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CORK Bibliography: Prisoners

74 citations. January 2010 to present

Prepared: September 2011

Awgu E; Magura S; Rosenblum A. Heroin-dependent inmates' experiences with buprenorphine or methadone maintenance. Journal of Psychoactive Drugs 42(3): 339-346, 2010. (25 refs.)

Methadone and buprenorphine are both efficacious treatments for opioid dependency, but they also have different pharmacological properties and clinical delivery methods that can affect their acceptability to patients. This study was intended to increase our knowledge of heroin-dependent individuals' perceptions of methadone vs. buprenorphine maintenance based on actual experiences with each. The study sample consists of heroin-dependent men at the Rikers Island jail in New York City who were voluntarily randomly assigned to methadone or buprenorphine maintenance in jail. Methadone patients were more likely to report feeling uncomfortable the first few days, having side/withdrawal effects during treatment, and being concerned about continued dependency on medication after release. In contrast, buprenorphine patients' main issue was the bitter taste. All of the buprenorphine patients stated that they would recommend the medication to others, with almost all preferring it to methadone. Ninety-three percent of buprenorphine vs. 44% of methadone patients intended to enroll in those respective treatments after release, with an added one-quarter of the methadone patients intending to enroll in buprenorphine instead. These results reinforce the importance of increasing access to buprenorphine treatment in the community for indigent heroin-dependent offenders.

Bahr SJ; Harris L; Fisher JK; Armstrong AH. Successful reentry what differentiates successful and unsuccessful parolees? International Journal of offender Therapy and Comparative Criminology 54(5): 667-692, 2010. (60 refs.)

In this research the authors examine the reentry of 51 parolees during the 3 years following their release from prison. The objective is to gain increased understanding of what differentiates successful parolees from those who fail. Success is defined as being discharged from parole by 3 years after release. The study examines the extent to which drug treatment, friendships, work, family bonds, and age are associated with reentry success. Contrary to expectations, it is found that closeness to mother, closeness to father, having a partner, being a parent, and education level are not associated with parole success. Those who succeed on parole are more likely to have taken a substance abuse class while in prison and on release tend to spend more time in enjoyable activities with friends. Among the employed, those that worked at least 40 hours a week are more likely to complete parole successfully. Qualitative data indicate that successful parolees had more support from family and friends and had more self-efficacy, which help them stay away from drugs and peers who use drugs. The findings are consistent with an integrated life course theory.

Baillargeon J; Penn JV; Knight K; Harzke AJ; Baillargeon G; Becker EA. Risk of reincarceration among prisoners with co-occurring severe mental illness and substance use disorders. Administration and Policy in Mental Health and Mental Health Services Research 37(4): 367-374, 2010. (35 refs.)

This study examined whether the presence of a comorbid substance use disorder increased the risk of criminal recidivism and reincarceration in prison inmates with a severe mental illness. Our analyses of more than 61,000 Texas prison inmates showed that those with a co-occurring psychiatric and substance use disorder exhibited a substantially higher risk of multiple incarcerations over a 6-year period compared to inmates with psychiatric disorders alone or substance use disorders alone. Further research is needed to identify the factors associated with criminal recidivism among released prisoners with co-occurring disorders.

Binswanger IA; Blatchford PJ; Lindsay RG; Stern MF. Risk factors for all-cause, overdose and early deaths after release from prison in Washington State. Drug and Alcohol Dependence 117(1): 1-6, 2011. (55 refs.)

Background: High mortality rates after release from prison have been well-documented, particularly from overdose. However, little is known about the risk factors for death after release from prison. Therefore, the objective of this study was to determine the demographic and incarceration-related risk factors for all-cause, overdose and early mortality after release from prison. Methods: We conducted a retrospective cohort study of inmates released from a state prison system from 1999 through 2003. The cohort included 30,237 who had a total of 38,809 releases from prison. Potential risk factors included gender, race/ethnicity, age, length of incarceration, and community supervision. Cox proportional hazards regression was used to determine risk factors for all-cause, overdose and early (within 30 days of release) death after release from prison. Results: Age over 50 was associated with an increased risk for all-cause mortality (hazard ratio [HR] 2.67 for each decade increase, 95% confidence interval [CI] 2.23, 3.20) but not for overdose deaths or early deaths. Latinos were at decreased risk of death compared to Whites only for all-cause mortality (HR 0.61, 95% CI 0.42, 0.87). Increasing years of incarceration were associated with a decreased risk of all-cause mortality (HR 0.95, 95% CI 0.91, 0.99) and overdose deaths (HR 0.80, 95% CI 0.68, 0.95), but not early deaths. Gender and type of release were not significantly associated with all-cause, overdose or early deaths. Conclusions: Age, ethnicity and length of incarceration were associated with mortality after release from prison. Interventions to reduce mortality among former inmates are needed.

Binswanger IA; Merrill JO; Krueger PM; White MC; Booth RE; Elmore JG. Gender differences in chronic medical, psychiatric, and substance-dependence disorders among jail Inmates. American Journal of Public Health 100(3): 476-482, 2010. (50 refs.)

Objectives. We investigated whether there were gender differences in chronic medical, psychiatric, and substance-dependence disorders among jail inmates and whether substance dependence mediated any gender differences found. Methods. We analyzed data from a nationally representative survey of 6982 US jail inmates. Weighted estimates of disease prevalence were calculated by gender for chronic medical disorders (cancer, hypertension, diabetes, arthritis, asthma, hepatitis, and cirrhosis), psychiatric disorders (depressive, bipolar, psychotic, posttraumatic stress, anxiety, and personality), and substance-dependence disorders. We conducted logistic regression to examine the relationship between gender and these disorders. Results. Compared with men, women had a significantly higher prevalence of all medical and psychiatric conditions (P <=.01 for each) and drug dependence (P<.001), but women had a lower prevalence of alcohol dependence (P<.001). Gender differences persisted after adjustment for sociodemographic factors and substance dependence. Conclusions. Women in jail had a higher burden of chronic medical disorders, psychiatric disorders, and drug dependence than men, including conditions found more commonly in men in the general population. Thus, there is a need for targeted attention to the chronic medical, psychiatric, and drug-treatment needs of women at risk for incarceration, both in jail and after release

Brown RT; Allison PA; Nieto FJ. Impact of jail sanctions during drug court participation upon substance abuse treatment completion. Addiction 106(1): 135-142, 2011. (57 refs.)

Aims: This study of participants in a US drug treatment court describes the relationship between the imposition of short-term jail sanctions and substance abuse treatment dropout, and examines offender characteristics moderating or modifying the impact of jail sanctions on treatment dropout. Methods: Data were derived from administrative information collected by the Dane County Wisconsin Drug Treatment Court from 1996-2004 on all 573 participants achieving a final disposition of treatment completion or failure during those program years. Iterative Cox proportional hazards models of time to treatment failure were created; jail sanctions during drug court participation were framed as time-dependent covariates. A theoretical framework and specific statistical criteria guided construction of a final parsimonious model of time to treatment drop-out. Findings: Treatment failure was associated with unemployment [hazard ratio (HR) in unemployed versus employed = 1.41, P-value 0.0079], lower educational attainment (HR in high school non-graduate versus graduate = 1.41, P = 0.02) and application of the first jail sanction (HR 2.71, P < 0.001). The association between treatment failure and a first sanction was considerably stronger for sanctions administered earlier in participation (HR for sanction 1 at < 30 days 11.34, P-value 0.0002). Conclusions: An initial jail sanction for non-adherence may be more likely to foster treatment compliance in less refractory individuals (i.e. those not already acclimated or socialized to incarceration or other corrections interventions). More stringent supervisory conditions and individualized services may be required to reintegrate such offenders and promote longer-term public safety.

Butler T; Indig D; Allnutt S; Mamoon H. Co-occurring mental illness and substance use disorder among Australian prisoners. Drug and Alcohol Review 30(2): 188-194, 2011. (35 refs.)

Introduction and Aims. Estimate the prevalence of co-occurring substance use disorder and mental illness in a sample of Australian prisoners, and describe patterns of co-occurring substance use disorder and mental illness. Design and Methods. The sample comprised 1478 individuals (1208 men, 270 women) from two surveys of prisoners' mental health: the 2001 New South Wales Inmate Health Survey, and a consecutive sample of prison receptions. Individuals were drawn from all of the state's 29 prisons. Mental health and substance use disorders were assessed using the Composite International Diagnostic Interview. Results. The overall prevalence of any mental disorder was 42.7% and the prevalence of any substance use disorder was 55.3%. With the exception of alcohol use disorder, women had higher rates than men of mental illness and substance use disorders. The prevalence of a co-occurring mental illness and substance use disorder in the past 12 months was 29% (46% among women vs. 25% among men). The association between cannabis use disorder and psychosis was significant for men only [odds ratio (OR) = 2.4]. Among women there was a significant association between affective disorder and co-occurring alcohol use disorder (OR = 2.4), and stimulant use disorder (OR = 2.4). Discussion and Conclusion. The results highlight the high prevalence of co-occurring substance use and mental illness among prisoners. These results indicate that mental health services in prisons need to be adequately resourced to address co-occurring mental health and substance use problems, and these services need to be appropriately structured to effectively screen, manage and treat this group.

Carlson BE; Shafer MS; Duffee DE. Traumatic histories and stressful life events of incarcerated parents II: Gender and ethnic differences in substance abuse and service needs. Prison Journal 90(4): 494-515, 2010. (50 refs.)

Substance abuse is increasingly common in prison inmates. This article presents findings on substance abuse and service needs of male and female inmate parents in Arizona, with a particular focus on gender and ethnic differences across inmates. A sample of 838 incarcerated fathers and 1,441 mothers completed anonymous questionnaires regarding traumatic and stressful events experienced as children and/or adults, including addiction. Exposure to childhood and adult traumatic events, especially child abuse, was related to self-reported alcohol and drug problems for both males and females. Mothers reported significantly more postrelease service needs than fathers. Implications for practice and policy are discussed.

Chang CC; Huang CL; Chen CY. The impact of implementing smoking bans among incarcerated substance users: A qualitative study. Evaluation & the Health Professions 33(4): 473-479, 2010. (11 refs.)

This article reports a study evaluating the effects of implementing smoking bans among drug-using prisoners in Taiwan. Seventy-seven new entrants were recruited in May 2008. Six focus groups were conducted in a prison-based treatment center, the only prison with a total smoking ban in Taiwan. All the subjects were male and their average age was 37 years. Three general reactions to the ban were identified across all focus groups: (a) unfair/hypocritical policy; (b) being forced to stop smoking; and (c) finding ways to smoke anyway. Future studies should compare the effects of total versus partial smoking bans among drug abusers in prison to better explore policy options.

Chen CY; Wu PN; Su LW; Chou YJ; Lin KM. Three-year mortality and predictors after release: A longitudinal study of the first-time drug offenders in Taiwan. Addiction 105(5): 920-927, 2010. (36 refs.)

Aims: To assess the possible increase in mortality rate and associated socio-demographic and judiciary determinants among first-time drug offenders during the first 3 years after release from correctional facilities. Setting and participants: A total of 22 224 male and 4444 female adults who had served a sentence of at least 1 day in correctional facilities for illegal drug-related offences were identified from the judiciary records of the Ministry of Justice, Taiwan. Design and measurements: The underlying causes of death were defined by the International Classification of Diseases, ninth revision. Findings: All-cause standardized mortality ratios (SMR) were 7 for schedule I (e.g. heroin) and 3 for schedule II (e.g. methamphetamine) drug offenders, respectively; accidents, suicide and circulatory diseases were three leading causes of death. After release, the risk of death among those drug offenders without subsequent incarceration increased gradually until the 9th month. Those who were aged 30 years or older, had an engagement with a higher-ranked schedule substance or who received severe sentences were two to three times more likely to die. Substantial reduction in the risk of death was linked with re-imprisonment. Conclusions: The SMR estimates for external causes were greater than those for disease-related causes in drug offenders, and schedule I drugs-related mortality rate was twice as high as that with schedule II drugs. In transitioning from the correctional setting to the community, the health needs of drug offenders should be addressed by the provision of continuous, adequate medical care tailored to individual background, medical history and drug experience.

Chen G. Gender differences in sense of coherence, perceived social support, and negative emotions among drug-abstinent Israeli inmates. International Journal of offender Therapy and Comparative Criminology 54(6): 937-958, 2010. (85 refs.)

This study examines gender differences in the sense of coherence, perceived social support, and negative emotions among drug-abstinent Israeli inmates. One hundred nineteen inmates have participated in this study (65 men and 54 women). The findings indicate that among female inmates, abstinence of more than a year is related to a decrease in sense of coherence and to an increase in their perceived friend support. In contrast, among male inmates, abstinence of more than a year is related to an increase in sense of coherence and no change at all in their perceived friend support. In addition, hostility level is lower and sense of coherence is higher when the length of abstinence exceeds a year among male inmates. In contrast, among female inmates hostility level is higher when the sense of coherence is lower, without any connection to the length of abstinence. The implications of these findings to treatment intervention are discussed.

Christensen SE. Health promotion and human right protection: Finding a balance for HIV testing policies in US state prisons. Journal of the Association of Nurses in AIDS Care 22(3): 238- 243, 2011. (25 refs.)

In 2008, approximately 1.5 million people were reported to be incarcerated in a prison in the United States (Maruschak, 2009). Previous research has shown that many incarcerated individuals engage in high-risk sexual behaviors and/or have a history of substance abuse (Centers for Disease Control and Prevention [CDC], n.d., para. 2), thereby putting them in a high-risk group for contracting HIV infection. As one would expect, this high-risk behavior has translated into startling statistics. According to the most recent U.S. Bureau of Justice report, the number of HIV-infected individuals living in the United States who are incarcerated is approximately 2.5 times higher than that of the general population (Maruschak, 2009). What is even more alarming is the fact that many of the infected individuals are unaware of their HIV status at the time of incarceration (Desai, Latta, Spaulding, Rich, & Flanigan, 2002). In addition to the high-risk behaviors engaged in by many of those who enter prison before their incarceration, once an individual is established within the prison setting, high-risk behaviors often continue. Many studies have examined the incidence of sexual activity in prisons; however, the results have been far from conclusive. Saum, Surratt, Inciardi, and Bennett (1995) reported a rate of 2%, whereas an earlier survey that was conducted when HIV was a newly emerging and unknown infection estimated a much higher rate of 65% (Wooden & Parker, 1982).

Coviello DM; Cornish JW; Lynch KG; Alterman AI; O'Brien CP. A randomized trial of oral naltrexone for treating opioid-dependent offenders. American Journal on Addictions 19(5): 422-432, 2010. (47 refs.)

Offenders with a history of opioid dependence are a particularly difficult group to treat. A large proportion of offenders typically relapse shortly after release from prison, commit drug-related crimes, and then are arrested and eventually re-incarcerated. Previous research demonstrated that oral naltrexone was effective in reducing opioid use and preventing recidivism among offenders under federal supervision. The 111 opioid-dependent offenders in this study were under various levels of supervision that included county and federal probation/parole, a treatment court, an alternative disposition program, and an intermediate punishment program. Subjects were randomly assigned to receive 6 months of either 300 mg per week of oral naltrexone plus standard psychosocial treatment as usual (n = 56) or standard psychosocial treatment as usual (TAU) without naltrexone (n = 55). While the TAU subjects who remained in treatment used more opioids than the naltrexone subjects who remained, the high dropout rate for both groups made it difficult to assess the effectiveness of naltrexone. The study provides limited support for the use of oral naltrexone for offenders who are not closely monitored by the criminal justice system.

Cropsey KL; Jones-Whaley S; Jackson DO; Hale GJ. Smoking characteristics of community corrections clients. Nicotine & Tobacco Research 12(1): 53-58, 2010. (26 refs.)

While smoking rates are 3-4 times higher among criminal justice populations than in the general population, no studies have previously examined smoking characteristics in a community corrections population. The current study involved descriptive analyses of self-reported survey data from 217 criminal justice supervisees reporting for urine drug screens during a 5-day period at a community corrections facility in the southeastern United States. Most participants were current smokers (72.3%), males (65.9%), and Black (50.2%) who reported smoking three fourths of a pack of cigarettes per day and had been smoking for about 15 years. More than half of smokers reported that they would be interested in receiving cessation assistance if free help were available and of these, 60% were interested in pharmacotherapy. White smokers used more cigarettes per day, were more likely to have already tried medication to help them quit smoking, and were also more interested in pharmacotherapies and less interested in behavioral therapies compared with Black smokers. Female smokers did not differ from male smokers on key smoking characteristics, but male smokers were more likely to have tried or regularly used other tobacco products, such as cigars. Female smokers were significantly more likely to report interest in using a pharmacotherapy agent for future cessation, while male smokers reported more interest in nonpharmacotherapy approaches to quit smoking. Results from this study highlight important differences among smoking groups and may indicate the need to test tailored smoking interventions.

Cropsey KL; McClure LA; Jackson DO; Villalobos GC; Weaver MF; Stitzer ML. The impact of quitting smoking on weight among women prisoners participating in a smoking cessation intervention. American Journal of Public Health 100(8): 1442-1448, 2010. (35 refs.)

Objectives. We examined the impact of smoking cessation on weight change in a population of women prisoners. Methods. Women prisoners (n=360) enrolled in a smoking cessation intervention; 250 received a 10-week group intervention plus transdermal nicotine replacement. Results. Women who quit smoking had significant weight gain at 3- and 6-month follow-ups, with a net difference of 10 pounds between smokers and abstainers at 6 months. By the 12-month follow-up, weight gain decreased among abstainers. Conclusions. We are the first, to our knowledge, to demonstrate weight gain associated with smoking cessation among women prisoners. Smoking cessation interventions that address postcessation weight gain as a preventative measure may be beneficial in improving health and reducing the high prevalence of smoking in prisoner populations.

Farnia M; Ebrahimi B; Shams A; Zamani S. Scaling up methadone maintenance treatment for opioid-dependent prisoners in Iran. International Journal of Drug Policy 21(5): 422-424, 2010. (24 refs.)

Background: Research evidence indicates that prisoners in Iran are at risk of drug-related harm, including acquisition of blood-borne infections. In response, several prevention interventions including methadone maintenance treatment (MMT) have been introduced into prisons in Iran. Methods: This report reviews and presents some important information extracted from published articles, and available documents on HIV sentinel surveillance and provision of MMT inside correctional settings in Iran. Results: Biological surveillance data in 2005 showed that on average about 3% of prisoners in the country tested positive for HIV infection. MTT that constitutes a main component of the Prison Organisation's HIV prevention package is becoming increasingly accessible to opioid-dependent prisoners. Between 2002 and 2008, the number of opioid-dependent prisoners receiving MMT increased steadily from 100 to more than 25000. Conclusion: Experiences in Iran suggest that access to MMT would be helpful for reducing illicit drug injection in a prison setting and can be considered as a major intervention for preventing the transmission of blood-borne infections among prisoners.

Farrell M; Strang J; Stover H. Hepatitis B vaccination in prisons: A much-needed targeted universal intervention. (editorial). Addiction 105(2): 189-190, 2010. (16 refs.)

French MT; Fang H; Fretz R. Economic evaluation of a prerelease substance abuse treatment program for repeat criminal offenders. Journal of Substance Abuse Treatment 38(1): 31-41, 2010. (56 refs.)

Substance use disorders are common conditions among repeat criminal offenders. Without addressing these underlying substance use behaviors, parolees are significantly more likely to recidivate within I year of release. New Jersey is one of the first states to actively pursue substance abuse treatment options for inmates who are in the final stages of their sentences. Given the fiscal realities of taxpayer-supported programs, such initiatives must clearly demonstrate economic benefits for sustainability and growth. This article conducted one of the few comprehensive economic evaluations of prerelease substance abuse treatment to determine whether Community Education Centers' programs in New Jersey generated desirable outcomes, significant economic benefits, and positive net benefits. Relative to a matched comparison group of offenders who did not receive treatment, the intervention group returned an average economic benefit of $4,307 to $6,209 over the I-year postrelease period. These economic benefits are underscored by the fact that the treatment program is housed in a separate facility, with a lower average per them from that of the general innate population. These results provide quantitative economic evidence that prerelease substance abuse treatment programs have the potential to reduce recidivism and save taxpayer dollars without adding to existing prison resources.

Freudenberg N. HIV in the epicenter of the epicenter: HIV and drug use among criminal justice populations in New York City, 1980-2007. Substance Use & Misuse 46(2-3): 159-170, 2011. (85 refs.)

During the 1990s, some of the highest rates of HIV infection in the United States were found among inmates in the New York City jail and prisons systems. This article traces the history of drug use and HIV infection among populations incarcerated in New York City jails and New York State prisons between 1980 and 2007. It describes and analyzes the policies and programs that were initiated to respond to these epidemics and assesses the lessons learned from almost three decades of experience with HIV among populations in New York's correctional facilities.

Gideon L. Drug offenders' perceptions of motivation: The role of motivation in rehabilitation and reintegration. International Journal of Offender Therapy and Comparative Criminology 54(4): 597-610, 2010. (57 refs.)

This article presents a qualitative analysis of participants' perceptions of the importance of motivation in the detoxification and rehabilitation process. As part of an outcome evaluation of recovering drug addicts who participated in a prison-based therapeutic community, 39 participants (a nonrandomized subsample) are interviewed regarding their rehabilitation and reintegration experiences. Although many studies show that participation in prison-based drug treatment programs reduces the likelihood of recidivism, clients in this study suggest that other factors might be equally important, and in particular clients' own motivation to change their lives. This study raises some questions about the true ability of drug treatment programs to treat and rehabilitate drug-abusing offenders, diverting the emphasis from the treatment program itself to the participants' motivation to change. Findings are discussed in regard to prison-based drug treatment programs, after-release impediments encountered by inmates, and inmates' expectations of successful reintegration into the normative noncriminal society.

Gough E; Kempf MC; Graham L; Manzanero M; Hook EW; Bartolucci A; Chamot E. HIV and Hepatitis B and C incidence rates in US correctional populations and high risk groups: A systematic review and meta-analysis. BMC Public Health 10: e-article 777, 2010. (131 refs.)

Background: High Human Immunodeficiency Virus (HIV) prevalence and high risk behaviors have been well documented within United States (US) correctional systems. However, uncertainty remains regarding the extent to which placing people in prison or jail increases their risk of HIV infection, and regarding which inmate populations experience an increased incidence of HIV. Describing these dynamics more clearly is essential to understanding how inmates and former detainees may be a source for further spread of HIV to the general US population. Methods: The authors conducted a systematic review and meta-analysis of studies describing HIV incidence in US correctional facility residents and, for comparison, in high risk groups for HIV infection, such as non-incarcerated intravenous drug users (IVDU) and men who have sex with men (MSM) in the US. HIV incidence rates were further compared with Hepatitis B and Hepatitis C Virus rates in these same populations. Results: Thirty-six predominantly prospective cohort studies were included. Across all infection outcomes, continuously incarcerated inmates and treatment recruited IVDU showed the lowest incidence, while MSM and street recruited IVDU showed the highest. HIV incidence was highest among inmates released and re-incarcerated. Possible sources of heterogeneity identified among HIV studies were risk population and race. Conclusions: Although important literature gaps were found, current evidence suggests that policies and interventions for HIV prevention in correctional populations should prioritize curtailing risk of infection during the post-release period. Future research should evaluate HIV incidence rates in inmate populations, accounting for proportion of high risk sub-groups.

Hakansson A; Bradvik L; Schlyter F; Berglund M. Factors associated with the history of attempted suicide: A criminal justice population examined with the Addiction Severity Index (ASI). Crisis 31(1): 12-21, 2010. (75 refs.)

Background: The present study examines a population of criminal justice clients for suspected substance-related problems. Aims: It aims to identify variables associated with a history of suicide attempt (SA). Method: 6,836 clients were interviewed with the Addiction Severity Index (ASI). Attempters were compared to nonattempters regarding substance use, medical/psychiatric status, family history, and social relationships in a stepwise forward logistic regression. Results: Attempters (21%) were more likely to report binge drinking, intake of illicit drugs, injection of drugs, physical and mental illness, problematic family history, and history of being abused. After logistic regression, SA was independently associated with older age, female gender, binge drinking, delirium tremens, injection, overdose, medical problems, psychiatric symptoms, family history of alcohol or psychiatric problems, and sexual, physical, and emotional abuse. The psychiatric and family/social domains (including being abused) most strongly separated attempters from nonattempters. Conclusions: Family background factors, psychiatric symptoms, severity of substance use, and sexual, physical, and emotional abuse appear to be factors associated with SA among criminal justice clients.

Haller DM; Sebo P; Cerutti B; Bertrand D; Eytan A; Niveau G et al. Primary care services provided to adolescents in detention: A cross-sectional study using ICPC-2. Acta Paediatrica 99(7): 1060-1064, 2010. (29 refs.)

Aim: The aim of this study was to provide a detailed description of the health problems for which primary care services are provided to adolescents in a juvenile detention facility in Europe. Methods: We reviewed the medical files of all detainees in a juvenile detention centre in Switzerland in 2007. The health problems for which primary care services were provided were coded using the International Classification for Primary Care, version 2. Analysis was descriptive, stratified by gender. Results: A total of 314 adolescents (18% female) aged 11-19 years were included. Most (89%) had a health assessment and 195 (62%) had consultations with a primary care physician; 80% of the latter had a physical health problem, and 60% had a mental health problem. The most commonly managed problems were skin (49.7%), respiratory (23.6%), behavioural (22.6%) and gynaecological problems (females: 23.9%); 13% females (no males) had sexually transmitted infections (STI), and 8.7% were pregnant. Substance abuse was common (tobacco: 64.6%, alcohol: 26.2%, cannabis: 31.3%). Conclusion: In addition to health problems known to be more prevalent among young offenders, such as mental health problems and STI, these adolescent detainees required care for a range of common primary care problems. These data should inform the development of comprehensive primary care services in all juvenile detention facilities in Europe.

Hennessey KA; Stein MD; Rosengard C; Rose JS; Clarke JG. Childhood attention deficit hyperactivity disorder, substance use, and adult functioning among incarcerated women. Journal of Attention Disorders 14(3): 273-280, 2010. (44 refs.)

Objective: To estimate prevalence of childhood ADHD among incarcerated women and determine its association with substance use and adult functioning. Method: 192 female participants are recruited from the Department of Corrections in Rhode Island. Childhood ADHD is defined as scoring >46 on the Wender Utah Rating Scale. Results: The findings reveal that 46% met criteria for childhood ADHD. Multivariate analysis reveal that women meeting WURS criteria were more likely to be inconsistently employed (OR = 0.23, 95% CI = 0.10-0.54), recently homeless (OR = 2.09, 95% CI = 1.02-4.30), lifetime incarceration of more than 90 days (OR = 3.00, 95% CI = 1.37-6.57), current smokers (OR = 2.99, 95% CI = 1.24-7.20), and ever used marijuana regularly (OR = 3.47, 95% CI = 1.61-7.45). Conclusion: Among incarcerated women, childhood ADHD is associated with negative social and health behaviors.

Horyniak D; Dietze P; Larance B; Winstock A; Degenhardt L. The prevalence and correlates of buprenorphine inhalation amongst opioid substitution treatment (OST) clients in Australia. International Journal of Drug Policy 22(2): 167- 171, 2011. (21 refs.)

Background: Diversion and injection of buprenorphine (Subutex (R)) and buprenorphine-naloxone (Suboxone (R)) have been well documented. Recent international research and local anecdotal evidence suggest that these medications are also used by other routes of administration, including smoking and snorting. Methods: A cross-sectional sample of 440 opioid substitution treatment (OST) clients was recruited through pharmacies and clinics in three Australian jurisdictions, and interviewed face-to-face using a structured questionnaire. Eligible participants were those aged 18 or over, who had resided in their home state for at least six months, and had been in their current treatment episode for at least 4 weeks. We compared differences in characteristics between clients who had ever inhaled (smoked or snorted) buprenorphine (including buprenorphine-naloxone) and other OST clients. Logistic regression was used to identify correlates of buprenorphine inhalation. Sixty-eight clients who had never used buprenorphine were excluded from analysis. Results: Sixty-five clients (18%) reported having ever inhaled buprenorphine, with Subutex (R) smoking being most common, reported by 50 clients (77%). In multivariable logistic regression, those who reported ever inhaling buprenorphine were significantly more likely to: be aged 35 or younger, have ever been in prison and have ever injected buprenorphine. Clients from New South Wales and Victoria were significantly less likely to have ever inhaled buprenorphine than those from South Australia. Conclusions: Our data indicates that the inhalation of buprenorphine has occurred in a significant minority of Australian OST clients. The motivations, contexts and potential health consequences of buprenorphine use by these atypical routes of administration, particularly in a correctional setting, warrant further exploration.

Iralu J; Duran B; Pearson CR; Jiang YZ; Foley K; Harrison M. Risk factors for HIV disease progression in a rural southwest American Indian population. Public Health Reports 125(Supplement 4): 43-50, 2010. (32 refs.)

Objectives. Risk factors for human immunodeficiency virus (HIV) disease progression among American Indians (AIs) have been poorly characterized. We assessed the impact of socioeconomic factors and use of traditional healing on HIV disease progression in a rural AI community. Methods. From January 2004 through December 2006, we interviewed 36 HIV-positive AIs regarding their socioeconomic status, incarceration, and use of traditional healing. We also collected chart-abstracted adherence and substance-abuse data. Through bivariate analysis, we compared these factors with the CD4-cell counts and log HIV-1 viral loads (VLs). Using a simple regression model, we assessed interactions between the significant associations and the outcome. Results. Participant characteristics included being male (58.3%), being trans-gender (13.9%), having ever been incarcerated (63.9%), having a household income of <$1,000/month (41.7%), being unemployed (61.1%), being diagnosed with alcohol abuse (50.0%), and using traditional medicine (27.8%) in the last 12 months. Higher VLs were associated with recent incarceration (p<0.05), household income of <$1,000/month (p<0.05), and provider-assessed alcohol abuse (p<0.05). We found an interaction between incarceration and alcohol abuse, and alcohol abuse was the factor more strongly associated with higher VLs. A lower CD4 count was associated with recent incarceration (p<0.05) and use of traditional medicine (p<0.05). Conclusions. Alcohol abuse is an important contributor to HIV disease progression, and participants with lower CD4 counts were more likely to use traditional medicine. HIV care among this rural AI population should focus on addressing alcohol abuse and other socioeconomic risk factors and promote collaboration between Western medical and Navajo traditional practitioners.

Jackson DO; Mrug S; Cook F; Beidleman W; Cropsey KL. Factors predicting substance dependence and psychotropic medication use among offenders in community corrections. Addictive Behaviors 36(7): 755-758, 2011. (19 refs.)

Co-occurring substance abuse and mental illness is prevalent among criminal offenders, but little is mown about risk factors for these co-occurring disorders (COD) in community corrections population. To identify risk factors for COD in community corrections offenders, we analyzed assessment data from 5,595 offenders maintained under community supervision at a substance use diversion program. Three groups, offenders with substance use disorders who were taking psychotropic medications (SUPM), offenders with a substance use disorder (SUD) only and controls were compared. Logistic regressions were used to identify predictors of SUPM versus SUD only and controls. SUPM status was predicted by being White or female, having some medical insurance (private or government aided), being unemployed, prior history of abuse/trauma and prior history of suicidal ideation or behavior. Offenders with substance use disorders and co-occurring psychiatric problems face salient social risk that may need to be targeted through integrated services.

Kauffman RM; Ferketich AK; Murray DM; Bellair PE; Wewers ME. Measuring tobacco use in a prison population. Nicotine & Tobacco Research 12(6): 582-588, 2010. (23 refs.)

Widespread tobacco use and high interest in quitting make prisons an ideal environment for smoking cessation interventions; however, little has been done to assist prisoners in their efforts to quit. Valid measurement of tobacco use is a prerequisite to evaluation of cessation programs, yet there has been only one published examination of tobacco use measures among prisoners. Tobacco use interviews were conducted with 200 male prisoners. Three measures of tobacco use, exhaled carbon monoxide (eCO), salivary cotinine measured by enzyme immunoassay (EIA), and salivary cotinine measured by liquid chromatography/tandem mass spectrometry (LC/MS/MS), were evaluated using self-reported tobacco use as the reference. Optimum cutpoints were identified by maximization of the Youden index. Carbon monoxide breath testing, though the poorest performing of the three measures examined, still had excellent discrimination (cutpoint >= 4 ppm, sensitivity = 88.3%, specificity = 94.9%). Cotinine EIA performed better than eCO (cutpoint >= 10 ng/ml, sensitivity = 92.2%, specificity = 94.3%) but poorer than cotinine LC/MS/MS (cutpoint >= 9 ng/ml, sensitivity = 98.6%, specificity = 97.8%). eCO had the poorest performance as a standalone test, though validity of the test may be improved with increased frequency of testing. False-negative results using cotinine EIA limit its utility as a standalone test, however, as part of a two-stage screening process it may reduce the cost of testing. Cotinine LC/MS/MS, while most expensive, was the most accurate standalone measure of prisoners' tobacco use.

Kinner SA. Commentary on Merrall et al. (2010). Understanding mortality and health outcomes for ex-prisoners: First steps on a long road. (editorial). Addiction 105(9): 1555-1556, 2010. (19 refs.)

Kinner SA; Preen DB; Kariminia A; Butler T; Andrews JY; Stoove M et al. Counting the cost: Estimating the number of deaths among recently released prisoners in Australia. Medical Journal of Australia 195(2): 64-68, 2011. (40 refs.)

Objective: To estimate the number of deaths among people released from prison in Australia in the 2007-08 financial year, within 4 weeks and 1 year of release. Design, participants and setting: Application of crude mortality rates for ex-prisoners (obtained from two independent, state-based record-linkage studies [New South Wales and Western Australia]) to a national estimate of the number and'characteristics of people released from prison in 2007-08. Main outcome measures: Estimated number of deaths among adults, released from Australian prisons in 2007-08, within 4 weeks and 1 year of release, classified by age, sex, Indigenous status and cause of death. Results: It was estimated that among people released from prison in 2007-08, between 449 (95% Cl, 380-527) and 472 (95% Cl, 438-507) died within 1 year of release. Of these, between 68(95% Cl, 56-82) and 138(95% Cl, 101-183) died within 4 weeks of release. Most of these deaths were not drug-related: Conclusion: The estimated annual number of deaths among recently released prisoners in Australia is considerably greater than the annual number of deaths in custody, highlighting the extreme vulnerability of this population on return to the community. There is an urgent need to establish a national system for routine monitoring of ex-prisoner mortality and to continue the duty of care beyond the prison walls.

Kjelsberg E; Laake P. Is the high mortality risk in sentenced offenders independent of previous imprisonment? European Journal of Epidemiology 25(4): 237-243, 2010. (25 refs.)

The mortality in prisoners is high. However, our knowledge about the mortality in convicted offenders, irrespective of incarceration history, is limited. Our aim was to investigate possible predictors for over-all and cause specific mortality in a nation-wide study of convicted offenders with and without previous imprisonment. This case-control study drew random samples of deceased and living offenders (N = 1,112) from four complete cohorts of convicted offenders, two male (born 1967 and 1977, respectively), and two female (born 1967-70 and 1977-80, respectively). All criminal records were systematized and information about date and cause of death was collected on those deceased. Multivariable analyses demonstrated that age at first court conviction (OR = 0.88, 95% CI = 0.84-0.93), drug related crimes (OR = 1.99, 95% CI = 1.23-3.22), and crime diversity (1.51, 95% CI = 1.07-2.13) were significant predictors of premature death in males. In females, age at first court conviction (OR = 0.92, 95% CI = 0.88-0.97), drug related crimes (OR = 2.24, 95% CI = 1.37-3.69) and belonging to the oldest cohort (OR = 2.10, 95% CI = 1.35-3.26) were significant predictors of premature death. Age at first court conviction remained a significant predictor for death in all cause specific multivariable mortality analyses. In addition, having committed drug related crimes and high crime diversity were strong predictors for substance related deaths. Males did more often die in accidents or commit suicide. Somatic deaths were most often encountered in the oldest cohort. Incarceration did not remain a significant predictor for premature death in any of the multivariable analyses. Measures intended to prevent premature death in convicted offenders should target wider populations than hitherto acknowledged.

Ko NY; Yen CF; Chen CH; Lee HC; Ko WC; Lin HH et al. Applying the transtheoretical model to the readiness to change blood-borne virus transmission behaviors among drug-dependent inmates. American Journal on Addictions 19(5): 433-439, 2010. (49 refs.)

Our study set out to assess readiness to change blood-borne virus transmission behaviors using the Transtheoretical Model among inmates in a court-ordered detention center. A cross-sectional descriptive study was conducted in southern Taiwan. All men convicted of illicit drug use and sentenced to undergo the 6-month detoxification program were invited to participate. Half of the 172 participating inmates described themselves as being in the contemplation stage of change. The length of residency in the detoxification program was not associated with self-reported readiness to change, chi 2 = 6.53, p = .16. Inmates in the precontemplation stage had increased rates for high-risk behaviors than those in the contemplation and action stages (p < .001). The efficacy of forced-abstinence detention programs on readiness to change risky behaviors needs to be reevaluated.

Kolind T; Frank VA; Dahl H. Drug treatment or alleviating the negative consequences of imprisonment? A critical view of prison-based drug treatment in Denmark. International Journal of Drug Policy 21(1): 43-48, 2010. (57 refs.)

Background: The availability of prison-based drug treatment has increased markedly throughout Europe over the last 15 years in terms of both volume and programme diversity. However, prison drug treatment faces problems and challenges because of the tension between ideologies of rehabilitation and punishment. Methods: This article reports on a study of four cannabis treatment programmes and four psychosocial drug treatment programmes in four Danish prisons during 2007. The data include the transcripts of 22 semi-structured qualitative interviews with counsellors and prison employees, prison statistics, and information about Danish laws and regulations. Results: These treatment programmes reflect the 'treatment guarantee' in Danish prisons. However, they are simultaneously embedded in a new policy of zero tolerance and intensified disciplinary sanctions. This ambivalence is reflected in the experiences of treatment counsellors: reluctantly, they feel associated with the prison institution in the eyes of the prisoners; they experience severe opposition from prison officers; and the official goals of the programmes, such as making clients drug free and preparing them for a life without crime, are replaced by more pragmatic aims such as alleviating the pain of imprisonment felt by programme clients. Conclusion: The article concludes that at a time when prison-based drug treatment is growing, it is crucial that we thoroughly research and critically discuss its content and the restrictions facing such treatment programmes. One way of doing this is through research with counsellors involved in delivering drug treatment services. By so doing, the programmes can become more pragmatic and focused, and alternatives to prison-based drug treatment can be seriously considered.

Larney S. Does opioid substitution treatment in prisons reduce injecting-related HIV risk behaviours? A systematic review. (review). Addiction 105(2): 216-223, 2010. (53 refs.)

Objectives: To review systematically the evidence on opioid substitution treatment (OST) in prisons in reducing injecting-related human immunodeficiency virus (HIV) risk behaviours. Methods: Systematic review in accordance with guidelines of the Cochrane Collaboration. Electronic databases were searched to identify studies of prison-based opioid substitution treatment programmes that included assessment of effects of prison OST on injecting drug use, sharing of needles and syringes and HIV incidence. Published data were used to calculate risk ratios for outcomes of interest. Risk ratios were not pooled due to the low number of studies and differences in study designs. Results: Five studies were included in the review. Poor follow-up rates were reported in two studies, and representativeness of the sample was uncertain in the remaining three studies. Compared to inmates in control conditions, for treated inmates the risk of injecting drug use was reduced by 55-75% and risk of needle and syringe sharing was reduced by 47-73%. No study reported a direct effect of prison OST on HIV incidence. Conclusions: There may be a role for OST in preventing HIV transmission in prisons, but methodologically rigorous research addressing this question specifically is required. OST should be implemented in prisons as part of comprehensive HIV prevention programmes that also provide condoms and sterile injecting and tattooing equipment.

Lintonen TP; Vartiainen H; Aarnio J; Hakamaki S; Viitanen P; Wuolijoki T et al. Drug use among prisoners: By any definition, it's a big problem. Substance Use & Misuse 46(4): 440-451, 2011. (44 refs.)

According to several studies, the prevalence of drug use among prisoners is manyfold compared to general population. However, comparisons across studies are hampered by the use of a variety of mutually noncomparable methodologies. We report substance use among Finnish prisoners using three methods and analyze these differences. The material consisted of 610 Finnish prisoners in 2006 and represents all Finnish prisoners. The subjects participated in a comprehensive field study including a standardized psychiatric interview (SCID-I). Alcohol abuse/dependence was diagnosed in 68%% (SCID-I) and 72%% (ICD-10) among men and 70%% (both SCID-I and ICD-10) among women. Drug abuse/dependence was diagnosed in 62%% (SCID-I) and 69%% (ICD-10) among men and 64%% (SCID-I) and 70%% (ICD-10) among women prisoners. Interview data revealed that the majority had at least tried most substances. Both alcohol and drug abuse/dependence were vastly more common among Finnish prisoners than reported elsewhere. The DSM-IV-based SCID-I produced slightly lower prevalence estimates than an ICD-10 clinical examination, but overall SCID/ICD agreement was very good. It seems that physicians use information other than that captured by standardized structured clinical interview when placing a diagnosis. Nonclinical interview-based prevalence figures may overestimate harmful use of drugs unless known risk patterns of use (e.g., intravenous use) are specifically addressed.

Lobmaier PP; Kunoe N; Gossop M; Katevoll T; Waal H. Naltrexone implants compared to methadone: Outcomes six months after prison release. European Addiction Research 16(3): 139-145, 2010. (62 refs.)

Background: After prison release, offenders with heroin use problems are at high risk of relapse and overdose death. There is a particular need for treatments that can be initiated in prison and continued after release into the community. Methadone maintenance treatment has been shown to reduce heroin use, criminality and mortality. Naltrexone implant treatment has not previously been evaluated in prison settings. Methods: This study compares the effects of naltrexone implants and methadone treatment on heroin and other illicit drug use, and criminality among heroin-dependent inmates after release from prison. Results: Forty-six volunteers were randomly allocated to naltrexone implants or methadone before release. Intention-to-treat analyses showed reductions in both groups in frequency of use of heroin and benzodiazepines, as well as criminality, 6 months after prison release. Conclusions: Naltrexone implants may be a valuable treatment option in prison settings.

Lobmaier PP; Kunoe N; Waal H. Treatment research in prison: Problems and solutions in a randomized trial. Addiction Research & Theory 18(1): 1-13, 2010. (60 refs.)

Opioid-dependent individuals are frequently incarcerated and relapse rates following their release are high. Evidence of the effectiveness of prison-based treatments and community aftercare is limited. We report the preliminary findings of a randomized controlled trial that encountered specific challenges inherent in prison research. Naltrexone implants were compared with methadone maintenance treatment among pre-release inmates. Naltrexone implants have not previously been evaluated in prison settings. Approximately 41% of eligible inmates volunteered to participate; 27 of the total 46 participants commenced treatment according to the protocol. Although most inmates intended to remain abstinent from heroin after their release, the relapse rates among individuals who had not commenced treatment were high. Naltrexone implants were regarded as a valuable treatment option. During the study, several problems were encountered regarding enrollment, treatment initiation and aftercare. These findings have important implications for future prison research. Random allocation to the fixed interventions was inefficient in limiting the risk of selection bias. Alternative approaches should be considered, such as sequential multiple assignment randomized trials.

Long CG; Hall L; Dolley O; Hollin CR. Substance-abusing women in a medium secure psychiatric setting: characteristics and psychometric test performance. Journal of Substance Use 16(3): 230- 242, 2011. (64 refs.)

Aims: The aim is to describe the characteristics and psychometric test performance of women admitted to a medium secure hospital. Method: Consecutive admission was classified into risk-relevant categories using case note data. Responses to psychometric measures of dependence, substance-related problems, self-efficacy, motivation for change, craving and coping were assessed. Results: Forty-four out of 55 consecutive admissions had a risk-relevant pattern of substance use before admission. Analysis of psychometric test performance produced two groups of patients differentiated according to self-efficacy, craving and belief in the benefits of change. Conclusions: Although further work needs to be done in assessing the applicability of specific psychometrics to specialist populations, findings reinforce the importance of matching treatment interventions to stages of readiness to change.

Lopez V; Kopak A; Robillard A; Gillmore MR; Holliday RC; Braithwaite RL. Pathways to sexual risk taking among female adolescent detainees. Journal of Youth and Adolescence 40(8): 945-957, 2011. (63 refs.)

Sexual risk taking among female delinquents represents a significant public health problem. Research is needed to understand the pathways leading to sexual risk taking among this population. This study sought to address this issue by identifying and testing two pathways from child maltreatment to non-condom use among 329 White and 484 African American female adolescent detainees: a relational pathway and a substance use coping pathway. The relational pathway indicated that child maltreatment would be related to non-condom use via depressive self-concept and condom use self-efficacy. The substance use coping pathway suggested that depressive self-concept and alcohol-based expectancies for sexual enhancement would mediate the relationship between child maltreatment and non-condom use. As hypothesized, the relational pathway variables were associated with one another in the expected directions; however, evidence of mediation was not found. Support for mediation was found for the substance use coping pathway. Exploratory across group comparison analysis indicated that the relational pathway was significant for White girls whereas the substance use coping pathway was significant for African American girls. Limitations and implications for future research are discussed.

Magyar MS; Edens JF; Lilienfeld SO; Douglas KS; Poythress NG. Examining the relationship among substance abuse, negative emotionality and impulsivity across subtypes of antisocial and psychopathic substance abusers. journal of criminal justice 39(3, special issueI): 232-237, 2011. (47 refs.)

Growing evidence suggests that individuals with Antisocial Personality Disorder (ASPD) can be categorized into theoretically meaningful subtypes. This study builds on earlier cluster-analytic research (Poythress et al., 2010) that identified four subtypes of ASPD in a large sample of prison inmates and offenders ordered into mandatory substance abuse treatment. These four subtypes ( primary, secondary, and "fearful" psychopathic and non-psychopathic ASPD) differed in theoretically important ways on various criterion measures. Of those participants in substance abuse treatment (N = 571), we compare the four clusters, as well as non-ASPD substance abusers, in terms of (a) the severity of their self-reported alcohol and drug problems and (b) whether the severity of their substance abuse is predicted by similar etiologically important correlates (i.e., negative emotionality, impulsivity). There were modest subgroup. differences in abuse, although as expected secondary psychopaths reported more severe misuse than primary psychopaths. Associations between impulsivity and negative emotionality and drug use for the total sample were in the expected direction, though relatively modest in magnitude. Unexpectedly, these associations were weaker among psychopathic subtypes relative to the non-psychopathic subgroups. These findings suggest that the etiology of drug use may differ across subgroups of chronically antisocial individuals.

McMurran M; Riemsma R; Manning N; Misso K; Kleijnen J. Interventions for alcohol-related offending by women: A systematic review. (review). Clinical Psychology Review 31(6): 909-922, 2011. (56 refs.)

Treatment programmes specifically for women offenders are under-developed. A systematic review of studies that could inform interventions for alcohol-related offending by women is reported. Three questions were addressed: 1) What is the most up to date knowledge of 'what works' with females who commit alcohol-related offences? 2) What are the identifiable risk-needs factors for non-alcohol dependent women who commit offences involving alcohol misuse? 3) Are there differences between male and female alcohol-related offending? Four studies addressed the effectiveness of psychosocial interventions; three addressed identifiable risk-needs; and 19 addressed differences between male and female offenders' alcohol-related offending. Heterogeneity of these studies precluded meta-analyses, and so a narrative synthesis method was used. There is insufficient evidence to answer the question of what treatment works with women who commit alcohol-related offences. Drunk-driving is most widely studied, and women offenders appear to have more psychosocial problems than men. Alcohol increases the likelihood of violence for both men and women, and, while the mechanisms whereby alcohol increases the likelihood of violence are likely the same in men and women, the effect may be moderated by gender-associated issues. Again, women offenders appear to have more psychosocial problems than men. Implications for developing interventions are discussed.

Merrall ELC; Kariminia A; Binswanger IA; Hobbs MS; Farrell M; Marsden J et al. Meta-analysis of drug-related deaths soon after release from prison. (review). Addiction 105(9): 1545-1554, 2010. (38 refs.)

Aims: The transition from prison back into the community is particularly hazardous for drug-using offenders whose tolerance for heroin has been reduced by imprisonment. Studies have indicated an increased risk of drug-related death soon after release from prison, particularly in the first 2 weeks. For precise, up-to-date understanding of these risks, a meta-analysis was conducted on the risk of drug-related death in weeks 1 + 2 and 3 + 4 compared with later 2-week periods in the first 12 weeks after release from prison. Methods: English-language studies were identified that followed up adult prisoners for mortality from time of index release for at least 12 weeks. Six studies from six prison systems met the inclusion criteria and relevant data were extracted independently. Results: These studies contributed a total of 69,093 person-years and 1033 deaths in the first 12 weeks after release, of which 612 were drug-related. A three- to eightfold increased risk of drug-related death was found when comparing weeks 1 + 2 with weeks 3-12, with notable heterogeneity between countries: United Kingdom, 7.5 (95% CI: 5.7-9.9); Australia, 4.0 (95% CI: 3.4-4.8); Washington State, USA, 8.4 (95% CI: 5.0-14.2) and New Mexico State, USA, 3.1 (95% CI: 1.3-7.1). Comparing weeks 3 + 4 with weeks 5-12, the pooled relative risk was: 1.7 (95% CI: 1.3-2.2). Conclusions: These findings confirm that there is an increased risk of drug-related death during the first 2 weeks after release from prison and that the risk remains elevated up to at least the fourth week.

Messina N; Grella CE; Cartier J; Torres S. A randomized experimental study of gender-responsive substance abuse treatment for women in prison. Journal of Substance Abuse Treatment 38(2): 97-107, 2010. (50 refs.)

This experimental pilot study compared postrelease outcomes for 115 women who participated in prison-based substance abuse treatment. Women were randomized to a gender-responsive treatment (GRT) program using manualized curricula (Helping Women Recover and Beyond Trauma) or a standard prison-based therapeutic community. Data were collected from the participants at prison program entry and 6 and 12 months after release. Bivariate and multivariate analyses were conducted. Results indicate that both groups improved in psychological well-being; however, GRT participants had greater reductions in drug use, were more likely to remain in residential aftercare longer (2.6 vs. 1.8 months, p < .05), and were less likely to have been reincarcerated within 12 months after parole (31% vs. 45%, respectively; a 67% reduction in odds for the experimental group, p < .05). Findings show the beneficial effects of treatment components oriented toward women's needs and support the integration of GRT in prison programs for women.

Miller JM; Miller HV. Considering the effectiveness of drug treatment behind bars: Findings from the South Carolina RSAT Evaluation. Justice Quarterly 28(1): 70-86, 2011. (39 refs.)

Through funding from the national Residential Substance Abuse Treatment Program, the South Carolina Department of Corrections implemented the Correctional Recovery Academy in the Turbeville Medium Security Institution to treat drug-dependent offenders. The program features a cognitive-behavioral change modality delivered in a modified therapeutic community to first time, non-violent, drug-dependent, youthful male offenders. A quasi-experimental design was employed to specify impact as indicated by recidivism, relapse, and parole revocation. While analyses revealed no statistically significant difference between treatment and control group participants on these outcome measures, implications regarding the efficacy of the treatment modality are ambiguous as implementation failure masked determination of program effects. Drug testing frequency after release, however, was found to be a significant factor precluding failure, contrary to the conventional view that increased testing identifies greater use.

Moller LF; Matic S; van den Bergh BJ; Moloney K; Hayton P; Gatherer A. Acute drug-related mortality of people recently released from prisons. Public Health 124(11): 637-639, 2010. (5 refs.)

The rate of acute drug-related mortality, or overdose deaths, among prisoners in the immediate post-release period is unacceptably high. Such incidents result from many factors, including decreased tolerance after a period of relative abstinence during imprisonment and the concurrent use of multiple drugs which, with every additional illicit drug consumed in combination with opioids, nearly doubles the risk of death from opioids. Other important factors are the lack of pre-release counselling, post-release follow-up and failure to identify those at risk. Substance dependence is a chronic disorder with high relapse rates and often requires long-term continuous treatment. The deaths are preventable and a number of interventions including opioid substitution treatment reduces the risk of overdose among opioid users after release.

Nijhawan AE; Salloway R; Nunn AS; Poshkus M; Clarke JG. Preventive healthcare for underserved women: Results of a prison survey. Journal of Women's Health 19(1): 17-22, 2010. (24 refs.)

Objectives: We sought to determine the preventive healthcare needs of incarcerated women in the following areas: cervical cancer and breast cancer screening, sexually transmitted infection (STI) screening, hepatitis screening and vaccination, and smoking cessation. Methods: A cross-sectional interview survey of a random sample of 100 incarcerated women at the Rhode Island Department of Corrections (RIDOC) in Cranston, Rhode Island, was conducted. Results: Participants were 62% white, 11% African American, 13% Hispanic, and 14% of mixed race. Mean age was 35 years. Of those surveyed, 67% reported having had a Papanicolou (Pap) smear in the past year, the strongest predictor of which was having received a Pap smear while incarcerated. Of the inmates >40 years old, 58% reported having had a mammogram in the past 2 years. The majority (88%) reported testing for STIs in the past, and 39% desired testing during their current incarceration. As for hepatitis C, 70% had been tested previously and 37% of those reported testing positive. Hispanics were less likely than whites to have been tested for hepatitis C (OR 0.1). Over half (54%) of the women who reported testing positive for hepatitis C also reported having completed the hepatitis A and B vaccine series. Among smokers (80% of all survey participants), 61% were interested in quitting. Those who had been incarcerated multiple times were less likely to want to quit smoking (OR 0.1). Conclusions: Incarceration presents a unique opportunity to provide preventive healthcare to high-risk, medically underserved women.

Odegard E; Amundsen EJ; Kielland KB; Kristoffersen R. The contribution of imprisonment and release to fatal overdose among a cohort of Norwegian drug abusers. Addiction Research & Theory 18(1): 51-58, 2010. (12 refs.)

This study was designed to supplement knowledge of three aspects of fatal overdose and imprisonment. Our aims were to investigate whether drug abusers arc subject to a higher-than-usual risk of fatal overdose immediately after release from prison, to assess the length of the high-risk period and to investigate the net effect of imprisonment - the pooled effect of both imprisonment and release - on overdose death. The analyses were conducted on the basis of data from a cohort of 338 imprisoned Norwegian drug abusers. Cox regression models were applied including the explanatory time-dependent covariate for imprisonment and the post-release period. We find that the risk of death from overdose during the 2 weeks after release from prison was 10 times higher, and during the 3-week period six times higher, than during other time spent outside prison. An elevated risk was also indicated for the fourth week. Taking into account findings in the literature, the period of elevated risk should be considered to last up to 4 weeks. When the risk period analysed includes both time spent in prison and the post-release period, the risk of fatal overdose is not found to differ from other periods outside prison.

Papadodima SA; Sakelliadis EI; Sergentanis TN; Giotakos O; Sergentanis IN; Spiliopoulou CA. Smoking in prison: A hierarchical approach at the crossroad of personality and childhood events. European Journal of Public Health 20(4): 470-474, 2010. (37 refs.)

Background: Smoking has long been considered part of prison culture and studies have shown a high prevalence of smoking within correctional facilities. Methods: A self-administered, anonymous questionnaire was administered to 173 male prisoners in the Chalkida prison, Greece. To assess current smoking habits, a hierarchical approach was adopted. The underlying conceptual framework included: (i) demographic parameters, (ii) adverse childhood history (physical abuse, parental neglect, parental divorce, alcoholism in the family, sexual abuse and psychiatric condition in the family), (iii) education, personality traits, such as impulsivity (Barrat Impulsivity Scale-11), aggression (BussPerry Aggression Questionnaire and Lifetime History of Aggression), and personal history of mental disease, (iv) prison-related features (duration of sentence, sentence already served and change in smoking habits during imprisonment). Results: Eighty percentage of the study sample reported current smoking; 43.4% disclosed deterioration in their smoking habits during imprisonment. The hierarchical approach pointed to: (i) adverse childhood events, i. e. alcoholism in the family [ adjusted odds ratio (OR) = 6.29, 95% confidence interval (CI): 2.44-16.25], psychiatric condition in the family (adjusted OR= 4.10, 95% CI: 1.31-12.84), physical abuse (adjusted OR = 2.90, 95% CI: 1.30-6.46), parental neglect (adjusted OR = 2.66, 95% CI: 1.19-5.95), parental divorce (adjusted OR= 2.14, 95% CI: 1.00-4.56), and (ii) impulsivity (adjusted OR= 2.26, 95% CI: 1.12-4.58) as independent risk factors. In addition, deterioration of smoking habits during imprisonment exerted an effect of borderline significance (adjusted OR = 2.02, 95% CI: 0.97-4.24). Conclusions: Heavy smoking in prison principally integrates two components: unfavourable childhood and current personality traits (impulsivity).

Poehlmann J; Dallaire D; Loper AB; Shear LD. Children's contact with their incarcerated parents research findings and recommendations. American Psychologist 65(6): 575-598, 2010. (94 refs.)

Approximately 1.7 million children have parents who are incarcerated in prison in the United States, and possibly millions of additional children have a parent incarcerated in jail. Many affected children experience increased risk for developing behavior problems, academic failure, and substance abuse. For a growing number of children, incarcerated parents, caregivers, and professionals, parent child contact during the imprisonment period is a key issue. In this article, we present a conceptual model to provide a framework within which to interpret findings about parent child contact when parents are incarcerated. We then summarize recent research examining parent child contact in context. On the basis of the research reviewed, we present initial recommendations for children's contact with incarcerated parents and also suggest areas for future intervention and research with this vulnerable population.

Ragan DT; Beaver KM. Chronic offenders: A life-course analysis of marijuana users. Youth & Society 42(2): 174-198, 2010. (93 refs.)

Marijuana is the most widely used illegal drug, and the use of marijuana has been linked to a wide array of maladaptive outcomes. As a result, there is great interest in identifying the factors that are associated with the use of marijuana and with desistance from marijuana. The current study employed a life-course framework to examine the factors associated with early onset of marijuana use, with the use of marijuana during adolescence, and with desistance from marijuana use in young adulthood. Analysis of data drawn from the National Longitudinal Study of Adolescent Health revealed that low self-control and delinquent peers were predictive of marijuana use, an early onset of marijuana use, and desistance from marijuana use. In addition, the models revealed that marriage increased the odds of desistance from marijuana use, even after controlling for delinquent peers, low self-control, and selection effects. The implications of our findings are noted.

Roettger ME; Swisher RR; Kuhl DC; Chavez J. Paternal incarceration and trajectories of marijuana and other illegal drug use from adolescence into young adulthood: Evidence from longitudinal panels of males and females in the United States. Addiction 106(1): 121-132, 2011. (52 refs.)

Aims: One-eighth of young adults in the United States report that their biological father has ever been incarcerated (FEI). This study is the first to examine associations between FEI and trajectories of substance use during the transition from adolescence into young adulthood for the US population. Design: Using multi-level modeling techniques, trajectories of marijuana and other illegal drug use are examined, with FEI as the primary independent variable. Setting: Data are from the first three waves of the National Longitudinal Study of Adolescent Health, a nationally representative sample of US adolescents beginning in 1995. Participants: Panels of 7157 males and 7997 females followed from adolescence (7th-12th grades) into early adulthood (ages 18-27 years). Measurements: Dependent variables included an ordinal measure of marijuana frequency of use in last thirty days, and a dichotomous measure for whether respondent had any use in the last thirty days of illegal drugs such crystal meth, cocaine, heroin, hallucinogens, PCP, LSD, speed, and ecstasy. Findings: Among males and females, respectively, FEI is associated with an increased frequency of marijuana use, and increased odds of any other illegal drug use. Interactions between FEI and age further reveal that FEI is associated with an accentuated trajectory (i.e. a steeper slope) of marijuana use, and an elevated risk (i.e. higher mean level) of other illegal drug use. Conclusions: Analysis provides some of the first evidence that paternal incarceration is significantly associated with drug use among U.S. males and females, even after controlling for a number of family background, parental, and individual characteristics.

Schonbrun YC; Strong DR; Anderson BJ; Caviness CM; Brown RA; Stein MD. Alcoholics Anonymous and hazardously drinking women returning to the community after incarceration: Predictors of attendance and outcome. Alcoholism: Clinical and Experimental Research 35(3): 532-539, 2011. (50 refs.)

Background: The number of women incarcerated within the United States has risen dramatically in recent decades, and high rates of alcohol problems are evident among this population. Although little is known about the patterns of help utilization and efficacy for alcohol problems, preliminary evidence suggests that Alcoholics Anonymous (AA) is a widely available resource for this population. Methods: Data were collected as part of a study evaluating the effect of a brief intervention to reduce alcohol use among hazardously drinking (i.e., score of 8 or above on the Alcohol Use Disorders Identification Test or 4 or more drinks at a time on at least 3 days in prior 3 months) incarcerated women. The current study characterized demographic, clinical, and previous AA attendance variables associated with AA attendance in the 6 months following incarceration. Associations between frequency of AA attendance and drinking outcomes following incarceration were also evaluated. Results: Among the 224 participants who provided data about AA attendance, 54% reported some AA attendance during the follow-up assessment period. AA attendance in the year prior to study entry (OR = 4.02; 95% CI: 3.32 to 4.71) and greater baseline consequences of alcohol use (OR = 2.09; 95% CI: 1.73 to 2.44) were associated with increased odds of higher frequency of AA attendance following incarceration. Weekly or greater AA attendance was associated with reductions in negative drinking consequences (B = -0.45; p < 0.01) and frequency of drinking days (B = -0.28; p < 0.01) following incarceration. Conclusions: Findings from this study suggest that AA is frequently utilized by hazardously drinking women following incarceration. Alcohol outcomes may be enhanced by AA attendance at a weekly or greater frequency is associated with better alcohol outcomes relative to lower levels of AA attendance. Evaluation of clinical guidelines for prescribing AA attendance for incarcerated women remains a task for future research.

Sherman SG; Sutcliffe CG; Srirojn B; German D; Thomson N; Aramrattana A et al. Predictors and consequences of incarceration among a sample of young Thai methamphetamine users. Drug and Alcohol Review 29(4): 399-405, 2010. (23 refs.)

Introduction and Aims. Our study examined the incidence of arrest and incarceration, investigated predictors of incarceration and explored the persistence of depression, alcohol use and drug use after incarceration among young methamphetamine users from Thailand. Design and Methods. Participants were aged 18-25 years old and were a part of a 12 month randomised social network trial that aimed to reduce sexual risk and methamphetamine use. Estimates of the incidence of arrest and incarceration over 12 months were calculated. A matched case-control study (n = 73 cases; n = 223 controls) was performed to examine incarceration risk factors using conditional logistic regression. Persistence of drug-risk behaviours were explored after incarceration. Results. Study participants (n = 950) were 72% male, with a median age of 19 years and a median of 9 years of schooling. Frequent drug and alcohol use were reported at baseline. In total, 35% of the sample reported ever having been arrested and 22% reported ever having been incarcerated at baseline. During the 12 month follow up, 16% of the sample was arrested. In univariate analyses, risk factors for incarceration included frequent drug and alcohol use, being less educated, and a history of arrest and incarceration. A high prevalence of drug and alcohol use and involvement in the drug economy persisted after arrest. Discussion and Conclusions. The study indicates a high prevalence of recidivism among this young sample, with continued involvement in drug-risk behaviours after incarceration. Appropriate interventions are needed to address root causes of arrest, largely related to substance use.

Springer SA. Commentary on Larney (2010): A call to action-opioid substitution therapy as a conduit to routine care and primary prevention of HIV transmission among opioid-dependent prisoners. (commentary). Addiction 105(2): 224-225, 2010. (18 refs.)

Springer SA. Improving healthcare for incarcerated women. (editorial). Journal of Women's Health 19(1): 13-15, 2010. (40 refs.)

Springer SA; Azar MM; Altice FL. HIV, alcohol dependence, and the criminal justice system: A review and call for evidence-based treatment for released prisoners. (review). American Journal of Drug and Alcohol Abuse 37(1): 12-21, 2011. (102 refs.)

Background: People with both HIV and alcohol use disorders (AUDs) are disproportionately concentrated within the U. S. criminal justice system; approximately one-quarter of all people with HIV cycle through the system each year. HIV-infected prisoners with AUDs face many obstacles as they transition back to the community. Specifically, although they have impressive HIV treatment outcomes during the period of incarceration while they are free from alcohol. Upon release, however, they face inordinate challenges including relapse to alcohol use resulting in significant morbidity and mortality. Objective: To review the existing literature regarding the relationship of HIV and treatment for AUDs within the criminal justice system in an effort to determine "best practices" that might effectively result in improved treatment of HIV and AUDs for released prisoners. Methods: PubMed, PsychInfo and Medline were queried for articles published in English from 1990 to 2009. Selected references from primary articles were also examined. Results: Randomized controlled trials affirm the role of pharmacotherapy using naltrexone (NTX) as the therapeutic option conferring the best treatment outcome for AUDs in community settings. Absent from these trials were inclusion of released prisoners or HIV-infected individuals. Relapse to alcohol abuse among HIV-infected prisoners is associated with reduced retention in care, poor adherence to antiretroviral therapy with consequential poor HIV treatment outcomes and higher levels of HIV risk behaviors. Conclusions and Scientific Significance: Untreated alcohol dependence, particularly for released HIV-infected prisoners, has negative consequences both for the individual and society and requires a concentrated effort and rethinking of our existing approaches for this vulnerable population.

Springer SA; Chen S; Altice FL. Improved HIV and substance abuse treatment outcomes for released HIV-infected prisoners: The impact of buprenorphine treatment. Journal of Urban Health. Bulletin Of the New York Academy Of Medicine 87(4): 592-602, 2010. (45 refs.)

HIV-infected prisoners fare poorly after release. Though rarely available, opioid agonist therapy (OAT) may be one way to improve HIV and substance abuse treatment outcomes after release. Of the 69 HIV-infected prisoners enrolled in a randomized controlled trial of directly administered antiretroviral therapy, 48 (70%) met DSM-IV criteria for opioid dependence. Of these, 30 (62.5%) selected OAT, either as methadone (N = 7, 14.5%) or buprenorphine/naloxone (BPN/NLX; N = 23, 48.0%). Twelve-week HIV and substance abuse treatment outcomes are reported as a sub-study for those selecting BPN/NLX. Retention was high: 21 (91%) completed BPN/NLX induction and 17 (74%) remained on BPN/NLX after 12 weeks. Compared with baseline, the proportion with a non-detectable viral load (61% vs 63% log(10) copies/mL) and mean CD4 count (367 vs 344 cells/mL) was unchanged at 12 weeks. Opiate-negative urine testing remained 83% for the 21 who completed induction. Using means from 10-point Likert scales, opioid craving was reduced from 6.0 to 1.8 within 3 days of BPN/NLX induction and satisfaction remained high at 9.5 throughout the 12 weeks. Adverse events were few and mild. BPN/NLX therapy was acceptable, safe and effective for both HIV and opioid treatment outcomes among released HIV-infected prisoners. Future randomized controlled trials are needed to affirm its benefit in this highly vulnerable population.

Staton-Tindall M; Frisman L; Lin HJ; Leukefeld C; Oser C; Havens JR et al. Relationship influence and health risk behavior among re-entering women offenders. Womens Health Issues 21(3): 230- 238, 2011. (41 refs.)

Background: Studies have shown that relationships can influence health risk behaviors such as drug use among women offenders. This study takes an exploratory look at the positive and negative influences of parents, peers, and partners for women prisoners to better understand their health risk behavior for HIV, including risky sex and drug use. Methods: The current study includes secondary analysis of cross-sectional data from women offenders enrolled in three protocols of the National Institute on Drug Abuse-funded Criminal Justice Drug Abuse Treatment Studies cooperative agreement. Baseline interviews were completed with incarcerated women preparing for community re-entry and focused on behaviors during the 6 months before incarceration. Relationship influences during the 6 months before prison were categorized as "positive" or "negative" for the women offenders. Findings: Multivariate regression models suggested that positive parental influence was significantly associated with reduced HIV risk and reduced drug use in the 6 months before incarceration. However, negative peer influence increased drug use including both risky needle behavior and any drug use in the 6 months before incarceration. Conclusion: These data suggest that, although relationships are generally important to women, particular types of relationship influences may be related to risky behavior. Implications for targeting re-entry interventions for women offenders are discussed.

Stein LAR; Lebeau R; Clair M; Rossi JS; Martin RM; Golembeske C. Validation of a measure to assess alcohol- and marijuana-related risks and consequences among incarcerated adolescents. Drug and Alcohol Dependence 109(1-3): 104-113, 2010. (60 refs.)

Few measures exist to assess risky behaviors and consequences as they relate to substance use in juvenile delinquents. This study sought to validate such a measure on a racially and ethnically diverse sample (N = 175). Results indicate that alcohol-related risky behaviors and consequences comprise a single scale as do marijuana-related risky behaviors and consequences. Furthermore, results suggest that the retention of common items for both scales produces reliable and valid scales and maintains parsimony. Internal consistencies were more than adequate (0.72-0.83) and test-retest stabilities, even across several months were acceptable (0.52-0.50). The scales evidenced a high degree of concurrent and predictive incremental validity in predicting conduct disorder, dependence symptoms, and consumption patterns. Researchers can use these scales to measure a generalized construct tapping risks and consequences as related to alcohol and marijuana use. Ease of use may make these scales appealing to clinicians who can provide feedback to clients regarding risky behaviors involving alcohol and marijuana.

Stein LAR; Lebeau R; Colby SM; Barnett NP; Golembeske C; Monti PM. Motivational interviewing for incarcerated adolescents: Effects of depressive symptoms on reducing alcohol and marijuana use after release. Journal of Studies on Alcohol and Drugs 72(3): 497- 506, 2011. (51 refs.)

Objective: Motivational interviewing to reduce alcohol and marijuana use among incarcerated adolescents was evaluated. Method: Adolescents (N = 162, 84% male; M = 17.10 years old) were randomly assigned to receive motivational interviewing or relaxation training, with follow-up assessment 3 months after release. Results: Compared with those who received relaxation training, adolescents who received motivational interviewing had lower rates of alcohol and marijuana use at follow-up, with some evidence for moderating effects of depression. At low levels of depression, adolescents who received motivational interviewing had lower rates of use. Adolescents who received relaxation training and who had high levels of depressive symptoms early in incarceration showed less use at follow-up than those low in depressive symptoms who received relaxation training. Conclusions: This brief motivational interviewing intervention during incarceration reduces alcohol and marijuana use after release. In addition, depressive symptoms early in incarceration should be considered in treating these adolescents, but more work is needed to extend follow-up period and account for the impact of depression on outcomes.

Stein MD; Caviness CM; Anderson BJ; Hebert M; Clarke JG. A brief alcohol intervention for hazardously drinking incarcerated women. Addiction 105(3): 466-475, 2010. (34 refs.)

Objective: To test the hypothesis that among hazardously drinking incarcerated women who are returning to the community, a brief alcohol intervention will result in less alcohol use at follow-up relative to standard of care. Methods: Eligible participants endorsed hazardous alcohol consumption-four or more drinks at a time on at least 3 separate days in the previous 3 months or a score of 8 or above on the Alcohol Use Disorders Identification Test. Participants were randomized to either an assessment-only condition or to two brief motivationally focused sessions, the first delivered during incarceration, the second 1 month later after community re-entry. Participants recalled drinking behaviors at 3 and 6 months after the baseline interview using a 90-day time-line follow-back method. Results: The 245 female participants averaged 34 years of age, and were 71% Caucasian. The mean percentage of alcohol use days in the 3 months prior to incarceration was 51.7% and heavy alcohol use days was 43.9%. Intervention effects on abstinent days were statistically significant at 3 months (odds ratio = 1.96, 95% confidence interval 1.17, 3.30); the percentage of days abstinent was 68% for those randomized to intervention and 57% for controls. At 6 months the effect of the intervention was attenuated and no longer statistically significant. Conclusions: Among incarcerated women who reported hazardous drinking, a two-session brief alcohol intervention increased abstinent days at 3 months, but this effect decayed by 6 months. Study participants continued to drink heavily after return to the community. More intensive intervention pre-release and after re-entry may benefit hazardously drinking incarcerated women.

Stover H; Michels II. Drug use and opioid substitution treatment for prisoners. (review). Harm Reduction Journal 7(e-17), 2010. (49 refs.)

Drug use is prevalent throughout prison populations, and, despite advances in drug treatment programmes for inmates, access to and the quality of these programmes remain substantially poorer than those available for non-incarcerated drug users. Because prisoners may be at greater risk for some of the harms associated with drug use, they deserve therapeutic modalities and attitudes that are at least equal to those available for drug users outside prison. This article discusses drug use by inmates and its associated harms. In addition, this article provides a survey of studies conducted in prisons of opioid substitution therapy (OST), a clinically effective and cost-effective drug treatment strategy. The findings from this overview indicate why treatment efforts for drug users in prison are often poorer than those available for drug users in the non-prison community and demonstrate how the implementation of OST programmes benefits not only prisoners but also prison staff and the community at large. Finally, the article outlines strategies that have been found effective for implementing OST in prisons and offers suggestions for applying these strategies more broadly.

Sullivan WC. A note on the influence of maternal inebriety on the offspring. (reprint from 1899). International Journal of Epidemiology 40(2): 278-282, 2011. (12 refs.)

Author's Introduction: The object of the following paper is to present the result of a number of observations touching certain aspects of the question of habitual inebriety, notably the r�le of maternal alcoholism as an agent in race degeneracy. . . . I have selected from the female population of Liverpool Prison, amongst whom habitual inebriety is very prevalent, a series of cases of chronic drunkards who have borne children; and from the history of these children, and more particularly from the indications given by the infant mortality, I have sought to illustrate the mode in which the maternal intoxication appears to have reacted on the development of the offspring. In the selection I have endeavoured, as far as possible, to choose cases in which alcoholism occurred uncomplicated by other degenerative factors. Author's Conclusion: The observations which we have thus briefly analysed enable us to form a fairly clear idea of the mode in which maternal inebriety reacts upon the offspring. We are familiar with the fact, clearly established by Morel, that the chronic alcoholism of one or both parents frequently appears as the first moment in the degenerative career of a family; that it represents a state of artificial degradation of the organism, capable of transmission in augmented force to the descendants, and culminating in some four generations in the extinction of the stock. In the case of maternal inebriety we have the same mode of action to consider, but with it, and very much more potent, we have the continued toxic influence exercised on the developing embryo throughout pregnancy. The brilliant researches of F�r� in the field of experimental teratology have sufficiently demonstrated the gravity of this influence. We have, further, to bear in mind the possible effect of alcoholic excesses during lactation. Lastly, reinforcing all these modes of influence, we have the detrimental effects, positive and negative, of the deterioration of the milieu as an indirect consequence of the mother's drunkenness.

Thibodeau L; Jorenby DE; Seal DW; Kim SY; Sosman JM. Prerelease intent predicts smoking behavior postrelease following a prison smoking ban. Nicotine & Tobacco Research 12(2): 152-158, 2010. (37 refs.)

Introduction: More than 2 million persons are incarcerated in the United States. Most are young minority men, soon to reenter the community. The majority are also lifelong smokers with high rates of health-related problems. As prisons implement smoking bans, it is not known whether health behavior change that is mandated, rather than selected, can be maintained. The Wisconsin Department of Corrections smoking ban is a unique opportunity to investigate determinants of smoking behavior after release from prison. Methods: A convenience sample of 49 incarcerated men near release participated in two interviews (1-month prerelease, in prison, and 1-month postrelease via telephone). Descriptive analyses and multivariate modeling were conducted to determine associations with postrelease smoking. Results: Participants had a mean age of 36.7 years, 12.4 years of education, and a 2.3-year incarceration; 47% were Black and 41% White. They had smoked 14.5 years. Most (67%) believed that their health was improved after the smoking ban. Paired t tests revealed decreases in Positive and Negative Affect Scale negative affect (p = .001) and Patient Health Questionnaire-8 depression (p = .009) postrelease. Univariate analysis showed correlations of intent to smoke upon release with smoking relapse postrelease (p = .001), White race with smoking relapse postrelease (p = .045), and perceived better health since the prison smoking ban with nonsmoking on release (p = .01). There was a trend toward use of alcohol with smoking relapse on release (p = .061). Discussion: Prerelease smoking intention predicted postrelease behavior. Belief in improved health after the prison smoking ban correlated with nonsmoking on release. Targeted relapse prevention interventions are needed for people reentering the community.

Wang EA; Moore BA; Sullivan LE; Fiellin DA. Effect of incarceration history on outcomes of primary care office-based buprenorphine/naloxone. Journal of General Internal Medicine 25(7): 670-674, 2010. (42 refs.)

Behaviors associated with opioid dependence often involve criminal activity, which can lead to incarceration. The impact of a history of incarceration on outcomes in primary care office-based buprenorphine/naloxone is not known. The purpose of this study is to determine whether having a history of incarceration affects response to primary care office-based buprenorphine/naloxone treatment. In this post hoc secondary analysis of a randomized clinical trial, we compared demographic, clinical characteristics, and treatment outcomes among 166 participants receiving primary care office-based buprenorphine/naloxone treatment stratifying on history of incarceration. Participants with a history of incarceration have similar treatment outcomes with primary care office-based buprenorphine/naloxone than those without a history of incarceration (consecutive weeks of opioid-negative urine samples, 6.2 vs. 5.9, p = 0.43; treatment retention, 38% vs. 46%, p = 0.28). Prior history of incarceration does not appear to impact primary care office-based treatment of opioid dependence with buprenorphine/naloxone. Community health care providers can be reassured that initiating buprenorphine/naloxone in opioid dependent individuals with a history of incarceration will have similar outcomes as those without this history.

Welsh WN. Inmate responses to prison-based drug treatment: A repeated measures analysis. Drug and Alcohol Dependence 109(1-3): 37-44, 2010. (84 refs.)

Using a sample of 347 prison inmates and general linear modeling (GLM) repeated measures analyses, this paper examined during-treatment responses (e.g., changes in psychological and social functioning) to prison-based TC drug treatment. These effects have rarely been examined in previous studies, and never with a fully multivariate model accounting for within-subjects effects (changes over time), between-subjects effects (e.g., levels of risk and motivation), and within/between-subjects interactions (time x risk x motivation). The results provide evidence of positive inmate change in response to prison TC treatment, but the patterns of results varied depending upon: (a) specific indicators of psychological and social functioning, motivation, and treatment process; (b) the time periods examined (I, 6, and 12 months during treatment); and (c) baseline levels of risk and motivation. Significant interactions between time and type of inmate suggest important new directions for research, theory, and practice in offender-based substance abuse treatment.

Wildeman C; Western B. Incarceration in fragile families. Future of Children 20(2): 157-177, 2010. (49 refs.)

Since the mid-1970s the U.S. imprisonment rate has increased roughly fivefold. As Christopher Wildeman and Bruce Western explain, the effects of this sea change in the imprisonment rate-commonly called mass imprisonment or the prison boom-have been concentrated among those most likely to form fragile families: poor and minority men with little schooling. Imprisonment diminishes the earnings of adult men, compromises their health, reduces familial resources, and contributes to family breakup. It also adds to the deficits of poor children, thus ensuring that the effects of imprisonment on inequality are transferred intergenerationally. Perversely, incarceration has its most corrosive effects on families whose fathers were involved in neither domestic violence nor violent crime before being imprisoned. Because having a parent go to prison is now so common for poor, minority children and so negatively affects them, the authors argue that mass imprisonment may increase future racial and class inequality-and may even lead to more crime in the long term, thereby undoing any benefits of the prison boom. U.S. crime policy has thus, in the name of public safety, produced more vulnerable families and reduced the life chances of their children. Wildeman and Western advocate several policy reforms, such as limiting prison time for drug offenders and for parolees who violate the technical conditions of their parole, reconsidering sentence enhancements for repeat offenders, and expanding supports for prisoners and ex-prisoners. But Wildeman and Western argue that criminal justice reform alone will not solve the problems of school failure, joblessness, untreated addiction, and mental illness that pave the way to prison. In fact, focusing solely on criminal justice reforms would repeat the mistakes the nation made during the prison boom: trying to solve deep social problems with criminal justice policies. Addressing those broad problems, they say, requires a greater social commitment to education, public health, and the employment opportunities of low-skilled men and women. The primary sources of order and stability -- public safety in its wide sense -- are the informal social controls of family and work. Thus, broad social policies hold the promise not only of improving the well-being of fragile families, but also, by strengthening families and providing jobs, of contributing to public safety.

Wilkins C; Sweetsur P. The association between spending on methamphetamine/amphetamine and cannabis for personal use and earnings from acquisitive crime among police detainees in New Zealand. Addiction 106(4): 789-797, 2011. (47 refs.)

Aims: Few studies have examined the statistical association between methamphetamine/amphetamine use and acquisitive crime. Both methamphetamine/amphetamine and cannabis use have been implicated by New Zealand Police as factors in acquisitive offending among active criminal populations. The aim of our study was to examine the statistical association between spending on methamphetamine/amphetamine and cannabis and earnings from acquisitive crime among police detainees in New Zealand. Setting: Four police stations in different regions. Participants: A sample of 2125 police detainees were interviewed about their drug use and acquisitive crime. Design: Statistical models were developed to predict involvement in acquisitive crime using spending on methamphetamine/amphetamine and cannabis for personal use, and to examine associations between the level of spending on methamphetamine/amphetamine and cannabis for personal use and level of dollar earnings from acquisitive crime. Measurements: Self-reported spending on drug use and self-reported earnings from acquisitive crime in the past 30 days. Findings: Spending on cannabis and methamphetamine/amphetamine could predict involvement in acquisitive crime. Level of spending on methamphetamine/amphetamine and cannabis was associated positively with the level of earnings from property crime. Level of spending on methamphetamine/amphetamine was also associated positively with level of earnings from drug dealing. There was a largely negative association between level of spending on cannabis and level of earnings from drug dealing. Conclusions: High spending on methamphetamine/amphetamine is associated statistically with higher earnings from acquisitive crime among police detainees. Further research into this association, and in particular the causal nature of the association, is required to obtain clear policy recommendations.

Wolff H; Sebo P; Haller DM; Eytan A; Niveau G; Bertrand D et al. Health problems among detainees in Switzerland: A study using the ICPC-2 classification. BMC Public Health 11: e-article 245, 2011. (41 refs.)

Background: Little is known about the health status of prisoners in Switzerland. The aim of this study was to provide a detailed description of the health problems presented by detainees in Switzerland's largest remand prison. Methods: In this retrospective cross-sectional study we reviewed the health records of all detainees leaving Switzerland's largest remand prison in 2007. The health problems were coded using the International Classification for Primary Care (ICPC-2). Analyses were descriptive, stratified by gender. Results: A total of 2195 health records were reviewed. Mean age was 29.5 years (SD 9.5); 95% were male; 87.8% were migrants. Mean length of stay was 80 days (SD 160). Illicit drug use (40.2%) and mental health problems (32.6%) were frequent, but most of these detainees (57.6%) had more generic primary care problems, such as skin (27.0%), infectious diseases (23.5%), musculoskeletal (19.2%), injury related (18.3%), digestive (15.0%) or respiratory problems (14.0%). Furthermore, 7.9% reported exposure to violence during arrest by the police. Conclusion: Morbidity is high in this young, predominantly male population of detainees, in particular in relation to substance abuse. Other health problems more commonly seen in general practice are also frequent. These findings support the further development of coordinated primary care and mental health services within detention centers.

Xu DS; Hartman D; Ludrosky K; Campbell J; Starling RC; Taylor DO et al. Impact of donor high-risk social behaviors on recipient survival in cardiac transplantation. Transplantation 89(7): 873-878, 2010. (26 refs.)

Objective. To investigate the impact of cardiac donor participation in high-risk social behaviors (HRSBs) on recipient survival. Methods. Retrospective chart review queried cardiac transplantations performed at our institution from August 1994 to November 2007 involving donors known to have engaged in HRSBs. Kaplan-Meier methodology was used to analyze survival rates, and a Cox proportional hazards regression was performed to determine the impact of donor HRSBs on survival. Results. We identified 143 donors with social histories containing the following HRSBs: incarceration (n=69), unprofessional tattoos or piercings (n=44), alternative lifestyle practice (n=11), cocaine use (n=60), heroin smoking (n=6), marijuana use (n=79), oral narcotic abuse (n=20), and intravenous drug use (n=21). At the time of donation, viral screens detected 10 donors who were hepatitis B virus (HBV) positive, 11 donors who were hepatitis C virus (HCV) positive, and no donors who were positive for the HIV. One-year and 5-year survival were 92.2% and 84.4%, respectively. Cox regression analysis found only donor HCV infection to be associated with poorer recipient survival (P=0.14). Conclusion. Using cardiac allografts from high-risk donors who are serologically negative for viruses does not seem to impact recipient survival. There is a considerable risk for transmission of HBV and HCV when these are detected by pretransplant screens. However, if pretransplant screening does not discover donor HBV, HCV, or HIV infection, it is unlikely that subclinical disease transmission will occur.

Yoon J. Effect of increased private share of inpatient psychiatric resources on jail population growth: Evidence from the United States. Social Science & Medicine 72(4): 447- 455, 2011. (80 refs.)

There is a strong connection between the mental health and criminal justice systems. This research empirically tested whether the privatization of the inpatient mental health system alters this relationship, contributing to jail population growth. Using state-level panel data on U.S. states and the District of Columbia for the years 1985-1998, this study analyzed the relationship between the size of jail populations and private share of hospital psychiatric beds, first for overall private beds and then separately by private for-profit and nonprofit. Empirical models controlled for changes in mental health financing and resources, variations in criminal justice practice, and demographic and socio-economic factors as well as state and year fixed effects. A method of instrumental variables was employed to make a stronger case for causal inference. Results show that a one-percentage point increase in the private for-profit share of psychiatric beds contributes to the growth of jail inmates by approximately 2.3% annually. A greater private nonprofit share of psychiatric beds does not appear to influence the size of jail populations. These findings suggest that the increased private for-profit share of inpatient psychiatric resources undermines the safety-net and some control function of the mental health system and leads to a greater number of jail inmates.

Zahari MM; Bae WH; Zainal NZ; Habil H; Kamarulzaman A; Altice FL. Psychiatric and substance abuse comorbidity among HIV seropositive and HIV seronegative prisoners in Malaysia. American Journal of Drug and Alcohol Abuse 36(1): 31-38, 2010. (48 refs.)

Objective: To examine the association between HIV infection and psychiatric disorders among prisoners, where mental illness, substance abuse, and HIV are disproportionately represented. Design: Cross-sectional study. Methods: Using a sequential randomization scheme, 200 HIV-seropositive and 200 HIV-seronegative prisoners were selected for evaluation of psychiatric illnesses with the Structured Clinical Interview for Diagnostic Statistical Manual of Mental Disorders-IV (SCID-I). Results: The prevalence of mental illness and substance use disorders, particularly opioid dependence, was extremely high. HIV infection was significantly correlated with age, ethnicity, marital status, history of injection drug use, lifetime duration of incarceration, substance abuse, and polysubstance drug use. After controlling for potential confounders, HIV infection was significantly associated with non-substance-induced psychiatric disorders (AOR = 1.92; 95% CI: 1.03-3.59). While prisoners with a triple diagnosis (psychiatric disorders, substance use disorders, and HIV) spent 46.7 more cumulative lifetime months in prison than those with only a psychiatric diagnosis (p<.01), those with a dual diagnosis (psychiatric plus substance use disorders) were comparable to those with one psychiatric diagnosis only. Neither HIV infection nor triple diagnosis was associated with violent offenses. Conclusion: These findings suggest that a public health approach that simultaneously addresses psychiatric illnesses, substance abuse, and HIV infection is needed in both the correctional and the community settings in order to provide adequate care for triply-diagnosed patients and prevent them from returning to prison.

Zamani S; Farnia M; Torknejad A; Alaei BA; Gholizadeh M; Kasraee F et al. Patterns of drug use and HIV-related risk behaviors among incarcerated people in a prison in Iran. Journal of Urban Health. Bulletin Of the New York Academy Of Medicine 87(4): 603-616, 2010. (33 refs.)

Previous research indicates that prisoners in Iran are at risk of drug-related harm, including acquisition of blood-borne infections. In response, several prevention interventions have been introduced into prisons in Iran, such as methadone maintenance treatment (MMT). MMT is now provided to opioid-dependent prisoners in 142 of the 230 prisons and correctional settings in Iran. A baseline behavioral survey was conducted in Karaj Central prison which mainly holds prisoners with drug-related charges. Overall, 203 male prisoners from randomly selected rooms in two prison blocks were interviewed using a structured questionnaire in 2007, just before the introduction of MMT program in this prison. Among participants, 7% reported never having used illicit drugs in their lifetime, but 51% had used non-injecting illicit drugs, and as high as 42% reported having injected an illicit drug. Up to 79% (160/203) of all participants reported using drugs, and about 6% (12/203) reported drug injecting during their current incarceration term. Same-gender sexual practice during current incarceration term was reported by 2.5% (5/203) of all male prisoners. Comparison between injecting and non-injecting drug-using prisoners indicated that drug injectors had higher rates of previous incarcerations, commenced drug use at a younger age, were more likely to have used illicit drugs in the previous week, were more likely to have been treated by a physician for drug addiction, had higher rates of registration for methadone treatment inside prison, and were more likely to have been tested for HIV infection. These study findings provide a behavioral profile of prisoners in regard to drug-related harm and can be considered in any plan to introduce or improve provision of MMT in prisons in Iran or other countries with similar features.

Zhang SX; Roberts REL; McCollister KE. Therapeutic community in a California prison: Treatment outcomes after 5 years. Crime & Delinquency 57(1): 82-101, 2011. (32 refs.)

Therapeutic communities have become increasingly popular among correctional agencies with drug-involved offenders. This quasi-experimental study followed a group of inmates who participated in a prison-based therapeutic community in a California state prison, with a comparison group of matched offenders, for more than 5 years after their initial prison release. Contrary to successes reported elsewhere, this study found no difference in new arrests and returns to prison between therapeutic community participants and the comparison participants after 5 years. Overall, more than 60% of both groups were returned to prison within 2 years following their initial release. After 5 years, the return-to-prison rate reached about 73% for both groups. The average time spent in prison following initial release was about the same for both groups. Rearrest offenses were also similar in both groups. Policy implications are discussed.