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CORK Bibliography: Prisoners

70 citations. January 2007 to present

Prepared: September 2008

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

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

Baltieri DA; de Andrade AG. Alcohol and drug consumption among sexual offenders. Forensic Science International 175(1): 31-35, 2008. (30 refs.)

Purpose: To evaluate the role of alcohol and drug consumption between sexual offenders against boys and girls. Method: It was an observational, retrospective and cross-sectional study carried out by the Ambulatory for the treatment of sexual disorders of ABC Medical College, Santo Andre, Sao Paulo, Brazil (ABSex). The sample comprised 104 convicts, over 18 years old, sentenced only for sexual crimes against children (below 11 years old). Alcohol and drug consumption, sexual abuse history, sexual impulsivity, and risk of recidivism were evaluated. Results: The sexual offenders against boys showed higher alcohol consumption problems than sexual offenders against girls (chi(2) = 19.76, 1 d.f., p < 0.01). The severity of alcohol consumption was also significantly higher in the sexual offenders against non-related boys than in the sexual offenders against non-related girls (p = 0.037, ANOVA). After adjustment for other variables, such as monthly income before the penalty and alcohol consumption at the moment of the crime, the alcohol consumption severity in sexual offenders against boys was significantly higher than in sexual offenders against girls (OR = 1.05, CI 1.01-1.08, p < 0.01). Conclusions: Alcohol use or abuse is associated with the perpetration of sexual aggression. The role of alcohol consumption seems to be greater in sexual offenders against boys than in girls and this can contribute to criminal recidivism.

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

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

Bruce RD; Schleifer RA. Ethical and human rights imperatives to ensure medication-assisted treatment for opioid dependence in prisons and pre-trial detention. (editorial). International Journal of Drug Policy 19(1): 17-23, 2008. (66 refs.)

Opioid dependence is a complex medical condition affecting neurocognitive and physical functioning. Forced or abrupt opioid withdrawal may cause profound physical and psychological suffering, including nausea, vomiting, diarrhoea, extreme agitation and/or anxiety. Opioid-dependent individuals are especially vulnerable at the time of arrest or initial detention, when they may, as a result of their chemical dependency, be coerced into providing incriminating testimony, or be driven to engage in risky behaviour (such as sharing needles in detention) in order to avoid painful withdrawal symptoms. Upon incarceration, many opioid-dependent prisoners are forced to undergo abrupt opioid withdrawal (both from legally prescribed agonist therapy such as methadone as well as illicit opioids). Physical and psychological symptoms attendant to withdrawal may impair capacity to make informed legal decisions, and cause prisoners to risk HIV and other blood-borne diseases by sharing injection equipment. Although prisons must provide at least the standard of care to prisoners that is available in the general population, medication-assisted treatment, endorsed by international health and drug agencies as an integral part of HIV prevention and care strategies for opioid-dependent drug users, is unavailable to most prisoners. Medication-assisted treatment is a well-studied and validated pharmacological therapy for the medical condition known as opioid dependence. The failure to ensure prisoner access to this medical therapy threatens fundamental human rights protections against cruel, inhuman or degrading treatment and rights to health and to life. It also poses serious ethical problems for health care providers, violating basic principles of beneficence and non-maleficence (i.e., do good/do no harm). Governments must take immediate action to ensure access to opioid substitution to prisoners to ensure fulfilment of ethical and human rights obligations.

Burdon WM; Dang J; Prendergast ML; Messina NP; Farabee D. Differential effectiveness of residential versus outpatient aftercare for parolees from prison-based therapeutic community treatment programs. Substance Abuse Treatment, Prevention, and Policy 2: article 16, 2007. (45 refs.)

Background: Research has indicated that more intense treatment is associated with better outcomes among clients who are appropriately matched to treatment intensity level based on the severity of their drug/alcohol problem. This study examined the differential effectiveness of community-based residential and outpatient treatment attended by male and female drug-involved parolees from prison-based therapeutic community substance abuse treatment programs based on the severity of their drug/alcohol problems. Methods: Subjects were 4,165 male and female parolees who received prison-based therapeutic community substance abuse treatment and who subsequently participated in only outpatient or only residential treatment following release from prison. The dependent variable of interest was return to prison within 12 months. The primary independent variables of interest were alcohol/drug problem severity (low, high) and type of aftercare (residential, outpatient). Chi-square analyses were conducted to examine the differences in 12-month RTP rates between and within the two groups of parolees (residential and outpatient parolees) based on alcohol/drug problem severity (low severity, high severity). Logistic regression analyses were performed to determine if aftercare modality (outpatient only vs. residential only) was a significant predictor of 12-month RTP rates for subjects who were classified as low severity versus those who were classified as high severity. Results: Subjects benefited equally from outpatient and residential aftercare, regardless of the severity of their drug/alcohol problem. Conclusion: As states and the federal prison system further expand prison-based treatment services, the demand and supply of aftercare treatment services will also increase. As this occurs, systems and policies governing the transitioning of individuals from prison- to community-based treatment should include a systematic and validated assessment of post-prison treatment needs and a valid and reliable means to assess the quality of community-based treatment services. They should also ensure that parolees experience a truly uninterrupted continuum of care through appropriate recognition of progress made in prison-based treatment.

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

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

Butler T; Boonwaat L; Hailstone S; Falconer T; Lems P; Ginley T et al. The 2004 Australian prison entrants' blood-borne virus and risk behaviour survey. Australian and New Zealand Journal of Public Health 31(1): 44-50, 2007. (28 refs.)

Objectives: To assess the prevalence of blood-borne viruses and associated risk factors among prison entrants at seven Australian prisons across four States. Design: Consecutive cross-sectional design. Voluntary confidential testing of all prison entrants for serological markers of human immunodeficiency virus (HIV), hepatitis C (HCV) and hepatitis B (HBV) over 14 consecutive days in May 2004. Demographic data and data related to risks for blood-borne virus transmission, such as sexual activity, body piercing, tattooing, and injecting drug use, were collected. Results: National prevalence for HIV was 1%, hepatitis B core antibody 20%, and hepatitis C antibody 34%. Fifty-nine per cent of participants had a history of injecting drug use. Among injecting drug users, the prevalence of HIV was 1%, hepatitis C antibody 56%, and hepatitis B core antibody 27%. Forty-one per cent of those screened reported a previous incarceration. In the multivariate model, Queensland and Western Australian (WA) prison entrants were significantly less likely to test positive to HCV than those in New South Wales (NSW). Amphetamine was the most commonly injected drug in Queensland, Tasmania and WA. In NSW, heroin was the most common drug injected. In the multivariate analysis a history of injecting drug use, being aged 30 years or more, and a prior incarceration were positively associated with hepatitis C infection. For hepatitis B core antibody, age over 30 years and a history of injecting drug use were associated with an increased risk. Conclusions: The findings support the view that prisoner populations are vulnerable to blood-borne virus infection, particularly hepatitis B and C. Prisoner populations should be included in routine surveillance programs so as to provide a more representative picture of blood-borne virus epidemiology in Australia.

Chan KS; Wenzel S; Mandell W; Orlando M; Ebener P. Are prisoner characteristics associated with therapeutic community treatment process? American Journal of Drug and Alcohol Abuse 33(2): 267-279, 2007. (28 refs.)

The relationship between prisoner client characteristics and Therapeutic Community treatment process was examined in a male program (N = 164) and a female program (N = 195). Analyses were based on client reports on a multidimensional measure of treatment process and administrative data. Prisoner clients who are older or are poly-substance users had better Community Environment scores. Clients with children and fewer lifetime arrests had better scores on Personal Development and Change. Treatment process scores were comparable for clients in the female program and the male program. However, the association of treatment process with client characteristics appears stronger in the male program.

Chapman AL; Cellucci T. The role of antisocial and borderline personality features in substance dependence among incarcerated females. Addictive Behaviors 32(6): 1131-1145, 2007. (45 refs.)

This study examined the association of borderline personality disorder (BPD) and antisocial personality disorder (ASPD) with substance dependence among incarcerated females (N = 105) as well as the influence of the co-occurrence of BPD and ASPD on psychosocial functioning in substance-dependent participants. The severity of BPD and ASPD both were associated with drug dependence, but BPD was not associated with alcohol dependence. After controlling for ASPD severity, BPD severity was no longer associated with dug dependence. The ASPD features of criminal activity and recklessness were most uniquely associated with drug and alcohol dependence (respectively). None of the BPD features was uniquely associated with alcohol or drug dependence after controlling for ASPD. A co-occurring BPD diagnosis was associated with mood disturbance and experiential avoidance among substance-dependent participants. An ASPD diagnosis was associated with an earlier age at first arrest, along with greater childhood abuse and severity of alcohol dependence. These findings have important implications for further understanding and developing ways to help substance-dependent incarcerated females.

Coffin PO. Mortality after release from prison. (letter). New England Journal of Medicine 356(17): 1785-1785, 2007. (5 refs.)

Darke S. From the can to the coffin: Deaths among recently released prisoners. (editorial). Addiction 103(2): 256-257, 2008. (13 refs.)

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

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

Doyon S; Welsh C. Intoxication of a prison inmate with an ethyl alcohol-based hand sanitizer. (letter). New England Journal of Medicine 356(5): 529-530, 2007. (4 refs.)

Farrell M; Marsden J. Acute risk of drug-related death among newly released prisoners in England and Wales. Addiction 103(2): 251-255, 2008. (18 refs.)

Aims: To investigate drug-related deaths among newly released prisoners in England and Wales. Design Database linkage study. Participants National sample of 48 771 male and female sentenced prisoners released during 1998-2000 with all recorded deaths included to November 2003. Findings There were 442 recorded deaths, of which 261 (59%) were drug-related. In the year following index release, the drug-related mortality rate was 5.2 per 1000 among men and 5.9 per 1000 among women. All-cause mortality in the first and second weeks following release for men was 37 and 26 deaths per 1000 per annum, respectively (95% of which were drug-related). There were 47 and 38 deaths per 1000 per annum, respectively, among women, all of which were drug-related. In the first year after prison release, there were 342 male deaths (45.8 were expected in the general population) and there were 100 female deaths (8.3 expected in the general population). Drug-related deaths were attributed mainly to substance use disorders and drug overdose. Coronial records cited the involvement of opioids in 95% of deaths, benzodiazepines in 20%, cocaine in 14% and tricyclic antidepressants in 10%. Drug-related deaths among men were more likely to involve heroin and deaths among women were more likely to involve benzodiazepines, cocaine and tricyclic antidepressants. Conclusions: Newly released male and female prisoners are at acute risk of drug-related death. Appropriate prevention measures include overdose awareness education, opioid maintenance pharmacotherapy, planned referral to community-based treatment services and a community overdose-response using opioid antagonists.

Feldman M; Kumar VK; Angelini F; Pekala RJ; Porter J. Individual differences in substance preference and substance use. Journal of Addictions & Offender Counseling 27(2): 82-101, 2007. (63 refs.)

Using H. J. Eysenck's (1957, 1967) theory of temperament, this study examined the relationship between drug preference, drug use, and personality among incarcerated inmates. Analysis indicated a general preference for marijuana and alcohol over 8 other commonly used drugs across different personality types. Theoretical and clinical implications are offered.

Fontana L; Beckerman A. Recently released with HIV/AIDS: Primary care treatment needs and experiences. Journal of Health Care for the Poor and Underserved 18(3): 699-714, 2007. (33 refs.)

The research objectives of this study are to describe the re-entry experiences of people recently released from jail who were living with HIV/AIDS, and to identify factors that influence their access to primary care and adherence to a treatment regimen. The research used a mixed-method, qualitative and quantitative research design. The findings indicate that the overall instability in the lives of many of the former inmates studied hampered their ability to attend to their HIV/AIDS-related health care needs. Most former inmates returned to the community with co-occurring problems related to housing and substance abuse. Complicating their access to health care were fragmented health care and correctional systems. The study highlights the need for coordination and collaboration between correctional facilities and community-based health care and human service providers that leads to a deliberative and planned transition from jail to service systems in the community.

Freudenberg N; Moseley J; Labriola M; Daniels J; Murrill C. Comparison of health and social characteristics of people leaving New York City jails by age, gender, and race/ethnicity: Implications for public health interventions. Public Health Reports 122(6): 733-743, 2007. (53 refs.)

Objectives. We compared health and social needs by gender, age, and race/ ethnicity of people leaving New York City jails and assessed the implication of these differences for the development of jail reentry programs. Methods. Surveys were completed with 1,946 individuals (536 men, 704 women, and 706 adolescent males) between 1997 and 2004. Structured questionnaires captured data on demographic, criminal justice, substance use, and health characteristics. Bivariate comparisons were performed to determine variations between men and women, men and male adolescents, and nonLatino black and Hispanic/Latino respondents. Results. The majority of participants were black and Hispanic/Latino, reported high levels of substance use, had high rates of recidivism, and experienced difficult living circumstances. Compared with men, women were more likely to be homeless, use illicit drugs, report drug charges at index arrest, have health problems, and be parents. Adolescent males were more likely than men to rely on illegal activities for income and to have used marijuana and alcohol recently, and were less likely to report homelessness or health problems. Ethnic/racial differences between black and Hispanic/Latino respondents within gender and age groups were smaller than differences among these groups. Conclusions. Jails concentrate individuals with multifaceted health and social problems, providing opportunities to engage at-risk populations in comprehensive reentry programs. Gender, age, and ethnic/racial differences among incarcerated populations require that interventions be tailored to the specific needs of these different groups.

Garner BR; Knight K; Flynn PM; Morey JT; Simpson DD. Measuring offender attributes and engagement in treatment using the client evaluation of self and treatment. Criminal Justice and Behavior 34(9): 1113-1129, 2007. (63 refs.)

Monitoring drug-abuse-treatment delivery and progress requires the use of validated instruments to measure client motivation, psychosocial and cognitive functioning, and other treatment-process dynamics. As part of the National Institute on Drug Abuse Criminal Justice Drug Abuse Treatment Studies project for examining client-performance indicators for treatment of correctional populations, this study examined psychometric properties of the Criminal Justice Client Evaluation of Self and Treatment (CJ CEST). The sample included 3,266 offenders from 26 corrections-based treatment programs located in six states. Overall, the client assessment demonstrated good reliabilities evaluated at the individual and program levels and in test-retest administrations. In addition, evidence for construct validity was favorable. It is concluded that the CJ CEST is a brief yet comprehensive instrument that effectively and efficiently measures client needs and functioning at intake and also is appropriate for use during treatment to monitor progress over time in corrections-based drug-treatment programs.

Gordon MS; Kinlock TW; Schwartz RP; O'Grady KE. A randomized clinical trial of methadone maintenance for prisoners: Findings at 6 months post-release. Addiction 103(8): 1333-1342, 2008. (57 refs.)

Aims: This study examined the effectiveness of methadone maintenance initiated prior to or just after release from prison at 6 months post-release. Design: A three-group randomized controlled trial was conducted between September 2003 and June 2005. Setting A Baltimore pre-release prison. Participants Two hundred and eleven adult pre-release inmates who were heroin-dependent during the year prior to incarceration. Intervention Participants were assigned randomly to the following: counseling only: counseling in prison, with passive referral to treatment upon release (n = 70); counseling + transfer: counseling in prison with transfer to methadone maintenance treatment upon release (n = 70); and counseling + methadone: methadone maintenance and counseling in prison, continued in a community-based methadone maintenance program upon release (n = 71). Measurements: Addiction Severity Index at study entry and follow-up. Additional assessments at 6 months post-release were treatment record review; urine drug testing for opioids, cocaine and other illicit drugs. Findings Counseling + methadone participants were significantly more likely than both counseling only and counseling + transfer participants to be retained in drug abuse treatment (P = 0.0001) and significantly less likely to have an opioid-positive urine specimen compared to counseling only (P = 0.002). Furthermore, counseling + methadone participants reported significantly fewer days of involvement in self-reported heroin use and criminal activity than counseling only participants. Conclusions: Methadone maintenance, initiated prior to or immediately after release from prison, increases treatment entry and reduces heroin use at 6 months post-release compared to counseling only. This intervention may be able to fill an urgent treatment need for prisoners with heroin addiction histories.

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

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

Grella CE; Greenwell L; Prendergast M; Farabee D; Hall E; Cartier J et al. Organizational characteristics of drug abuse treatment programs for offenders. Journal of Substance Abuse Treatment 32(3): 291-300, 2007. (74 refs.)

This article examines the association between the organizational characteristics of drug abuse treatment programs for offenders and the provision of wraparound services and three types of treatment orientations. Data are from the National Criminal Justice Treatment Practices Survey, which was conducted with program directors (N = 217). A greater number of wraparound services provided were associated with inpatient treatment, specialized treatment facilities, community setting (vs. correctional), services provided for more types of client populations, college-educated staff, and planned treatment for > 180 days. Therapeutic community orientation was associated with prison-based treatment and specialized treatment facilities. Cognitive-behavioral therapy orientation was associated with higher perceived importance of community treatment, more perceived staff influence on treatment, and treatment for 91-180 days. The 12-step orientation was most strongly associated with having staff specialized in substance abuse. Study findings have implications for developing effective reentry programs for offenders that bridge correctional and community treatment.

Grella CE; Greenwell L. Treatment needs and completion of community-based aftercare among substance-abusing women offenders. Women's Health Issues 17(4): 244-255, 2007. (72 refs.)

Background. Women offenders with substance abuse problems typically have many treatment needs on reentry to the community from prison. This paper explores the correlates of treatment needs among a sample of women offenders with substance-abuse problems (n = 1,404), and the relationship between their treatment needs and other background characteristics with completion of community-based treatment after parole. Methods. Treatment needs were assessed at admission into prison-based substance abuse treatment; participants were admitted into community-based treatment upon parole. Descriptive statistics and multiple regression were used to examine their treatment needs; logistic regression analysis was used to determine the factors related to completion of the aftercare program. Analysis of variance was used to examine ethnic differences in treatment needs. Results. Greater treatment needs were associated with unstable housing before incarceration, a history of sexual or physical abuse, mental health problems, alcohol or drug dependence, and first arrest at age < 19; lower treatment needs were associated with having been mandated to prison-based treatment (versus volunteering). Mental health problems and earlier age at first arrest predicted treatment noncompletion. Drug dependence was associated with higher treatment needs and a greater likelihood of treatment completion, whereas African American and Hispanic ethnicity were both associated with lower treatment needs (compared with Whites) and a lower likelihood of treatment completion. Conclusions. Interventions are needed to engage substance-abusing women offenders in community treatment after parole to address their treatment needs, improve their retention in treatment, and reduce the likelihood of recidivism.

Harris F; Hek G; Condon L. Health needs of prisoners in England and Wales: the implications for prison healthcare of gender, age and ethnicity. Health & Social Care in the Community 15(1): 56-66, 2007. (47 refs.)

This paper aims to provide evidence of the healthcare needs of prisoners in relation to gender, age and ethnicity, drawing from a larger systematic overview of the policy and research literature concerning primary care nursing in prisons in England and Wales. The literature overview shaped the initial stages of a research project funded by the Department of Health to examine the views and perspectives of prisoners and nurses working in prisons, and to identify good primary care nursing in the prison environment. At total of 17 databases were searched using search terms related to primary healthcare in prisons (health, nurs*, primary care, healthcare, family medicine, prison*, offender*, inmate*) with terms truncated where possible in the different databases. Following this, a sifting phase was employed using inclusion/exclusion criteria to narrow and focus the literature perceived as relevant to the research questions. All papers were critically appraised for quality using standardised tools. Findings from the literature overview show that prisoners are more likely to have suffered some form of social exclusion compared to the rest of society, and there are significantly greater degrees of mental health problems, substance abuse and worse physical health in prisoners than in the general population. Women, young offenders, older prisoners and those from minority ethnic groups have distinct health needs compared to the prison population taken as a whole, with implications for the delivery of prison healthcare, and how these needs are met effectively and appropriately.

Havens JR; Oser CB; Leukefeld CG; Webster JM; Martin SS; O'Connell DJ et al. Differences in prevalence of prescription opiate misuse among rural and urban probationers. American Journal of Drug and Alcohol Abuse 33(2): 309-317, 2007. (15 refs.)

We compared the prevalence of prescription opiate misuse among 2 cohorts of felony probationers (N = 1525). Multiple logistic regression was utilized to determine the independent correlates of prescription opiate misuse among rural (n = 782) and urban (n = 743) probationers participating in an HIV-intervention study. After adjustment for differences in demographic and drug use characteristics, rural participants were almost five times more likely than their urban counterparts to have misused prescription opiates. The prevalence of prescription opiate misuse was significantly higher among the rural probationers; however, given the paucity of illicit opiates and relatively recent emergence of prescription opiates in rural areas, rural substance abuse treatment may be ill-prepared to treat prescription opiate misuse.

Holloway K; Bennett T. Gender differences in drug misuse and related problem behaviors among arrestees in the UK. Substance Use & Misuse 42(6): 899-921, 2007. (44 refs.)

Traditionally, the addiction literature has focused on male drug users and less attention has been given to female users. More recently, research investigating gender differences in drug use and associated problem behaviors has emerged. This article contributes to the growing research base by drawing on data collected from structured interviews with 2,682 male and 453 female arrestees conducted as part of the New English and Welsh Arrestee Drug Abuse Monitoring (1999-2002) program. Clear gender differences in drug use and associated behaviors are identified. Women were found to be more serious drug users and to experience more associated problems than men. The research and policy implications of the research are discussed and the study's limitations are noted.

Howard MO; Balster RL; Cottler LB; Wu LT; Vaughn MG. Inhalant use among incarcerated adolescents in the United States: Prevalence, characteristics, and correlates of use. Drug and Alcohol Dependence 93(3): 197-209, 2008. (31 refs.)

Objective: To characterize patterns and correlates of inhalant use among incarcerated youth. Method: Residents (N=723) of 27 Missouri Division of Youth Services facilities completed interviews assessing substance use, psychiatric symptoms, antisocial traits, trauma, suicidality, and criminality. Results: Participants averaged 15.5 (S.D. = 1.2) years of age, wereethnically diverse, and predominantly male. More than one-third (36.9%) reported lifetime inhalant use; 47.9% of users had tried four or more inhalant products. Comparatively high rates of use were observed for Hispanic and small town/rural youth. Commonly abused agents included gasoline (22%), permanent markers (15%), computer "air duster," (15%) and spray paint (12%). Inhalant users evidenced significantly higher levels of criminal behavior, antisocial attitudes, current psychiatric symptoms, earlier onset of offending and substance use, and more extensive histories of head injury, kidney disease, hormonal problems, mental illness, suicidality, trauma, and SUbstance-related problems than nonusers. In multiple logistic regression models, race/ethnicity, geographic area of residence, fearlessness, suicidality, and polydrug use distinguished inhalant users and nonusers. Measures of cognitive impairment, impulsivity, fearlessness, blame externalization, polydrug use, and substance-related problems were positively associated with lifetime frequency of inhalant use. Conclusions: Inhalant use was widespread in this sample and associated with serious physical and mental health impairments.

Kingree JB; Thompson M. Sexually-related expectancies for alcohol use and marijuana use among juvenile detainees. Addictive Behaviors 32(9): 1936-1942, 2007. (10 refs.)

This study is focused on sexually-related expectancies for substance use among juvenile detainees. Over a 6 month period, 272 juveniles recruited from a short-term detention facility completed measures assessing sexually-related expectancies in relation to alcohol use and marijuana use as well as measures assessing their actual use of these substances. Repeated measures analyses of sexual risk expectancy measures indicated that the sample as a whole, and older respondents in particular, expected more sexual risk in relation to using alcohol than in relation to using marijuana. Repeated measures analyses of sexual enhancement expectancy measures indicated that Aftican-American and younger respondents expected more sexual enhancement from using marijuana than from using alcohol. Logistic regression analyses indicated that expectancies for sexual enhancement from alcohol use, and expectancies for sexual enhancement from marijuana use, were respectively associated with the use of these substances in a recent sexual incident. Limitations of the study are discussed.

Kinlock TW; Gordon MS; Schwartz RP; O'Grady K; Fitzgerald TT; Wilson M. A randomized clinical trial of methadone maintenance for prisoners: Results at 1-month post-release. Drug and Alcohol Dependence 91(2/3): 220-227, 2007. (56 refs.)

Background: Despite its effectiveness, methadone maintenance is rarely provided in American correctional facilities. This study is the first randomized clinical trial in the US to examine the effectiveness of methadone maintenance treatment provided to prisoners with pre-incarceration heroin addiction. Methods: A three-group randomized controlled trial was conducted between September 2003 and June 2005. Two hundred eleven Baltimore pre-release inmates who were heroin dependent during the year prior to incarceration were enrolled in this study. Participants were randomly assigned to the following: counseling only: counseling in prison, with passive referral to treatment upon release (n=70); counseling +transfer: counseling in prison with transfer to methadone maintenance treatment upon release (n = 70); and counseling + methadone: methadone maintenance and counseling in prison, continued in a community-based methadone maintenance program upon release (n=71). Results: Two hundred participants were located for follow-up interviews and included in the current analysis. The percentages of participants in each condition that entered community-based treatment were, respectively, counseling only 7.8%, counseling+transfer 50.0%, and counseling + methadone 68.6%, p <.05. All pairwise comparisons were statistically significant (all ps <.05). The percentage of participants in each condition that tested positive for opioids at 1-month post-release were, respectively, counseling only 62.9%, counseling + transfer 41.0%, and counseling + methadone 27.6%, p <.05, with the counseling only group significantly more likely to test positive than the counseling + methadone group. Conclusions: Methadone maintenance initiated prior to or immediately after release from prison appears to have beneficial short-term impact on community treatment entry and heroin use. This intervention may be able to fill an urgent treatment need for prisoners with heroin addiction histories.

Kinlock TW; Gordon MS; Schwartz RP; O'Grady KE. A study of methadone maintenance for male prisoners. Criminal Justice and Behavior 35(1): 34-47, 2008. (54 refs.)

This study examined benefits of methadone maintenance among prerelease prison inmates. Incarcerated males with preincarceration heroin dependence (n = 197) were randomly assigned to (a) group educational counseling (counseling only); (b) counseling, with opportunity to begin methadone maintenance on release (counseling + transfer); or (c) counseling and methadone maintenance in prison, with opportunity to continue methadone maintenance on release (counseling + methadone). At 90-day follow-up, counseling + methadone participants were significantly more likely than counseling-only and counseling + transfer participants to attend drug treatment (p = .0001) and less likely to be reincarcerated (p = .019). Counseling + methadone and counseling + transfer participants were significantly less likely (all ps < .05) to report heroin use, cocaine use, and criminal involvement than counseling-only participants. Follow-up is needed to determine whether these findings hold over a longer period.

Kugu N; Akyuz G; Dogan O. Psychiatric morbidity in murder and attempted murder crime convicts: A Turkey study. Forensic Science International 175(2-3): 107-112, 2008. (43 refs.)

In the present, the morbidity of psychiatric disorders of homicide/attempted homicide crime convicts imprisoned in Turkey, Sivas maximum security prison was investigated. Seventy imprisoned homicide/attempted homicide crime convicts included in this study. Sociodemographic information form, structured clinical interview for DSM-IV Axis-I disorders and structured clinical interview for DSM-III-R personality disorders applied to the participants. Most commonly diagnosed disorders among those convicts were current Axis-I disorders, depressive disorders (7.1%) and anxiety disorders (5.7%). Among Axis-I disorders, the most diagnosed one was the substance use disorders (45.7%). The most diagnosed Axis-II disorder was found as to be antisocial personality disorder (48.6%). The rate of convicts who were diagnosed as having both Axis-I and Axis-II disorders was 51.4%. The most prevalently accompanying lifetime Axis-I disorders to antisocial personality disorder with respect to Axis-I, and Axis-II comorbidity was substance use disorders. As a result, it was thought that the substance use disorders and antisocial personality disorder among the homicide/attempted homicide crime convicts were the most prevalent lifetime psychiatric disorders.

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

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

Lekka NP; Lee KH; Argyriou AA; Beratis S; Parks RW. Association of cigarette smoking and depressive symptoms in a forensic population. Depression and Anxiety 24(5): 325-330, 2007. (49 refs.)

The link between mental health issues and smoking has been an important area of investigation. However, little is known about this association in a general adult, male forensic population. The aim of this study was to identify demographic and clinical (depression and anxiety) variables that predict smoking in a forensic population. A large cohort of 353 inmates in a high-security prison underwent a psychiatric interview, including administration of the Montgomery-Asberg Rating Scale for Depression (MADRS) and Hamilton's Rating Scale for Anxiety (HAM-A). Multiple regression analysis suggested that younger age and higher depression scores might predict the amount of daily smoking in this population. In contrast, anxiety symptoms were not an independent predictor for smoking in our study. These findings support the need for additional research to focus on those factors associated with smoking in forensic populations. Psychiatric screening for younger male individuals in forensic settings and targeted cognitive-behavioral interventions to treat depressed smokers may ameliorate the smoking abstinence rate in prisons.

Lukasiewicz M; Falissard B; Michel L; Neveu X; Reynaud M; Gasquet I. Prevalence and factors associated with alcohol and drug-related disorders in prison: A French national study. Substance Abuse Treatment, Prevention, and Policy 2(e-article 1), 2007. (49 refs.)

Background: Most studies measuring substance-use disorders in prisons focus on incoming or on remand prisoners and are generally restricted to drugs. However, there is evidence that substance use initiation or continuation occurs in prison, and that alcohol use is common. The aim of this study is 1) to assess prevalence of both drug and alcohol abuse and dependence (DAD/AAD) in a national randomised cohort of French prisoners, short or long-term sentence 2) to assess the risk factors associated with DAD/AAD in prison. a stratified random strategy was used to select 1) 23 prisons among the different types of prison 2) 998 prisoners. Diagnoses were assessed according to a standardized procedure, each prisoner being assessed by two psychiatrists, one junior, using a structured interview (MINI 5 plus), and one senior, completing the procedure with an open clinical interview. At the end of the interview the clinicians met and agreed on a list of diagnoses. Cloninger's Temperament and Character Inventory (TCI) was also used. Results: More than a third of prisoners presented either AAD or DAD in the last 12 months. Cannabis was the most frequent drug and just under a fifth of prisoners had AAD. AAD and DAD were clearly different for the following: socio-demographic variables, childhood history, imprisonment characteristics, psychiatric comorbidity and Cloninger's TCI. Profiles of AAD in prison are similar to type II alcoholism. Conclusion: Regular screening of AAD/DAD in prison, and specific treatment programmes taking into account differences between prisoners with an AAD and prisoners with a DAD should be a public health priority in prison

Lukasiewicz M; Neveu X; Blecha L; Falissard B; Reynaud M; Gasquet I. Pathways to substance-related disorder: A structural model approach exploring the influence of temperament, character, and childhood adversity in a national cohort of prisoners. Alcohol and Alcoholism 43(3): 287-295, 2008. (43 refs.)

Aims: Using Cloninger's model of personality, we aimed to specify the relative influence of the more biologically determined variables, temperament and character and more environmentally driven influence, childhood adversity in the development of addiction; and to compare patterns found among alcoholics with those found among drug addicts. Methods: We studied a group of prisoners, at a high risk of substance abuse and past history of childhood adversity. Using a stratified random strategy we selected (i) 23 prisons among the different types of prison in France, (ii) 998 prisoners. Each prisoner was assessed by two psychiatrists-one junior, using a structured interview (MINI 5 plus), and one senior, completing the procedure with an open clinical interview. At the end of the interview the clinicians met and agreed on a list of diagnoses. Cloninger's Temperament and Character Inventory was used to measure personality. Structural equations models, which have been advocated to disentangle the respective influence of complex risk factors, were used. Results: the "novelty seeking" temperament was a crucial vulnerability factor, for both alcoholics and drug addicts, in the same proportion. Character and childhood adversity played a significant part only in the development of drug abuse. Conclusions: In a prison population, a common biological loaded factor, novelty seeking is found both at the core of alcohol- and drug-related disorder whereas environmentally loaded factors play a greater role in drug problems.

McGovern B. A golden opportunity: The treatment of hepatitis C in HIV-infected inmates. Journal of Addictive Diseases 27(2): 69-73, 2008. (20 refs.)

Encouraging results have been demonstrated in large clinical trials in HIV-infected patients taking pegylated interferon and ribavirin for the treatment of hepatitis C virus (HCV) infection. However, only a minority of patients are being treated in the community. Medical providers cite chaotic lifestyles, unstable living situations, and ongoing substance abuse as barriers to these complicated therapies. The stable environment of the correctional system affords a path for intensive education, screening, and treatment of these hard-to-reach patients. Since HIV/HCV coinfected patients are at risk for cirrhosis, end-stage live disease, and hepatocellular carcinoma, incarceration should be viewed as a golden opportunity for important medical interventions.

Miles H; Dutheil L; Welsby I; Haider D. 'Just Say No': A preliminary evaluation of a three-stage model of integrated treatment for substance use problems in conditions of medium security. Journal of Forensic Psychiatry & Psychology 18(2): 141-159, 2007. (53 refs.)

Preliminary outcome data evaluating a three-stage model of integrated treatment for substance use problems in conditions of medium security are presented to address the lack of previous research in this area. Stage 1 and Stage 2 are 12-week treatment groups, supporting participants in becoming and remaining substance free, respectively, through motivational interviewing, psycho-education, and relapse prevention approaches. 'Just Say No' (JSN) is a participant-led social group to support continued abstinence throughout admission and up to six months post-discharge. Case notes of all in-patients in 2005 were screened, revealing that 32 (74%) of inpatients had a prior history of substance use problems. Of the 19 who received treatment, 14 (74%) became abstinent by the end of 2005, rising to 15 (79%, missing 3) by the end of June 2006. However five refused, of whom three (60%) became abstinent, and eight were not referred due to unstable mental state or imminent discharge. There was a significant effect of treatment on whether or not in-patients became drug-free, although only JSN attendance had a significant effect on whether they remained drug-free. By the end of treatment (and maintained at six-month follow-up), participants' self-reported insight and confidence to make changes to their substance use had increased, and there was a trend towards participants reporting more adaptive beliefs about substances and less craving for cannabis. Participants were also satisfied with the treatment intervention.

Minc A; Butler T; Gahan G. The Jailbreak Health Project. Incorporating a unique radio programme for prisoners. International Journal of Drug Policy 18(5): 444-446, 2007. (1 refs.)

Several studies in NSW have identified prisoners to be at high risk for blood borne viruses. The prevalence of hepatitis C among men in NSW correctional centres is 40% and over 60% among women. It is even higher among those with histories of injecting drug use. As part of the state's strategy to minimise the spread of blood borne viruses and promote healthy lifestyles among prisoners, the Community Restorative Centre broadcasts a weekly half hour radio programme to prisoners and the community. The project is funded through the NSW Health Department and aims to provide support to prisoners, ex-prisoners and their families. Jailbreak's success hinges on the participation of the very people [prisoners] the show wishes to target. The radio show is aimed specifically at broadcasting health promotion and harm-minimisation messages to prisoners and their supporters although this is not obvious. When you tune in to Jailbreak you will hear a diverse range of opinion, music and poetry from people caught up in the criminal justice system. Nevertheless at the heart of this exciting and challenging project is the delivery of engaging, relevant and clear health messages to prison inmates, ex-inmates and families in relation to HIV, hepatitis and sexual health. Since 2002, valuable health information, often in the form of personal stories, vignettes and quiz questions, can be heard in and around Sydney on 2SER 107.3 FM or online at http: www.2ser.com. Jailbreak has not been without controversy and has to balance the security focus of correctional authorities and the illegality of substance use in correctional centres with the need to convey messages to prisoners in relation to harm-minimisation.

Morris ZS; McKeganey N. Client perceptions of drug treatment services in Scotland. Drugs: Education, Prevention and Policy 14(1): 49-60, 2007. (31 refs.)

Aim: This paper explores the relationship between treatment satisfaction and a range of drug use and non-drug outcomes. Client satisfaction was measured using the Treatment Perception Questionnaire (TPQ). Method: This paper presents data elicited from 841 drug users starting a new episode of drug treatment in Scotland in 2000/2001, and re-interviewed approximately eight months later. T-tests were used to compare Scottish data with other European samples, t-tests and ANOVA to investigate differences in TPQ scores, and logistic regression to explore the relationship between satisfaction and outcomes. Findings: Age and gender were not found to predict satisfaction; treatment modality, setting, and not having been on a waiting list predicted greater satisfaction. Client satisfaction predicted positive outcomes, including retention in treatment, the achievement of abstinence, lower drug use, stabilization, safer drug use and less crime. Satisfaction predicted improved employment and education status, physical and mental health, financial and housing circumstances. Conclusion: On the basis of these results a case is argued for attempting to maximize clients' satisfaction with services and a role for consultation in achieving this. Maximizing satisfaction may require changes to the duration of some treatments and review of treatment in prison units in particular.

Niveau G; Ritter C. Route of administration of illicit drugs among remand prison entrants. European Addiction Research 14(2): 92-98, 2008. (30 refs.)

Aims: To describe the self-reported routes of administration of illicit drugs among subjects entering a remand prison and the different drugs used by this population. Methods: A cross-sectional study, with a sample of 770 subjects, was conducted in Geneva ( Switzerland). Participants were assessed with the semi-structured interview from the Council of Europe Pompidou Group multi-city study. Results: 428 (55.6%) subjects admitted to having used illicit drugs during the 3 months prior to entry. Amongst these illicit drug users, 54.7% took several drugs. Injectable drugs ( heroin, cocaine or illicit benzodiazepines) were taken by 75.7% of drug users but the majority (84.1%) declared that they had not injected drugs during the 3 months prior to entering prison. 68 subjects (8.8% of the total sample) declared that they had injected drugs during the 3 months prior to entering prison, either alone or in association with other methods. Conclusion: By extrapolation it is possible to suggest that about 200 intravenous drug users entered the remand prison in Geneva in 1 year. This confirms the need for prison health services to implement a policy of treatment, prevention and education adapted to patterns of drug use in the local context.

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

O'Connell DJ; Enev TN; Martin SS; Inciardi JA. Working toward recovery: The interplay of past treatment and economic status in long-term outcomes for drug-involved offenders. Substance Use & Misuse 42(7): 1089-1107, 2007. (32 refs.)

Research on the relationship between employment and substance use tends to focus on employment lowering use. It is also potentially the case, however that lowered substance use among addicts may lead to better employment and thus to greater long-term abstinence. In this article, we utilize complementary elements of three mainstream criminological approaches to suggest how therapeutic community-based treatment of drug user(s) during the transition-from prison to community may lower clients' levels of substance use and thus increase their likelihood of better economic outcomes. We then use structural equations modeling to demonstrate how this process might play out. The data for this study were collected from 1992 through 1998 from the Delaware Department of Corrections.

Office of Applied Studies, Substance Abuse and Mental Health Services Administration. The DASIS Report. Facilities Offering Special Treatment Programs or Groups. (June 14, 2007). Rockville MD: Substance Abuse and Mental Health Services Administration, 2007. (2 refs.)

SAMHSA's National Survey of Substance Abuse Treatment Services (N-SSATS) provides information as to whether substance abuse treatment facilities offered special services. These special treatment services include specially designed treatment programs for adolescents, clients with co-occurring substance abuse and mental disorders, criminal justice clients, persons with HIV or AIDS, gays or lesbians, pregnant or postpartum women, adult women, adult men, seniors or older adults, and persons arrested for driving under the influence of alcohol or drugs (DUI) or driving while intoxicated (DWI). A total of 13,371 substance abuse treatment facilities responded to the 2005 National Survey of Substance Abuse Treatment Services and 83% of them offered at least one special program or group addressing particular needs of specific client types. Among the largest facilities the proportion was 88% and among the smallest, 72%. The most commonly offered special program or group was for persons with co-occurring substance abuse and mental disorders (38%), followed by programs for adult women (33%), adolescents (32%), DWI offenders (31%), criminal justice system clients (28%), adult men (25%), pregnant or post-partum women (14%), those with HIV/AIDS (11%), seniors (7%), and gays/lesbians (6%).

Public Domain

O'Grady KE; Kinlock TW; Hanlon TE. Prediction of violence history in substance-abusing inmates. Prison Journal 87(4): 416-433, 2007. (47 refs.)

This study examines the relationship of various developmental factors, drug abuse history, and current adjustment with history of violent criminal activity in 183 drug-abusing inmates. The purpose is to determine factors that discriminate among offenders who (a) have no history of violent criminal behavior, (b) have a history of violent criminal behavior but have never attempted or committed murder, and (c) have attempted or committed murder. Inmates who have attempted or committed murder committed their first crime, on average, as preadolescents, whereas inmates who have not committed violent crimes committed their first crime, on average, in their midteens. A history of torturing animals as a child is predictive of membership in the murder or attempted murder group. Inmates who attempted or committed murder were raised in families considerably more deviant than families of the other two groups. Finally, commission of violent crimes is associated with a higher current level of anxiety.

Oser C; Havens J; Staton-Tindall M; Wong C; Leukefeld C; Prendergast M. HIV sexual risk behaviors among ketamine and non-ketamine using criminal offenders prior to prison entry. Addiction Research & Theory 16(3): 289-302, 2008. (52 refs.)

This study is the first to examine ketamine use and its association with HIV sexual risk behaviors among a criminal offending population in the United States. Data were collected from 716 inmates as part of the Transitional Case Management (TCM) protocol within the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) cooperative agreement. Bivariate analyses were used to identify differences between ketamine users (n=44) and nonketamine users (n=672). Three Poisson regression models were used to identify the significant correlates of high risk sexual behaviors in the 30 days prior to incarceration-(1) number of times had unprotected sex while high, (2) number of times had unprotected vaginal sex, and (3) number of times had unprotected anal sex. Results indicate that ketamine was a significant correlate in all of the Poisson regression models. Findings add to the literature and indicate that ketamine use may be a marker for engaging in HIV risk behaviors among criminal offenders.

Pollini RA; Strathdee SA. Indicators of methamphetamine use and abuse in San Diego County, California: 2001-2005. Journal of Psychoactive Drugs Suppl. 4: 319-325, 2007. (13 refs.)

San Diego County, California, is a major distribution center for methamphetamine entering the U.S. from Mexico. All available indicators suggest that the use and abuse of methamphetamine increased between 2001 and 2005. Drug treatment admissions for primary methamphetamine use accounted for 49% of all drug treatment admissions in 2005, up from 37% in 2001, with trends showing smaller proportions of female and Hispanic users and a larger proportion of methamphetamine smokers (vs. inhalation or injection). Increases in prevalence of methamphetamine use were documented among arrestees as well; by 2005, 51% of female and 21% of juvenile arrestees tested positive for methamphetamine. The proportion of emergency department visits involving illicit drugs in which methamphetamine was reported increased from 32% in 2004 to 40% in 2005, although this change was not statistically significant, and methamphetamine-related deaths increased 48% between 2001 and 2005. Data from non-federal drug seizures in San Diego County documented an increase from 21% of all drug items analyzed in 2001 to 32% in 2005. In summary, methamphetamine remains the drug of utmost concern in San Diego. The availability of multiple data sources is imperative for constructing valid characterizations of trends in methamphetamine use and abuse and its affect on health.

Proescholdbell SK; Foley KL; Johnson J; Malek SH. Indoor air quality in prisons before and after implementation of a smoking ban law. Tobacco Control 17(2): 123-127, 2008. (24 refs.)

Objective: To ascertain whether a new indoor smoking ban law in North Carolina correctional facilities was successfully implemented and whether the indoor air quality has improved as a result. Method: Before the law came into effect, we tested the air quality of 22 dormitory and common areas within six North Carolina prisons using standard protocols for testing particulate matter. We measured particulate matter 2.5 mu m in diameter ( PM2.5) using state of the art TSI SidePak monitors. After the law went into effect, the same locations within each prison were tested again. Written inmate surveys were also conducted at two prisons, one with partial smoking ban ( indoors only) and one with a total smoking ban ( indoors and outdoors). Results: The findings indicate that, on average, levels of respirable suspended particulates ( RSPs), an accepted marker for secondhand smoke ( SHS) levels, decreased 77% in these prisons after the law took effect compared to levels obtained before ban implementation. Several areas were tobacco-free before the implementation of this ban. In those areas no significant decreases in RSPs were noted. Conclusion: Laws banning tobacco use in correctional facilities can significantly reduce indoor SHS exposure among inmates, visitors and staff and potentially lead to reduced use. To date, 24 US states have enacted 100% smoke-free correctional facility polices for all indoor areas even though inmates and staff have much higher tobacco use prevalence rates than the general population. With an estimated nine million people incarcerated worldwide, prison smoking bans could have a substantial impact in terms of health outcomes and long-term costs if they can effectively reduce exposure to secondhand smoke.

Rassool GH. The educational experiences and previous orientation of undergraduate nursing students in alcohol and drug: The English context. Journal of Addictions Nursing 18(1): 47-52, 2007. (27 refs.)

Several international and national reports have identified the need for nurses, including primary health care workers and staff in the prison health system, to receive adequate training in substance abuse education. The reports highlight the need for a systematic approach to education and training on substance abuse and the principles that underpin quality education and training. However, education about drugs and alcohol and their impact on health still find insufficient space within the nursing curriculum. The purpose of the study was to examine the previous orientation of alcohol and drug education and explore the personal and professional experiences of undergraduate nursing students. A sample of 110 undergraduate nursing students completed a questionnaire. The results showed that the majority of the participants did not receive any instruction on alcohol and other drugs. Alcohol seemed to be the major health problem, compared to other drug problems, encountered by the students in their personal life. The results of this study are congruent with previous findings of the lack of adequate educational preparation of undergraduate nursing students in alcohol and other drugs.

Roberts EA; Contois MW; Willis JC; Worthington MR; Knight K. Assessing offender needs and performance for planning and monitoring criminal justice drug treatment. Criminal Justice and Behavior 34(9): 1179-1187, 2007. (18 refs.)

With the rise of coerced treatment in both correctional and community settings, increased awareness and focus is being placed on motivation for change and treatment readiness as dynamic factors relevant to individual treatment planning. In addition, within correctional-treatment populations, the need for targeting criminal thinking and attitudes as primary treatment issues also has been well-established. The importance of these two issues to the effectiveness of treatment programming highlights the need for instruments that can reliably assess offender risk and needs, guide the treatment planning process, and monitor progress over time. This article provides an overview of how selected scales from the Texas Christian University Criminal Justice Client Evaluation of Self and Treatment and Criminal Thinking Scales instruments are being used to inform treatment planning and service delivery in a large, intensive therapeutic community program for substance-abusing offenders in Virginia.

Rounds-Bryant JL; Baker L. Substance dependence and level of treatment need among recently-incarcerated prisoners. American Journal of Drug and Alcohol Abuse 33(4): 557-561, 2007. (7 refs.)

This study assessed both prevalence rates of substance dependence and level of treatment need among recently- incarcerated prisoners in a southeastern state. Participants were 752 consecutive admissions to the state prison system in 2002. They were administered the 93 item Substance Abuse Subtle Screening Inventory (SASSI). The results indicated that approximately 72% of participants met criteria for substance dependence and 46% of participants met criteria for prison-based residential treatment. The results of this study can be used to inform allocation of prison-based treatment resources.

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

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

Seal DW; Eldrige GD; Kacanek D; Binson D; MacGowan RJ; Project START Study Group. A longitudinal, qualitative analysis of the context of substance use and sexual behavior among 18-to 29-year-old men after their release from prison. Social Science & Medicine 65(11): 2394-2406, 2007. (37 refs.)

Substance use, sexual behavior, and reincarceration among 89 men from 5 state prisons across the USA, aged 18-29 years, were examined in relation to individual patterns of coping with community reintegration after their release from prison. Analyses of a series of qualitative interviews conducted over a 6-month period post-release revealed three global reintegration coping patterns: moving toward successful reintegration, resuming behavioral patterns that preceded incarceration, and reintegrating through withdrawal or isolation. Four key contextual factors that differentiated these three coping patterns were the consistency and extensiveness of social relationships, the nature of social support, and the degree of structural stability (e.g., stable employment and housing). Participants were assigned a Likert scale score (1 for poor rating to 3 for better rating) for their pattern of global reintegration and for their rating on each of the four contextual factors across the longitudinal qualitative interviews. Collectively, these five factors differentiated the prevalence and frequency of substance use, patterns of sexual behavior, and incidence of reincarceration as assessed by a quantitative survey administered 6 months post-release. Poorer ratings on all five contextual indices were related to the use of substances other than marijuana and alcohol. Men with less consistent social relationships reported more sexual partners. However, vaginal or anal sex without a condom was associated with greater social consistency and greater structural stability, possibly due to the presence of a steady main partner. Reincarceration was significantly associated with poorer global reintegration ratings, more negative social support, and less structural stability. These findings highlight the need to consider the role of social and structural support systems in HIV and sexually transmitted infection risk reduction interventions for men after their release from prison.

Semple SJ; Zians J; Strathdee SA; Patterson TL. Methamphetamine-using felons: Psychosocial and behavioral characteristics. American Journal on Addictions 17(1): 28-35, 2008. (31 refs.)

Methamphetamine (meth) users with felony convictions may be important vectors in the HIV/AIDS pandemic because of their drug and sexual risk histories. This study gathered personal, psychosocial, and behavioral data from 450 HIV-negative, heterosexually identified, meth-using men and women. Significant differences were found between felons and non-felons in meth use patterns, contexts and reasons for use, involvement of social networks in meth use, and certain psychosocial and sexual risk variables. Our findings suggest that targeting meth use patterns and motivations, social networks, and sexual risk behaviors of meth-using felons may help to reduce HIV/AIDS transmission in and outside the prison system.

Severtson SG; Latimer WW. Factors related to correctional facility incarceration among active injection drug users in Baltimore, MD. Drug and Alcohol Dependence 94(1/3): 73-81, 2008. (33 refs.)

Aim: We investigated the moderating effect of impulse control on the association between drug use and incarceration among active injection drug users (IDU). Methods: The study sample consisted of 282 IDUs aged 15-50 years from the Baltimore metropolitan region who reported injection drug use within the past 6 months and indicated that heroin or speedball was their drug of choice. Impulse control was measured using commission error standardized scores from the Test of Variables of Attention (TOVA). Incarceration was obtained using self-reported lifetime history of incarceration in correctional facilities. Results: Findings indicated that impulse control moderated the association between years of injection drug use and incarceration in correctional facilities adjusting for ethnicity, gender, estimated pre-morbid intelligence, and age of first injection use. Specifically, among individuals who were intact in impulse control, four or more years of injection drug use was associated with incarceration (AOR=4.97, 95% Cl: 2.02-12.23). This finding was not observed among individuals with impaired impulse control (AOR = 0.57, 95% CI: 0.10-3.23). Furthermore, impulse control moderated the association between regular cocaine use and incarceration. Among individuals who had a history of cocaine use, individuals with low impulse control but not impaired were more likely to have reported time in a correctional facility (AOR = 6.28, 95% CI: 1.68-23.60). There was no association among individuals with impaired or intact impulse control. Conclusion: Results highlight the importance of considering cognitive measures of impulse control in addressing negative outcomes associated with drug use.

Shivy VA; Wu JJ; Moon AE; Mann SC; Holland JG; Eacho C. Ex-offenders reentering the workforce. Journal of Counseling Psychology 54(4): 466-473, 2007. (29 refs.)

Approximately 650,000 individuals will be released from incarceration in state and federal prisons this year. However, little is known about the challenges ex-offenders face when they endeavor to reenter the workforce. The authors used consensual qualitative research methods to analyze data from 2 focus groups: one for male (n = 6) and another for female (n = 9) nonviolent felony offenders, all of whom were receiving services at day reporting centers, which offer a nonresidential form of community corrections. Attendees discussed their reentry experiences, and 11 domains were identified,, encompassing ex-offenders' needs for education, training, and practical assistance; challenges in obtaining and maintaining a job; and available support, including personal networks and resources from the correctional system. Findings suggest that counseling professionals should attend to ex-offenders' social networks, including social aspects of the workplace, as such networks can offer support or represent a liability for individuals in transition. Substance abuse issues impact ex-offenders' social viability as well as their career-related reentry attempts. Finally, career development practitioners should understand the internal and external impacts of the stigma associated with incarceration.

Stallwitz A; Stover H. The impact of substitution treatment in prisons - A literature review. (review). International Journal of Drug Policy 18(6): 464-474, 2007. (88 refs.)

Substitution treatment (ST) has established itself as a generally recognised type of treatment for opioid dependence worldwide. Although the number of countries providing ST in prison has slowly started to grow over the last years, its application in the custody setting remains controversial. ST in prison is mainly employed in form of detoxification. Maintenance treatment is provided in only a limited number of international prisons. This literature review is centred around the question: "What is known about the effectiveness of prison based ST?" Furthermore, it investigates how this knowledge can be applied to improve treatment scope and quality. Effectiveness, as defined by the examined studies, refers to short- and lon.-term reduction of drug use and relapse, reduction in drug use related risk behaviours, reduction in criminal conduct and recidivism, facilitating the manageability of drug using prisoners and improving their physical stabilisation. In this context, substitute dosage, treatment duration, patient retention rates, complementary psycho-social care and the effects of disrupting maintenance treatment when entering the institution are scrutinised. Results show that prison-based ST and especially prison-based methadone maintenance treatment (PMMT) can reduce drug use and injection in penal institutions. Moreover, PMMT provision can reduce injecting risk behaviours as well as drugs charges and re-admission rates. However, for PMMT to retain patients in treatment and reduce illegal drug use and criminal behaviour a sufficiently high dose of methadone (e.g.. >60 mg) and the treatment duration lasting the entire period of imprisonment appear crucial. On the basis of the analysed results the authors recommend the provision of PMMT for individuals with long-standing opioid dependence and suggest major expansions of prison based ST in many countries.

Staton-Tindall M; Duvall JL; Leukefeld C; Oser CB. Health, mental health, substance use, and service utilization among rural and urban incarcerated women. Women's Health Issues 17(4): 183-192, 2007. (28 refs.)

Incarcerated women commonly report health, mental health, and substance use problems, yet there is limited research on service utilization before incarceration, particularly among women. from urban and rural areas. This study includes a stratified random sample of 100 rural and urban incarcerated women to profile the health, mental health, substance use, and service utilization; examine the relationship between the number of self-reported problems and service utilization; and examine self-reported health and mental health problems in prison as associated with preincarceration health-related problems and community service utilization. Study findings suggest that health and mental health problems and substance use do not differ significantly among rural and urban women prisoners. However, there are differences in service utilization-particularly behavioral health services including mental health and substance abuse services; urban women report more service utilization. In addition, rural women who reported using needed community services before prison also reported fewer health problems in prison. Implications for correctional and community treatment opportunities in rural and urban areas are discussed.

Staton-Tindall M; Royse D; Leukfeld C. Substance use, criminality, and social support: An exploratory analysis with incarcerated women. American Journal of Drug and Alcohol Abuse 33(2): 237-243, 2007. (11 refs.)

This exploratory study examined the extent to which substance use and criminality influence perceptions of social support. A stratified random sample of 100 incarcerated women in one Kentucky prison participated in face-to-face interviews. Overall, findings indicate that perceptions of social support significantly and negatively correlated with women's severity of substance use and criminal involvement. In addition, the breadth of a respondent's social network was negatively related to the age of first incarceration and to the severity of alcohol and drug use. Findings from this study suggest there is a relationship between severity of substance use, criminality, and perceptions of social support. Implications for substance use research and practice are discussed.

Stephens T; Mcgee W; Braithwaite RL. Age-based correlates of substance misuse among convicted felons in Georgia. American Journal of Drug and Alcohol Abuse 33(6): 885-892, 2007. (26 refs.)

Objective: This study sought to identify variables that independently correlate with age and substance use among a sample of 187 convicted felons in Georgia. Results: Results of regression analysis indicated that younger inmates were 2 times more likely than older inmates to report the occurrence of alcohol use (RR 2.07; 95% CI.37, 11.6) and three times more likely than older inmates to report some history of marijuana use ( RR 3.07; 95% CI 1.52, 6.11). In addition, younger inmates were half as likely or less to report using sedatives ( RR.53, 95% CI.22, 1.29), tranquilizers (RR.49, 95% CI.22, 1.29), crack or cocaine (RR.33, 95% CI.18,.62), heroin (RR.48, 95% CI.16, 1.25), and to having ever received treatment for a drug problem (RR.46, 95% CI.23,.90). Conclusion: In conclusion, age-based factors correlate with participant's history of substance use. Ascertainment of these variables among inmate populations has the potential to improve treatment decisions both during and after incarceration.

Sullivan CJ; Hamilton ZK. Exploring careers in deviance: A joint trajectory analysis of criminal behavior and substance use in an offender population. Deviant Behavior 28(6): 497-523, 2007. (64 refs.)

Empirically, one of the most consistently observed correlations in social science inquiry is that of substance use and criminal behavior. Recently, these behaviors have been examined separately within longitudinal, career-based frameworks. This study assesses the joint distribution of crime and substance use over several years and identifies a number of latent classes reflecting trends in these behaviors. The study data come Prom a sample of 524 offenders released from California Youth Authority custody. In general, the two behaviors tend to ebb and flow together, but the overall prevalence of substance use over time, absent offending, suggests some degree of independence.

Taxman FS; Perdoni ML; Harrison LD. Drug treatment services for adult offenders: The state of the state. Journal of Substance Abuse Treatment 32(3): 239-254, 2007. (67 refs.)

We conducted a national survey of prisons, jails, and community correctional agencies to estimate the prevalence of entry into and accessibility of correctional programs and drug treatment services for adult offenders. Substance abuse education and awareness is the most prevalent form of service provided, being offered in 74% of prisons, 61% of jails, and 53% of community correctional agencies; at the same time, remedial education is the most frequently available correctional program in prisons (89%) and jails (59.5%), whereas sex offender therapy (57.2%) and intensive supervision (41.9%) dominate in community correctional programs. Most substance abuse services provided to offenders are offered through correctional programs such as intensive supervision, day reporting, vocational education, and work release, among others. Although agencies report a high frequency of providing substance abuse services, the prevalence rates are misleading because less than a quarter of the offenders in prisons and jails and less than 10% of those in community correctional agencies have daily access to these services through correctional agencies; in addition, these are predominantly drug treatment services that offer few clinical services. Given that drug-involved offenders are likely to have dependence rates that are four times greater than those among the general public, the drug treatment services and correctional programs available to offenders do not appear to be appropriate for the needs of this population. The National Criminal Justice Treatment Practices survey provides a better understanding of the distribution of services and programs across prisons, jails, and community correctional agencies and allows researchers and policy makers to understand some of the gaps in services and programs that may negatively affect recidivism reduction efforts.

Taxman FS; Young DW; Wiersema B; Rhodes A; Mitchell S. The National Criminal Justice Treatment Practices survey: Multilevel survey methods and procedures. Journal of Substance Abuse Treatment 32(3): 225-238, 2007. (87 refs.)

The National Criminal Justice Treatment Practices (NCJTP) survey provides a comprehensive inquiry into the nature of programs and services provided to adult and juvenile offenders involved in the justice system in the United States. The multilevel survey design covers topics such as the mission and goals of correctional and treatment programs; organizational climate and culture for providing services; organizational capacity and needs; opinions of administrators and staff regarding rehabilitation, punishment, and services provided to offenders; treatment policies and procedures; and working relationships between correctional and other agencies. The methodology generates national estimates of the availability of programs and services for offenders. This article details the methodology and sampling frame for the NCJTP survey, response rates, and survey procedures. Prevalence estimates of juvenile and adult offenders under correctional control are provided with extemally validated comparisons to illustrate the veracity of the methodology. Limitations of the survey methods are also discussed.

Velasquez MM; von Sternberg K; Mullen PD; Carbonari JP; Kan LY. Psychiatric distress in incarcerated women with recent cocaine and alcohol abuse. Women's Health Issues 17(4): 264-272, 2007. (37 refs.)

Purpose. Women frequently abuse cocaine and alcohol before incarceration. Research indicates that women in criminal justice settings also suffer high rates of psychiatric distress. This study aimed to determine how preincarceration abuse of alcohol and cocaine affected current psychiatric distress among female jail detainees held for 10-14 days. Methods. A probability sample of women in a large urban jail (n = 469) were assessed for use of alcohol and cocaine during the 6 months before incarceration and for their current psychiatric distress. They were grouped based on their level of alcohol consumption and cocaine use: high cocaine/high alcohol; high cocaine/low alcohol; low cocaine/high alcohol; and low cocaine/low alcohol. Profile analysis was used to examine the relation of psychiatric distress, as measured by the Brief Symptom Inventory, to levels of recent alcohol and cocaine use. Results. Psychiatric distress is highest (and similar) among women in the high cocaine groups, regardless of alcohol use, and psychiatric distress is lowest among those who used both substances infrequently. Characteristics of psychiatric distress differed based on level of alcohol use, but only when cocaine use was low. High alcohol and cocaine use alone and together also predict the likelihood of psychiatric distress reaching a diagnosable level of severity. Conclusions. High cocaine, alcohol, or combined use is related to higher levels of psychiatric distress among incarcerated women in this jail. Women should be screened at the time of incarceration, and women who have alcohol and other drug problems should receive treatment that includes mental health services.

Weatherburn DJ. The role of drug and alcohol policy in reducing Indigenous over-representation in prison. (editorial). Drug and Alcohol Review 27(1): 91-94, 2008. (34 refs.)

Australian Indigenous imprisonment rates are higher now than they were at the time of the Royal Commission into Aboriginal Deaths in Custody. The Commission attributed Indigenous imprisonment to Indigenous cultural, economic and social disadvantage. Noel Pearson has argued that Indigenous drug and alcohol use is a more important cause of Indigenous contact with the justice system than Indigenous disadvantage. In this paper I argue that the available evidence provides strong support for Pearson's view and for the proposition that future efforts to reduce Indigenous imprisonment should place more emphasis on supply-side strategies for reducing Indigenous drug and alcohol abuse.

Welsh WN. A multisite evaluation of prison-based therapeutic community drug treatment. Criminal Justice and Behavior 34(11): 1481-1498, 2007. (75 refs.)

A quasi-experimental study examined multiple postrelease outcomes up to 2 years for inmates who participated in therapeutic community (TC) drug treatment programs (n = 217) or comparison groups (n = 49 1) at five state prisons. Statistical controls included level of need for treatment, current and prior criminal history, and postrelease employment. Prison TC was effective even without mandatory community aftercare, although main effects and interactions varied somewhat across different outcome measures and sites. TC significantly reduced rearrest and reincarceration rates but not drug relapse rates. Postrelease employment predicted drug relapse and reincarceration, and employment interacted with age to predict rearrest. Two sites had higher drug relapse rates than the other three. Implications for research and policy are discussed.

Welsh WN; McGrain PN. Predictors of therapeutic engagement in prison-based drug treatment. (review). Drug and Alcohol Dependence 96(3): 271-280, 2008. (106 refs.)

Few studies to date have examined predictors of therapeutic engagement (TE) or other indicators of responsiveness to prison drug treatment. Subjects were 347 inmates participating in a 12-month modified therapeutic community (TC) drug treatment program at a specialized treatment prison for convicted, drug-involved offenders. Data were obtained through correctional databases and the administration of the TCU Drug Screen II, the Resident Evaluation of Self and Treatment (REST), and the Counselor Rating of Client (CRC) form. Three main hypotheses were supported: (1) baseline motivation predicted therapeutic engagement net of other inmate characteristics; (2) critical dimensions of the treatment experience (e.g., peer support, counselor rapport) also predicted therapeutic engagement; and (3) dynamic predictors and programmatic characteristics became more important over time. Implications for research, theory and policy are discussed.

Wilbur MB; Marani JE; Appugliese D; Woods R; Siegel JA; Cabral HJ et al. Socioemotional effects of fathers' incarceration on low-income, urban, school-aged children. Pediatrics 120(3): E678-E685, 2007. (49 refs.)

OBJECTIVE. The goal was to evaluate whether children of incarcerated fathers are more likely to report or exhibit behavioral symptoms than their equally disadvantaged peers without an incarcerated father. METHODS. During an ongoing longitudinal study of intrauterine cocaine exposure involving 102 children (50% male and 89% black) from urban, low- income homes, questions regarding incarceration of the child's father were asked of the child's primary caregiver at each visit during school age. Children were administered the Children's Depression Inventory between the ages of 6 and 11 years, and their primary caregivers completed the Child Behavior Checklist. In addition, the children's teachers completed the Teacher Report Form. Children's Depression Inventory, Child Behavior Checklist, and Teacher Report Form data obtained at the oldest available age after the first report of paternal incarceration were analyzed. RESULTS. In bivariate analyses, children whose fathers were in jail had higher Children's Depression Inventory total scores compared with children without incarcerated fathers, indicating more depressive symptoms. This finding was robust in multivariate analyses after adjustment for children's age, gender, prenatal cocaine and alcohol exposure, and school- age violence exposure. Teachers reported higher Teacher Report Form externalizing scores for children whose fathers were in jail, after adjustment for age, gender, prenatal cocaine and marijuana exposure, and school- age violence exposure. CONCLUSIONS. Children of incarcerated fathers reported more depressive symptoms and their teachers noted more externalizing behaviors, after controlling for other biopsychosocial risks. Interventions targeted to ameliorate the distress of children with incarcerated fathers should be considered.

Wilson GB; Galloway J; Shewan D; Marshall L; Vojt G; Marley C. "Phewww, bingoed!": Motivations and variations of methods for using heroin in Scottish prisons. Addiction Research & Theory 15(2): 205-224, 2007. (18 refs.)

While prison is recognised as a setting for infectious disease transmission among drug users, little is known about psychological and situational factors influencing high-risk behaviours, knowledge vital to prison-based interventions. Qualitative interview and focus group data were collected from staff and prisoners in six Scottish prisons. A general view was that prison heroin use had increased, but injecting and sharing remained a covert and minority behaviour. "Anti-injecting culture'' among staff and most prisoners emerged as an important factor, though not linked by prisoners to an "anti-drug culture''. Of individual and social risk factors identified, only the desire to inject in prison for maximum effect was unique to prison injectors and sharers. This decision-based behaviour requires further theory-focussed research. Given these findings, introducing needle exchanges into Scottish prisons could undermine their low drug injection rates. Enabling injecting, albeit within a public health framework, conflicts with the major prison objective of rehabilitation.

Wojtowicz JP; Liu TY; Hedgpeth GW. Factors of addiction: New Jersey correctional population. Crime & Delinquency 53(3): 471-501, 2007. (45 refs.)

Most state inmates incarcerated under the jurisdiction of the New Jersey Department of Corrections are driven to crimes by drug abuse. Understanding the factors contributing to addiction is the first step in developing strategies for successful inmate reintegration. This study presents an analysis of inmate addiction and factor association using multivariate analysis procedures on 2003 New Jersey male inmate addiction data to identify significant demographic and criminal justice factors and to quantify the relative proportion of risk of addiction likelihood via the odds ratio measure. Significant factors identified include age, race, county of offense, controlled dangerous substances possession, burglary, robbery, and other nonviolent offenses. Odds ratios are presented for significant single factors and among subclass groups of multilevel variables. A statistically interesting and socially important multifactor analysis is performed for insight into particular subgroup, New Jersey Department of Corrections, Trenton, NJ.

Wormith JS; Althouse R; Simpson M; Reitzel LR; Fagan TJ; Morgan RD. The rehabilitation and reintegration of offenders: The current landscape and some future directions for correctional psychology. (review). Criminal Justice and Behavior 34(7): 879-892, 2007. (112 refs.)

The treatment literature on offender rehabilitation is reviewed with the purpose of deriving further direction for researchers and clinicians in the field of correctional psychology. After addressing the measurement of recidivism and other indicators of effectiveness, this empirically guided article reviews individual studies and meta-analyses on effectiveness of psychosocial correctional treatment for adult offenders and specialized treatment for substance abuse offenders and sexual offenders. A foundation in the general principles of offender intervention is established; principles such as risk, need, and responsivity are upheld; and common themes including the use of cognitive-behavioral interventions and the importance of treatment integrity emerge. However, questions move beyond "what works" to detailed queries about the nuances of effective service delivery, including client motivation. Well-controlled clinical studies and detailed process evaluations are still required. Other new directions include the application of positive psychology to offender treatment and the improvement of conditions under which community reentry is more likely to succeed. Directions for further research on correctional treatment are suggested.

Wunsch MJ; Nakamoto K; Goswami A; Schnoll SH. Prescription drug abuse among prisoners in rural southwestern Virginia. Journal of Addictive Diseases 26(4): 15-22, 2007. (24 refs.)

Non-medical-use of prescription medications is on the rise across the U.S., particularly in rural areas. In this study of 233 prisoners and probationers in southwestern Virginia, we add to an emerging profile of individuals abusing prescription medications. In this retrospective review of 2000-2004 augmented Addiction Severity Index data, those abusing prescription medications reported increased illicit drug and alcohol abuse, poly-drug abuse, psychiatric problems, and arrests for property crimes. Forty percent reported abuse of OxyContin((R)), a drug implicated in a number of deaths in this region. Compared to non-users, OxyContino((R)) users were younger, more likely to be female, and more likely to abuse benzodiazepines, methadone, cocaine, and heroin. Longevity of abuse of these other drugs belies suggestions that OxyContino was acting as a "gateway" drug leading naive users into addiction and risk of death.