 85 (37.8) contained GHB and 140 (62.2) contained GBL. None of the seized samples contained 1,4BD and there were no self-reported 1,4BD ingestions. Conclusions: Self-reported GHB ingestion was much more common than GBL ingestion, whereas GBL was more commonly found in the seized samples. These differences suggest that GBL use may be more common than previously thought and we suggest that there should be further debate about the legal status of the precursors of GHB.