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CORK Bibliography: Prisoners



87 citations. January 2011 to present

Prepared: September 2012



Albizu-Garcia CE; Caraballo JN; Caraballo-Correa G; Hernandez-Viver A; Roman-Badenas L. Assessing need for medication-assisted treatment for opiate-dependent prison inmates. Substance Abuse 33(1, special issue): 60-69, 2012. (29 refs.)

Individuals with a history of heroin dependence are overrepresented in American correctional facilities and 75% of inmates with a drug use disorder do not receive treatment during incarceration or after release. Medication-assisted treatment (MAT) with opiate agonists, such as methadone or buprenorphine, constitutes standard of care; to guide planning for an expansion of drug treatment services in correctional facilities, a needs assessment was conducted at the Department of Correction and Rehabilitation (DCR) of Puerto Rico (PR). The authors report on the research process, the findings that informed their recommendations for the DCR to expand MAT for eligible inmates, and lessons learned.

Copyright 2012, Taylor & Francis


Alm C; Eriksson A; Palmstierna T; Kristiansson M; Berman AH; Gumpert CH. Treatment patterns among offenders with mental health problems and substance use problems. Journal of Behavioral Health Services & Research 38(4): 497-509, 2011. (21 refs.)

Research on treatment utilization among offenders with mental health problems and substance use problems, i.e. the 'triply troubled', is scarce. The aim was to contribute to the general knowledge about treatment patterns among the triply troubled. This register-based study explored treatment patterns during a 3-year follow-up among 157 Swedish offenders with substance use problems who had undergone forensic psychiatric assessment. There were three subgroups of treatment users: low treatment, planned substance abuse treatment and substance abuse emergency room visits, and planned psychiatric treatment. About 40% of the participants displayed a stable treatment pattern. Outcomes were less successful for those participants displaying a non-stable treatment pattern. Allocation of treatment resources should take into account the associations between treatment patterns and recidivism into criminality. Also, it should be valuable for clinicians to gather information on treatment history in order to meet various treatment needs.

Copyright 2011, Springer


Asberg K; Renk K. Substance use coping as a mediator of the relationship between trauma symptoms and substance use consequences among incarcerated females with childhood sexual abuse histories. Substance Use & Misuse 47(7): 799-808, 2012. (78 refs.)

Rates of substance use and maltreatment are alarmingly high among incarcerated women. Although the direct link between trauma and substance use has been established, less is known about potential mediators. Thus, we examined substance use coping as a mediator between trauma symptoms and substance use consequences among a sample of incarcerated females (N = 111) who were survivors of childhood sexual abuse. Trauma symptoms predicted the severity of substance use consequences, with this relationship being mediated fully by avoidance coping (e.g., using substances to cope). Overall, trauma histories are important in predicting outcomes but must be examined in the context of current coping behaviors and substance use. Findings (data collected in 2007/2008) may help promote interventions that target patterns of coping and/or emotional avoidance among trauma survivors with substance use problems in incarcerated populations. The study's limitations are noted.

Copyright 2012, Informa Healthcare


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

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

Copyright 2011, Elsevier Science


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

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

Copyright 2011, Society for the Study of Addiction to Alcohol and Other Drugs


Burdon WM; St De Lore J; Prendergast ML. Developing and implementing a positive behavioral reinforcement intervention in prison-based drug treatment: Project BRITE. Journal of Psychoactive Drugs 2011(7): 40-50, 2011. (24 refs.)

Within prison settings, the reliance on punishment for controlling inappropriate or non-compliant behavior is self-evident. What is not so evident is the similarity between this reliance on punishment and the use of positive reinforcements to increase desired behaviors. However, seldom do inmates receive positive reinforcement for engaging in prosocial behaviors or, for inmates receiving drug treatment, behaviors that are consistent with or support their recovery. This study provides an overview of the development and implementation of a positive behavioral reinforcement intervention in male and female prison-based drug treatment programs. The active involvement of institutional staff, treatment staff, and inmates enrolled in the treatment programs in the development of the intervention along with the successful branding of the intervention were effective at promoting support and participation. However, these factors may also have ultimately impacted the ability of the randomized design to reliably demonstrate the effectiveness of the intervention.

Copyright 2011, Haight-Asbury Publishing


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

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

Copyright 2011, Wiley-Blackwell


Calcaterra S; Blatchford P; Friedmann PD; Binswanger IA. Psychostimulant-related deaths among former inmates. Journal of Addiction Medicine 6(2): 97-105, 2012. (65 refs.)

Objectives: Psychostimulants are highly addictive and their use is increasing. Little is known about psychostimulant-related deaths. This study identified characteristics, risk factors, and contributing substances reported upon death among former prison inmates who died from a psychostimulant-related death. Methods: This retrospective cohort study of released inmates from 1999 to 2003 (N = 30,237) linked data from the Washington State Department of Corrections with the National Death Index. We examined characteristics of individuals who died with psychostimulants listed among their causes of death. These were categorized into 3 groups: (1) noncocaine psychostimulants, (2) cocaine only, and (3) all psychostimulants. Cox proportional hazards regression determined risk factors for death in each group, and the risk of death in the first 2 weeks after release from prison Results: Of the 443 inmates who died, 25 (6%) had noncocaine psychostimulants listed among their causes of death. Six of these 25 deaths had both noncocaine psychostimulants and cocaine listed among their causes-of-death. Most of the former inmates who died with noncocaine psychostimulants were male (n = 21, 84%) and non-Hispanic white (88%, n = 22). Cocaine only was listed among the causes-of-death for 49 former inmates; mostwere male (n = 35, 71%) and non-Hispanicwhite (n = 27, 55%). Longer length of incarceration was associated with a reduced risk of death from any psychostimulant use (hazard ratio = 0.76, confidence interval = 0.63-0.920 for each additional year of incarceration) and from use of noncocaine psychostimulants (hazard ratio = 0.42, 95% CI = 0.22-0.80). Risk death was highest during the first 2 weeks postrelease for cocaine only-related deaths (incidence mortality ratio = 1224.0, confidence interval = 583-1865). Conclusions: Former prisoners have a significant risk of death from psychostimulants, especially within the first 2 weeks postrelease.

Copyright 2012, Lippincott, Williams & Wilkins


Campollo O; Roman S; Panduro A; Hernandez G; Diaz-Barriga L; Balanzario MC et al. Non-injection drug use and hepatitis C among drug treatment clients in west central Mexico. Drug and Alcohol Dependence 123(1-3): 269-272, 2012. (34 refs.)

Background: Research on hepatitis C virus (HCV) prevalence among non-injecting drug treatment clients in the United States, Europe and Asia indicate substantial differences by place. To date, little or no research on HCV and non-injection drug use (NIDU) has been conducted in Mexico. Methods: We examined the prevalence of HCV, hepatitis B virus (HBV), and HIV among non-injecting drug users (NIDUs) in community-based drug treatment (N = 122) and NIDUs in a prison-based drug treatment program (N = 30), both located in west central Mexico. Results: Among the community clients, prevalence was 4.1% (95% confidence interval [CI]: 1.8-9.2) for HCV, 5.7% for HBV (95% CI: 2.8-11.4), and 1.6% for HIV (95% CI: 0.4-5.8). Among the in-prison clients, prevalence was 40.0% (95% CI: 24.6-57.7) for HCV, 20.0% for HBV (95% CI: 9.5-37.3), and 6.7% for HIV (95% CI: 1.9-21.3). None of the clients were aware of being infected. Conclusion: The HCV prevalence found for the NIDU community treatment clients ranks among the lower HCV estimates published for NIDUs in treatment to date. The prevalence found for the in-prison clients ranks among the higher, raising a concern of possible elevated HCV infection among NIDUs in the west central Mexico prison one compounded by the finding that none of this study's clients knew they were HCV positive.

Copyright 2012, Elsevier Science


Chen ML; Yang KL; Chen HS; Shieh SF; Shieh TY. Prevalences of betel nut chewing and cigarette smoking among male prisoners before their imprisonment in Taiwan. Journal of Dental Sciences 7(2): 165-170, 2012. (20 refs.)

Background/purpose: Substance abuse is considered prevalent in incarcerated populations; however, consumption of betel nut in this group has not been adequately studied. In the present study, we attempted to elucidate the prevalences of betel nut chewing and cigarette smoking, and determine the relationship between use of the two substances among prisoners before imprisonment in order to increase our understanding of this phenomenon. Materials and methods: In 2000, a self-administered anonymous questionnaire was given to 976 male prisoners who were over 18 years of age and had been sentenced to imprisonment for a total incarnation period of more than 10 years in Kaohsiung Prison, Kaohsiung, Taiwan. Results: The response rate was 60.3% (589/976). Respective prevalences of betel nut chewing and smoking before imprisonment were 73.2% and 90.7%. Results of a cross-sectional analysis showed that dual-substance (betel nut and cigarette) users made up the majority (71.6%) of the study sample, whereas simple smokers and simple chewers comprised 19.0% and 1.5%, respectively. Only 7.8% of participants used neither substance. Smoking generally began 5.07 years before betel nut use. The duration of betel nut chewing was significantly associated with the daily quantity chewed (r = 0.212; P < 0.01, and a significant relationship was also found between the daily quantity chewed and smoking (r = 0.314; P < 0.01). Moreover, the daily quantity chewed increased concomitant with the chewing duration and daily quantity smoked. Conclusions: Prevalences of betel nut chewing and smoking are high among male Taiwanese prisoners before imprisonment. The association of use of these two substances among Taiwanese inmates was significant in a time-dependent manner.

Copyright 2012, Association for Dental Sciences of the Republic of China.


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

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

Copyright 2011, Elsevier Science


Clark CB; Perkins A; McCullumsmith CB; Islam MA; Hanover EE; Cropsey KL. Characteristics of victims of sexual abuse by gender and race in a community corrections population. Journal of Interpersonal Violence 27(9): 1844-1861, 2012. (44 refs.)

The purpose of this study was to examine how victims of sexual abuse in a community corrections population differ as a result of their sex and race. Of the 19,422 participants, a total of 1,298 (6.7%) reported a history of sexual abuse and were compared with nonabused participants. The sample was analyzed by race-gender groups (White men, White women, African American men, and African American women) using univariate and logistic regression analyses, which were conducted separately for each group. White women were the most likely to report a history of sexual abuse (26.5%), followed by African American women (16.0%), White men (4.0%), and African American men (1.1%). For all groups, histories of suicidal ideation and suicide attempts were associated with a history of sexual abuse. Sexual abuse was associated with substance abuse problems for women but not the men. Cannabis dependence was associated with sexual abuse for the White women while cocaine dependence was associated with sexual abuse for the African American women. Several other variables were associated with sexual abuse for women but not men, including lower education (White women only), a history of violent offenses (White women only), and living in a shelter (African American women only). African American men tended to have higher levels of education; this was the only variable uniquely associated with either male group. Receiving psychiatric medications was associated with sexual abuse for all groups except African American men and a history of sex for drugs was associated with sexual abuse for all groups except White men. Consistent with national sample, women, particularly White women, were more likely to be victims of sexual abuse. The gender-race differences for the sociodemographic factors associated with sexual abuse, particularly the risk of substance abuse for women, suggest the need for tailored interventions for sexual abuse prevention and treatment.

Copyright 2012, Sage Publications


Clarke JG; Martin RA; Stein LAR; Lopes CE; Mello J; Friedmann P; Bock B. Working Inside for Smoking Elimination (Project W.I.S.E.) study design and rationale to prevent return to smoking after release from a smoke free prison. BMC Public Health 11: 767, 2011. (49 refs.)

Background: Incarcerated individuals suffer disproportionately from the health effects of tobacco smoking due to the high smoking prevalence in this population. In addition there is an over-representation of ethnic and racial minorities, impoverished individuals, and those with mental health and drug addictions in prisons. Increasingly, prisons across the U. S. are becoming smoke free. However, relapse to smoking is common upon release from prison, approaching 90% within a few weeks. No evidence based treatments currently exist to assist individuals to remain abstinent after a period of prolonged, forced abstinence. Methods/Design: This paper describes the design and rationale of a randomized clinical trial to enhance smoking abstinence rates among individuals following release from a tobacco free prison. The intervention is six weekly sessions of motivational interviewing and cognitive behavioral therapy initiated approximately six weeks prior to release from prison. The control group views six time matched videos weekly starting about six weeks prior to release. Assessments take place in-person 3 weeks after release and then for non-smokers every 3 months up to 12 months. Smoking status is confirmed by urine cotinine. Discussion: Effective interventions are greatly needed to assist these individuals to remain smoke free and reduce health disparities among this socially and economically challenged group.

Copyright 2011, BioMed Central


Conner BT; Hampton AS; Hunter J; Urada D. Treating opioid use under California's Proposition 36: Differential outcomes by treatment modality. Journal of Psychoactive Drugs 2011(7): 77-83, 2011. (16 refs.)

In California, Proposition 36 (Prop. 36) has led to positive outcomes for a significant proportion of participants-increases in drug treatment completion, reduced drug use and recidivism, and increased employment. However, there are notable differences in outcomes among Prop. 36 subgroups, with some of the poorest outcomes observed among opioid users. This may be because very few Prop. 36 opioid users were placed in narcotic treatment programs (NTPs). Prop. 36 opioid users who were placed in NTPs using methadone had the greatest reductions in opioid use from treatment intake to discharge, as compared to Prop. 36 opioid users who received outpatient drug-free or residential treatment. As such, NTPs should be considered to be a highly efficacious and viable treatment option for Prop. 36 opioid users. Thus, to improve treatment outcomes among Prop. 36 opioid users, it is essential that the provision and utilization of NTPs be enhanced.

Copyright 2011, Haight-Asbury Publishing


Cuellar AE; Cheema J. As roughly 700,000 prisoners are released annually, about half will gain health coverage and care under federal laws. Health Affairs 31(5): 931-938, 2012. (25 refs.)

During 2009, 730,000 prisoners were released from federal and state prisons-a 21 percent increase from the number of prisoners released in 2000. Poor health and poor health coverage have been major challenges for former prisoners trying to reintegrate into the community and find work. We discuss these challenges and the likely effect of recent federal legislation, including the Second Chance Act, the Mental Health Parity and Addiction Equity Act, and the Affordable Care Act. We estimated that with the implementation of health reform, up to 33.6 percent of inmates released annually-more than 245,000 people in 2009-could enroll in Medicaid. Similarly, we estimated that up to 23.5 percent of prisoners released annually-more than 172,000 people in 2009-could be eligible for federal tax credits to defray the cost of purchasing insurance from state health exchanges. This health insurance, combined with new substance abuse services and patient-centered medical home models, could dramatically improve the health and success of former inmates as they return to the community. States should consider several policy changes to ease prisoners' transitions, including suspending rather than terminating Medicaid benefits for offenders; incorporating corrections information into eligibility determination systems; aiming Medicaid outreach and enrollment efforts at prison inmates; and designing comprehensive approaches to meeting former prisoners' health care needs.

Copyright 2012, Project Hope


Doran N; Hohman M; Koutsenok I. Linking basic and advanced motivational interviewing training outcomes for juvenile correctional staff in California. Journal of Psychoactive Drugs 2011(7): 19-26, 2011. (34 refs.)

Motivational interviewing (MI) is an evidence-based communication method that can be effective in engaging incarcerated juveniles in substance abuse programming and other treatment services. However, MI can be difficult to learn and often requires several training exposures for skill change. Few studies have examined MI training outcomes over time. This study reports outcomes for 222 juvenile corrections workers trained in MI in a three-day introductory and two-day advanced training. MI skills were measured via video-administered pre- and post-tests and with a written questionnaire. Combined results from a linear mixed model found that overall MI skills were positively associated with staff education level, and negatively associated with age and time between trainings. Those who attended their second training within nine months of the first training were more likely to score in the proficiency range. Motivation to use MI, belief in its efficacy with youth, job classification, and sex were not related to skill attainment.

Copyright 2011, Haight-Asbury Publishing


Dumont DM; Brockmann B; Dickman S; Alexander N; Rich JD. Public health and the epidemic of incarceration. (review). Annual Review of Public Health 33: 325+, 2012. (97 refs.)

An unprecedented number of Americans have been incarcerated in the past generation. In addition, arrests are concentrated in low-income, predominantly nonwhite communities where people are more likely to be medically underserved. As a result, rates of physical and mental illnesses are far higher among prison and jail inmates than among the general public. We review the health profiles of the incarcerated; health care in correctional facilities; and incarceration's repercussions for public health in the communities to which inmates return upon release. The review concludes with recommendations that public health and medical practitioners capitalize on the public health opportunities provided by correctional settings to reach medically underserved communities, while simultaneously advocating for fundamental system change to reduce unnecessary incarceration.

Copyright 2012, Annual Reviews


Evans E; Jaffe A; Urada D; Anglin MD. Differential outcomes of court-supervised substance abuse treatment among California parolees and probationers. International Journal of Offender Therapy And Comparative Criminology 56(4): 539-556, 2012. (44 refs.)

To explore the effectiveness of court-supervised drug treatment for California parolees, offender characteristics, treatment experiences, and outcomes were examined and contrasted to those of probationers. The analysis used statewide administrative data on 4,507 parolees and 22,701 probationers referred to treatment by Proposition 36 during fiscal year 2006-2007. Compared with probationers, parolee problems were more severe at treatment entry, more were treated in residential settings, treatment retention was shorter, and fewer completed treatment. Regarding outcomes, fewer parolees were successful at treatment discharge and more recidivated over 12-months post admission. Both groups improved in many areas by treatment discharge, but improvements were generally smaller among parolees. Significant interaction effects indicated that parolees benefited from residential care and more treatment days, even after controlling for covariates. Court-supervised drug treatment for parolees can "work;" however, parolees have more frequent and diverse needs, and their outcomes are enhanced by more intensive treatment. Findings suggest methods for optimizing the effectiveness of criminal-justice-supervised programs for treating drug-dependent offenders.

Copyright 2012, Sage Publications


Farabee D; Zhang S; Yang J. A preliminary examination of offender needs assessment: Are all those questions really necessary? Journal of Psychoactive Drugs 2011(7): 51-57, 2011. (14 refs.)

Criminologists generally agree that offender recidivism can be reduced by addressing the criminogenic needs of this population. Two prominent assessments of offender risks and needs are the Level of Service Inventory-Revised (LSI-R) and the Correctional Offender Management Profiling for Alternative Sanctions (COMPAS). Both predict recidivism, but they are largely based on data from records. In contrast, the determination of inmates' service needs is based on lengthy (and costly) offender interviews. In light of evidence that many correctional systems have not adopted standardized assessments of service needs and that time burden and costs are typically cited as barriers, the present study examined whether interviews involving complex scales improve the accuracy of offender needs assessment relative to a few single-item measures. To test this, 75 California prison inmates were administered the LSI-R, COMPAS, and a set of four yes/no items asking if they needed help with substance abuse, vocational training, housing, and education. Approximately 70% to 90% of inmates identified as needing these services according to the LSI-R or COMPAS could have been identified using these four supplemental items, though specificity rates were low for the financial and housing domains. The results suggest that simpler, less costly approaches to offender needs assessment might be achievable.

Copyright 2011, Haight-Asbury Publishing


Felthous AR. Suicide behind bars: Trends, inconsistencies, and practical implications. Journal of Forensic Sciences 56(6): 1541-1555, 2011. (90 refs.)

The results of two comprehensive approaches are compared: the nationwide surveys of suicides in U.S. jails by Hayes and the international meta-analyses of suicides in jails and prisons by Fazel et al. Factors are classified as demographic, situational, clinical, and methodical. More than 50% of U.S. jail suicide victims were men, white, unmarried, under 28 years of age, charged with minor or drug-related offenses, and intoxicated with drugs or alcohol. Suicides significantly occurred in isolation. Suicide victims in the international study were significantly (p < 0.001) men, white, married, pretrial, and charged with or convicted of violent offenses. Psychiatric diagnosis, alcohol abuse, taking psychotropic medication, and suicidal ideation were also positively correlated in the international study, but suicide victims were distributed more evenly over age-groups. Results of other studies illustrate the near universality of some findings. Three theories of suicide are briefly discussed.

Copyright 2011, Wiley-Blackwell


Finfgeld-Connett D; Johnson ED. Therapeutic substance abuse treatment for incarcerated women. Clinical Nursing Research 20(4): 462-481, 2011. (27 refs.)

The purpose of this qualitative systematic review was to explicate attributes of optimal therapeutic strategies for treating incarcerated women who have a history of substance abuse. An expansive search of electronic databases for qualitative research reports relating to substance abuse treatment for incarcerated women was conducted. Nine qualitative research reports comprised the sample for this review. Findings from these reports were extracted, placed into a data analysis matrix, coded, and categorized. Memos were written and strategies for treating incarcerated women with alcohol problems were identified. Therapeutic effects of treatment programs for incarcerated women with substance abuse problems appear to be enhanced when trust-based relationships are established, individualized and just care is provided, and treatment facilities are separate from the general prison environment.

Copyright 2011, Sage Publications


Forsberg LG; Ernst D; Sundqvist K; Farbring CA. Motivational interviewing delivered by existing prison staff: A randomized controlled study of effectiveness on substance use after release. Substance Use & Misuse 46(12): 1477-1485, 2011. (31 refs.)

A sample of 296 drug-using inmates in 14 Swedish prisons was randomized during 2004-2006 into three intervention groups; Motivational Interviewing delivered by counselors with workshop-only training, or by counselors with workshop training followed by peer group supervision, and controls. Drug and alcohol use was measured by the Addiction Severity Index (ASI) at intake and at 10 months after release. Complete data from 114 clients were analyzed by a stepwise regression analysis. All three groups reduced alcohol and drug use. Limitations in the study are discussed and future research is suggested. The study is financed by grants from the Research Committee of the National Prison and Probation Administration.

Copyright 2011, Informa Healthcare


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

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

Copyright 2011, Informa Healthcare


Giblin Y; Kelly A; Kelly E; Kennedy HG; Mohan D. Reducing the use of seclusion for mental disorder in a prison: Implementing a high support unit in a prison using participant action research. International Journal of Mental Health Systems 6: e-article 2, 2012. (21 refs.)

Background: Vulnerable prisoners and mentally disordered offenders who present with risk of harm to self or others were accommodated in Special Observation Cells (SOCs) isolated from others for considerable periods of time. This practice has been criticised by the Council of Europe Committee for the Prevention of Torture. The objective of this initiative was to reduce the use of seclusion within the prison and to improve the care of vulnerable and mentally ill prisoners within the prison. Results: The prison studied is a committal centre for sentenced prisoners with an official bed capacity of 630. The forensic mental health in-reach team, in co-operation with the prison health service followed the 'spiral' of planning, action and fact finding about the results of the action. In December 2010 a 10 bed High Support Unit (HSU) was established within the prison. During the first year, 96 prisoners were admitted. A third (35%) reported psychotic symptoms, 28% were referred due to the immediate risk of self-harm, 17% were accommodated for medical treatments and increased observation, 13% received specialised treatment by the Addiction Psychiatry team, 6% presented with emotional distress. One prisoner was accommodated on the HSU due to the acute risk he posed to others. A major mental illness was diagnosed in 29%, 20% required short-term increased support for crisis intervention and were found not to have a mental illness. A further 10% were deemed to be feigning symptoms of mental illness to seek refuge in the HSU. 7% had personality disorder as their primary diagnosis and 4% had a learning disability. Stratifying risk within the prison population through the provision of the HSU decreased the total episodes of seclusion in the prison by 59% (p < 0.001) in addition to providing a more effective psychiatric in-reach service to the prison. Pathways between the prison and the forensic psychiatric hospital saw no change in activity but improved continuity of care. Conclusions: The next step is to further stratify risk by establishing a low support unit to serve as a step-down from the high support unit.

Copyright 2012, BioMed Central


Gilham JJM. A qualitative study of incarcerated mothers' perceptions of the impact of separation on their children. Social Work in Public Health 27(1-2, special issue): 89-103, 2012. (50 refs.)

Many incarcerated women are mothers, and their children exhibit various responses to the separation that incarceration commands. This exploratory qualitative study examines incarcerated women's perceptions of the consequences of their illegal activity, confinement, and separation from their children on their offspring. The results indicate that although mothers are concerned about their children, they are typically unable to recognize the negative consequences of their actions on their children and their relationship with their children until beginning intensive treatment. Effective treatment must focus on the woman's personal issues along with their parenting abilities and skills to repair these relationships and promote healthy family functioning.

Copyright 2012, Taylor & Francis


Grella CE; Rodriguez L. Motivation for treatment among women offenders in prison-based treatment and longitudinal outcomes among those who participate in community aftercare. Journal of Psychoactive Drugs 2011(7): 58-67, 2011. (55 refs.)

Participation in aftercare may reduce risk of recidivism among women offenders with substance use problems following their release to the community. This study examines motivation to participate in aftercare among women offenders and whether their participation in both in-custody and aftercare treatment reduces their risk of recidivism. Surveys were conducted with women (N = 1,158) in prison-based substance abuse treatment programs. Return-to-prison was examined among participants in community-based aftercare (N = 1,182) over 12 months following treatment discharge. Higher treatment motivation was associated with child welfare involvement, prior treatment, and use of "harder" drugs; ethnic minority women had lower treatment motivation compared with White women. Participants who completed the aftercare program, or who had longer treatment duration, and those who had participated in an in-prison program prior to parole had reduced risk of recidivism. Study findings suggest the value of community aftercare for women offenders, particularly when combined with prior in-prison treatment.

Copyright 2011, Haight-Asbury Publishing


Hedrich D; Alves P; Farrell M; Stover H; Moller L; Mayet S. The effectiveness of opioid maintenance treatment in prison settings: A systematic review. (review). Addiction 107(3): 501, 2012. (73 refs.)

Aims: To review evidence on the effectiveness of opioid maintenance treatment (OMT) in prison and post-release. Methods Systemematic review of experimental and observational studies of prisoners receiving OMT regarding treatment retention, opioid use, risk behaviours, human immunodeficiency virus (HIV)/hepatitis C virus (HCV) incidence, criminality, re-incarceration and mortality. We searched electronic research databases, specialist journals and the EMCDDA library for relevant studies until January 2011. Review conducted according to Preferred Reporting Items for Systemematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Twenty-one studies were identified: six experimental and 15 observational. OMTwas associated significantly with reduced heroin use, injecting and syringe-sharing in prison if doses were adequate. Pre-release OMT was associated significantly with increased treatment entry and retention after release if arrangements existed to continue treatment. For other outcomes, associations with pre-release OMT were weaker. Four of five studies found post-release reductions in heroin use. Evidence regarding crime and re-incarceration was equivocal. There was insufficient evidence concerning HIV/HCV incidence. There was limited evidence that pre-release OMT reduces post-release mortality. Disruption of OMT continuity, especially due to brief periods of imprisonment, was associated with very significant increases in HCV incidence. Conclusions Benefits of prison OMT are similar to those in community settings. OMT presents an opportunity to recruit problem opioid users into treatment, to reduce illicit opioid use and risk behaviours in prison and potentially minimize overdose risks on release. If liaison with community-based programmes exists, prison OMT facilitates continuity of treatment and longer-term benefits can be achieved. For prisoners in OMT before imprisonment, prison OMT provides treatment continuity.

Copyright 2012, Society for the Study of Addiction


Hedrich D; Farrell M. Opioid maintenance in European prisons: Is the treatment gap closing? (editorial). Addiction 107(3): 461, 2012. (19 refs.)

Hopley AAB; Brunelle C. Personality mediators of psychopathy and substance dependence in male offenders. Addictive Behaviors 37(8): 947-955, 2012. (94 refs.)

Psychopathy and substance dependence (SOD) is highly prevalent in incarcerated populations and tends to co-occur in the same individuals. The factors underlying this relationship are not clearly understood. The primary purpose of this study was to investigate whether two personality models mediate the relationship between psychopathy and substance misuse in male offenders. Ninety-two inmates in provincial correctional centers in New Brunswick completed questionnaires, including the Sensitivity to Reward Sensitivity to Punishment Questionnaire to measure behavioral activation and behavioral inhibition, the Substance Use Risk Profile Scale to measure anxiety sensitivity, introversion/hopelessness, sensation seeking and impulsivity, and the Psychopathic Personality Inventory Revised to assess psychopathy levels. Results revealed that high impulsivity indirectly mediated the relationship between psychopathy and stimulant dependence. In addition, low anxiety sensitivity indirectly mediated the relationship between psychopathy and opioid dependence. Finally, impulsivity indirectly and inconsistently mediated the relationship between psychopathy and alcohol dependence. These results suggest that individuals with psychopathic traits are at increased risk of misusing certain drugs due to underlying personality-based differences.

Copyright 2012, Elsevier Science


Horton A. Heroin users: The need for improved treatment for incarcerated women. Social Work in Public Health 26(2): 176-188, 2011. (21 refs.)

This paper addresses the use of drugs, specifically heroin, by women. While women's rate of incarceration in the nation have dramatically increased, tripling in the last decade, prisons have not kept pace with the growth of the number of women in prison and the need for drug treatment and recovery for this population. This paper examines one programmatic effort to provide services to this most vulnerable population in the state of Illinois. The continuum of care model is considered in light of the challenges of high recidivism rates, particularly in the state of Illinois. It identifies a need for more effective evidence-based services at the state level for prison inmates before and after discharge. Effective program evaluation has not been a priority in some states, and perhaps Illinois correction is prototypical. More effective intervention may requiremore community involvement post-release for ex-offenders. Barriers to healthcare, employment and housing, are just as evident with female drug offenders as in the male population.

Copyright 2011, Taylor & Francis


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

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

Copyright 2011, Elsevier Science


Houser KA; Salvatore C; Welsh WN. Individual-level predictors of community aftercare completion. Prison Journal 92(1): 106-124, 2012. (74 refs.)

The importance of prison treatment for substance-using offenders in reducing recidivism and relapse has garnered much attention and acceptance over the past 30 years. The role of community aftercare as a continuum of the treatment process has been broadly acknowledged as essential in enhancing posttreatment success. However, our understanding of individual-level factors influencing a client's willingness to participate and engage in aftercare remains limited. This article presents findings of individual-level factors found to be associated with successful completion of aftercare among a sample of 259 ex-offenders admitted to aftercare following 12 months of in-prison drug treatment.

Copyright 2012, Sage Publications


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

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

Copyright 2011, Elsevier Science


Johnson S; MacDonald SF; Cheverie M; Myrick C; Fischer B. Prevalence and trends of non-medical opioid and other drug use histories among federal correctional inmates in methadone maintenance treatment in Canada. Drug and Alcohol Dependence 124(1-2): 172-176, 2012. (24 refs.)

Background: The prevalence of illicit drug use among correctional populations is high, and associated with high levels of drug related morbidity risks and harms. The purpose of this study was to examine temporal and regional patterns of illicit drug use among a sample of Canadian federal correctional inmates participating in correctional methadone maintenance treatment (MMT). Methods: Socio-demographic and drug use data collected from 1272 male federal offenders admitted to Correctional Service Canada's (CSC) MMT program between 2003 and 2008 were examined. Univariate analyses were conducted on inmates' key demographic and correctional characteristics, pre-MMT opioid use and other problematic drug use, and opioid and injecting use while incarcerated. Bivariate associations on drug use measures across regions and over time were computed. Results: Prevalence of heroin use decreased, and prevalence of prescription opioid (PO) use increased over the study period. Significant regional differences existed for PO use, specifically for morphine/hydromorphone and oxycodone use. The majority used opioids and injected while incarcerated, with overall downward trends over time and regional variations. Approximately half the sample indicated a history of lifetime non-opioid problematic drug use, most commonly cocaine (72%) for which substantial regional differences were found. Conclusions: Pre-MMT opioid and other problematic non-opioid drug use in the sample was high. Temporal and regional patterns of drug use observed may reflect developments in the general population, e.g. increasing PO misuse. The observed drug use patterns underscore the need for targeted drug specific prevention/treatment measures in correctional environments beyond existing interventions.

Copyright 2012, Elsevier Science


Jung H. Increase in the length of incarceration and the subsequent labor market outcomes: Evidence from men released from Illinois state prisons. Journal of Policy Analysis and Management 30(3): 499-U150, 2011. (46 refs.)

The sharp rise in U.S. incarceration rates has heightened long-standing concerns among scholars and policymakers that lengthy incarceration permanently harms the future labor market outcomes of prisoners. If true, then lengthy prison sentences will not only punish criminals for crimes committed, but will also make it far more difficult for ex-prisoners to reenter society as productive citizens. To investigate this claim I examine how increase in duration of incarceration affects subsequent earnings and employment. Comparing long-serving prisoners with short-serving ones in the Illinois state prison system, I find that the length of incarceration is positively associated with earnings and employment, even though these effects attenuate over time. The positive effects are stronger for individuals convicted of economically motivated and less violent crimes (such as property-and drug-related offenses) than for those convicted of violent crimes (such as person-related offenses). The effect is also stronger for prison entrants with self-reported drug addiction problems. The deterrent effect of lengthy incarceration and rehabilitation during incarceration are possible reasons for this positive effect. However, because this paper analyzes men who served less than four years in Illinois prison and excludes the population of men who served their terms exclusively in jail, readers should be cautious about generalizing findings of this paper.

Copyright 2011, Association for Public Policy Analysis and Management


Kinner SA; Milloy MJ; Wood E; Qi JZ; Zhang R; Kerr T. Incidence and risk factors for non-fatal overdose among a cohort of recently incarcerated illicit drug users. Addictive Behaviors 37(6): 691-696, 2012. (55 refs.)

Background: Release from prison is associated with a markedly increased risk of both fatal and non-fatal drug overdose, yet the risk factors for overdose in recently released prisoners are poorly understood. The aim of this study was to identify risk and protective factors for non-fatal overdose (NFOD) among a cohort of illicit drug users in Vancouver, Canada, according to recent incarceration. Methods: Prospective cohort of 2515 community-recruited illicit drug users in Vancouver, Canada, followed from 1996 to 2010. We examined factors associated with NFOD in the past six months separately among those who did and did not also report incarceration in the last six months. Results: One third of participants (n = 829, 33.0%) reported at least one recent NFOD. Among those recently incarcerated, risk factors independently and positively associated with NFOD included daily use of heroin, benzodiazepines, cocaine or methamphetamine, binge drug use, public injecting and previous NFOD. Older age, methadone maintenance treatment and HIV seropositivity were protective against NFOD. A similar set of risk factors was identified among those who had not been incarcerated recently. Conclusions: Among this cohort, and irrespective of recent incarceration, NFOD was associated with a range of modifiable risk factors including more frequent and riskier patterns of drug use. Not all ex-prisoners are at equal risk of overdose and there remains an urgent need to develop and implement evidence-based preventive interventions, targeting those with modifiable risk factors in this high risk group.

Copyright 2012, Elsevier Science


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

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

Copyright 2011, Australasian Medical Publishing


Kivimies K; Repo-Tiihonen E; Tiihonen J. Substance use among forensic psychiatric patients. American Journal of Drug and Alcohol Abuse 38(4): 273-277, 2012. (24 refs.)

Objectives: The primary goal of this study was to examine the relative differences in the use of illegal substances (i.e., amphetamine, cannabis, opiates) among forensic patients who have committed a violent crime compared with the general population. The aim was also to find out if there were differences in substance use among forensic versus nonforensic patients with psychosis diagnosis. Methods: The study population consisted of 190 persons, who were involuntarily ordered to hospital treatment as forensic patients in Finland. The information was compared with data from the national hospital discharge register. These results were also compared with national statistics from the general population. Results: Among forensic patients, the lifetime prevalence of cannabis use was 2-fold, amphetamine use 40-fold, and opiate use over 60-fold higher than estimated from the general population in Finland. Cannabis use was 1.5-fold more common than amphetamine use among forensic patients and 1.3-fold more common among nonforensic patients. The prevalences of cannabis-related diagnoses were 4.7- and 3.7-fold more common than opiate use among forensic and nonforensic patients, respectively. Conclusions: Cannabis, amphetamine, and opiate use are associated with an increased risk of becoming a forensic psychiatric patient, but no substantial differences were observed among patients with psychosis diagnosis in the relative risk increase for cannabis versus amphetamine versus opiate use, indicating that none of these drugs are uniquely associated with violent offending among mentally ill.

Copyright 2012, Informa Healthcare


Korcha RA; Polcin DL. Addressing the deluge of early release prisoners into US communities. (editorial). Addiction 107(1): 4-5, 2012. (6 refs.)

Lasnier B; Cantinotti M; Guyon L; Royer A; Brochu S; Chayer L. Implementing an indoor smoking ban in prison: Enforcement issues and effects on tobacco use, exposure to second-hand smoke and health of inmates. Canadian Journal of Public Health 102(4): 249-253, 2011. (15 refs.)

Objectives: To describe the issues encountered during the implementation of an indoor smoking ban in prison and its effects on self-reported tobacco use, perceived exposure to second-hand smoke (SHS) and perceived health status of inmates in Quebec's provincial correctional facilities. Methods: Quantitative data were obtained from 113 inmates in three provincial correctional facilities in the province of Quebec, Canada. Qualitative data were obtained from 52 inmates and 27 staff members. Participants were recruited through a self-selection process. Particular efforts were made to enrol proportions of men, women, smokers and non-smokers similar to those generally found among correctional populations. Results: Despite the indoor smoking ban, 93% of inmates who declared themselves smokers reported using tobacco products inside the correctional facilities and 48% did not report any reduction in their tobacco use. Only 46% of smokers declared having been caught smoking inside the facility, and more than half of them (58%) reported no disciplinary consequences to their smoking. A majority of inmates incarcerated before the implementation of the ban (66%) did not perceive a reduction of their exposure to SHS following the indoor ban. Enforcement issues were encountered during the implementation of the indoor ban, notably because of the amendment made to the original regulation (total smoking ban) and tolerance from smokers in the staff towards indoor smoking. They were also related to perceptions that banning indoor smoking is complex and poses management problems. Conclusion: This study's findings emphasize the importance of considering organizational and environmental factors when planning the implementation of an indoor smoking ban in correctional facilities.

Copyright 2011, Canadian Public Health Association


Lee KH; Bowen S; An-Fu B. Psychosocial outcomes of mindfulness-based relapse prevention in incarcerated substance abusers in Taiwan: A preliminary study. Journal of Substance Use 16(6): 476-483, 2011. (29 refs.)

Introduction: The current study evaluated effects of an adapted version of Mindfulness-Based Relapse Prevention (MBRP) on several psychosocial indices in a sample of incarcerated adult males with substance use disorders. Method: This study used a 2 (baseline vs post-session) x 2 (MBRP vs. treatment-as-usual (TAU) mixed design. Twenty-four incarcerated individuals with a history of substance abuse were randomly assigned to either MBRP or TAU. At pre- and post-session assessment points, participants completed the Drug Use Identification Disorders Test- Extended (DUDIT-E), the Drug Avoidance Self-Efficacy Scale (DASE) and positive/negative outcome expectancies (Ep/En). The Beck Depression Inventory-II (BDI-II) was completed in each weekly session of MBRP. MANOVA and repeated measures ANOVA examined changes between and within subjects, with the significant level set at 0.05. Results: No between-group differences were found on positive outcome expectancies or self-efficacy. Differences BDI-II scores among MBRP participants showed a downward trend over time. A Group x Time effect emerged for negative outcome expectancies, with significant differences between groups at post-course assessment. Conclusions: Results from this randomized trial suggest pre- to post-intervention trend-level effects of MBRP on depression, and significant group differences over time and at post-course on negative outcome expectancies, with the MBRP group reporting increases.

Copyright 2011, Informa Healthcare


Lintonen T; Obstbaum Y; Aarnio J; von Gruenewaldt V; Hakamaki S; Kaariainen J et al. The changing picture of substance abuse problems among Finnish prisoners. Social Psychiatry and Psychiatric Epidemiology 47(5): 835-842, 2012. (56 refs.)

Marginalized people are often absent from population surveys of substance use and from research based on care data. Special methods are needed to reach these small but very significant groups. This study analyses how patterns of intoxicant use have changed over time among one of the most marginalized group of people, the prisoners. Nationally representative samples of Finnish prisoners were examined: 903 prisoners in 1985, 325 prisoners in 1992, and 410 prisoners in 2006. Comprehensive field studies consisting of interviews and a clinical medical examination were used. In 1985, a diagnosis for alcoholism was given to 41% of the men and 36% of the women prisoners. An increase over time was observed, and in 2006, 52% of men and 51% of women prisoners were alcohol dependent. Dependence on a drug was diagnosed in 6% of men and 3% of women in 1985; this prevalence had increased to 58% of men and 60% of women in 2006. A dramatic change in prevalence of illegal drug use and drug addiction among prisoners has taken place in the past 20 years. Recognizing this shift from alcohol to other intoxicants is important since drugs are illegal substances and thus tend to lead to involvement with the judicial sector, thus stigmatizing and deepening the spiral of marginalization.

Copyright 2012, Springer Heidelberg


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

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

Copyright 2011, Informa Healthcare


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

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

Copyright 2011, Informa Healthcare


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

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

Copyright 2011, Springer


MacAskill S; Parkes T; Brooks O; Graham L; McAuley A; Brown A. Assessment of alcohol problems using AUDIT in a prison setting: More than an 'aye or no' question. BMC Public Health 11: article 865, 2011. (34 refs.)

Background: Alcohol problems are a major UK and international public health issue. The prevalence of alcohol problems is markedly higher among prisoners than the general population. However, studies suggest alcohol problems among prisoners are under-detected, under-recorded and under-treated. Identifying offenders with alcohol problems is fundamental to providing high quality healthcare. This paper reports use of the AUDIT screening tool to assess alcohol problems among prisoners. Methods: Universal screening was undertaken over ten weeks with all entrants to one male Scottish prison using the AUDIT standardised screening tool and supplementary contextual questions. The questionnaire was administered by trained prison officers during routine admission procedures. Overall 259 anonymised completed questionnaires were analysed. Results: AUDIT scores showed a high prevalence of alcohol problems with 73% of prisoner scores indicating an alcohol use disorder (8+), including 36% having scores indicating 'possible dependence' (20-40). AUDIT scores indicating 'possible dependence' were most apparent among 18-24 and 40-64 year-olds (40% and 56% respectively). However, individual questions showed important differences, with younger drinkers less likely to demonstrate habitual and addictive behaviours than the older age group. Disparity between high levels of harmful/hazardous/dependent drinking and low levels of 'treatment' emerged (only 27% of prisoners with scores indicating 'possible dependence' reported being 'in treatment'). Self-reported associations between drinking alcohol and the index crime were identified among two-fifths of respondents, rising to half of those reporting violent crimes. Conclusions: To our knowledge, this is the first study to identify differing behaviours and needs among prisoners with high AUDIT score ranges, through additional analysis of individual questions. The study has identified high prevalence of alcohol use, varied problem behaviours, and links across drinking, crime and recidivism, supporting the argument for more extensive provision of alcohol-focused interventions in prisons. These should be carefully targeted based on initial screening and assessment, responsive, and include care pathways linking prisoners to community services. Finally, findings confirm the value and feasibility of routine use of the AUDIT screening tool in prison settings, to considerably enhance practice in the detection and understanding of alcohol problems, improving on current more limited questioning (e. g. 'yes or no' questions).

Copyright 2011, BioMed Central


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

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

Copyright 2011, Elsevier Science


Magyar MS; Edens JF; Lilienfeld SO; Douglas KS; Poythress NG; Skeem JL. Using the Personality Assessment Inventory to predict male offenders' conduct during and progression through substance abuse treatment. Psychological Assessment 24(1): 216-225, 2012. (65 refs.)

Prior research has supported the utility of the Personality Assessment Inventory (PAI; Morey, 1991, 2007) to predict various negative outcomes among offender samples, yet few studies have specifically examined its association with behavior in treatment. In this study, the PAI was administered to 331 male offenders court ordered into substance abuse treatment. Several theoretically relevant PAI scales (e.g., Antisocial Features, Borderline Features) predicted various forms of problematic conduct (e.g., disruptive behavior, aggression) and subjective and objective ratings of treatment progress. Although there was relatively limited evidence for the superiority of any one predictor over the others, the Aggression (AGG) scale demonstrated incremental validity above and beyond other indicators for general noncompliance and aggressive behavior. Interpersonal scales also predicted select treatment behavior while sharing relatively little common variance with AGO. These findings highlight the importance of distinguishing lower order and higher order dimensions on the PAI and other measures.

Copyright 2012, American Psychological Association


McEvoy A; Spirgen N. Gambling among prison inmates: Patterns and implications. Journal of Gambling Studies 28(1): 69-76, 2012. (11 refs.)

There is an absence of research on gambling among prison inmates during their incarceration. Little is known about how prisoners organize gambling activities or the potential risks they face from gambling. Similarly, no empirical attention has been given to how correctional institutions respond to inmate gambling. This study employed interviews with 55 male prisoners and self-administered surveys with 159 correctional officers and staff, at two medium security prisons in Ohio. Data were gathered on prevalence and patterns of inmate gambling, perceived hazards of gambling, and perceived institutional responses to prisoner gambling. Findings suggest that inmate gambling is common and constitutes an important feature of the underground economy of prisons, yet little is done to deter or prevent this activity. Suggestions are made for more effective institutional responses.

Copyright 2012, Springer


McKenzie M; Zaller N; Dickman SL; Green TC; Parihk A; Friedmann PD et al. A randomized trial of methadone initiation prior to release from incarceration. Substance Abuse 33(1, special issue): 19-29, 2012. (42 refs.)

Individuals who use heroin and illicit opioids are at high risk for infection with human immunodeficiency virus (HIV) and other blood-borne pathogens, as well as incarceration. The purpose of the randomized trial reported here is to compare outcomes between participants who initiated methadone maintenance treatment (MMT) prior to release from incarceration, with those who were referred to treatment at the time of release. Participants who initiated MMT prior to release were significantly more likely to enter treatment postrelease (P < .001) and for participants who did enter treatment, those who received MMT prerelease did so within fewer days (P = .03). They also reported less heroin use (P = .008), other opiate use (P = .09), and injection drug use (P = .06) at 6 months. Initiating MMT in the weeks prior to release from incarceration is a feasible and effective way to improve MMT access postrelease and to decrease relapse to opioid use.

Copyright 2012, Taylor & Francis


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

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

Copyright 2011, Elsevier Science


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

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

Copyright 2011, Taylor & Francis


Monras M; Aparicio A; Lopez JA; Pons I. Prevalence of alcohol consumption related disorders in a prison population convicted of crimes against road safety. Actas Espanolas de Psiquiatria 39(3): 163-167, 2011. (18 refs.)

Introduction. Alcohol consumption is a major cause of traffic accidents, so that stricter laws have been enacted to avoid it. Despite this, there are still persons who break the law and go to prison because of driving under the effects of alcohol. We have investigated if these persons are occasionally alcohol drinkers or if they are alcoholics with difficult to modify alcohol patterns. Material and methods. A cross-sectional study including 50 inmates from two prisons who had committed traffic crimes were interviewed about their alcohol consumption habits and their criminal and psychopathological backgrounds. Results. 88% had indicators of alcoholism and most consumed other drugs. Previous psychopathology signs were only detected in 10% of the sample. A total of 72% had previous criminal records, half because of violent offences. They were socially adapted, with mean age 39 years, Spanish (86%), had a stable job and family (76%). Conclusions. Most of the inmates due to traffic crimes are alcoholic, but very few are detected. Their alcohol consumption generates other criminal conduct, treatment being necessary in order to avoid relapse and social exclusion.

Copyright 2011, Juan Jose Lopez-Ibor Foundation


Nordstrom BR; Williams AR. Drug treatments in criminal justice settings. (review). Psychiatric Clinics of North America 35(2): 375+, 2012. (97 refs.)

Studies report that the direct effect of drug-related crime (ie, not including the cost of arrest, prosecution, and incarceration) is the largest single cost related to addiction. Addiction to illicit substances and its connection to people going through the criminal justice system are discussed in this review. Emphasis is on the efficacy of drug treatment in offender populations. Outcomes from large national studies and smaller studies are presented that deal with addiction treatment and criminal offenses; also discussed are operant conditioning in drug addiction, contingency management in a criminal justice context, coercion in the criminal justice setting, and drug courts.

Copyright 2012, Elsevier Science


Opitz-Welke A; Konrad N. Inpatient treatment in the psychiatric department of a German prison hospital. International Journal of Law and Psychiatry 35(3, special issue): 240-243, 2012. (18 refs.)

Objective: Although the construct of psychic incompetence can prevent severely mentally disturbed persons from being imprisoned in Germany, the prevalence of mentally disordered persons who are detained is high. Data describing the characteristics of mentally disturbed detainees in Germany are scarce. The following study uses data from a psychiatric care institution in a prison to examine the distribution of psychiatric diagnoses in relation to age, nationality and legal status. The distribution of diagnoses is compared to that of the psychiatric department at a Berlin community hospital. Method: The data were recorded during each patient's hospital treatment and summarised on the day of discharge. The following variables were assessed: age, length of stay in days, main diagnosis, up to 2 additional diagnoses, frequency of violent or suicidal behaviour, and nationality. Data were collected from January 2010 to February 2011 in the psychiatric department of the Berlin Prison Hospital. Results: During a 14-month period, 107 patients were discharged from psychiatric inpatient care and N = 124 completed treatments were observed. Of these patients, 21.5% were pre-trial detainees, and 58% were of German nationality. The mean age was 37.7 years. Non-German patients were younger than German patients. Fifty-five percent of the patients suffered from a psychotic disorder, and 7.5% had a main diagnosis of antisocial personality disorder. Personality disorders were significantly less frequently diagnosed in non-German patients. An additional diagnosis of substance abuse was present in 66% of the patients, and 17.8% of the patients showed suicidal and/or violent behaviour or had to be restrained (immobilisation, isolation, compulsory medication). The frequency of suicide, violence and compulsory measures did not differ significantly between German and non-German patients, between younger and older patients or between remand and sentenced inmates. The distribution of psychiatric diagnoses was similar to that of a Berlin community hospital. Conclusions: Personality disorders were more frequently diagnosed in German than in non-German patients. The burden of personality disorders among mentally ill prison detainees in Berlin Prison Hospital was not significantly higher than that of a Berlin community hospital. The percentage of non-German patients in the psychiatric department of the Berlin Prison Hospital was more than two times higher than in a psychiatric department of a community hospital. The lower-than-expected rate of suicide attempts among pre-trial detainees may be an indicator of a beneficial effect of the treatment setting in the psychiatric department of Berlin Prison Hospital.

Copyright 2012, Elsevier Science


Peltan JR; Cellucci T. Childhood sexual abuse and substance abuse treatment utilization among substance-dependent incarcerated women. Journal of Substance Abuse Treatment 41(3): 215-224, 2011. (52 refs.)

Incarcerated women have high rates of substance abuse problems and trauma. A variety of variables may influence whether these women seek help or are referred for substance abuse problems. This study reports an exploratory project on service utilization among incarcerated substance-dependent women (N = 40) in southeastern Idaho. Using self-report and interview tools, most participants reported some substance abuse treatment history, although extent and types of treatment varied. Most of the women also reported some type of childhood abuse. Age, income, and consequences of alcohol and other drug use related positively to substance abuse treatment. However, severity of childhood sexual abuse and current trauma symptoms were negatively correlated with substance abuse treatment episodes. These women may use substances to cope with childhood trauma or may not perceive the substance abuse system as responsive to their co-occurring trauma symptoms.

Copyright 2011, Elsevier Science


Pettus-Davis C; Howard MO; Roberts-Lewis A; Scheyett AM. Naturally occurring social support in interventions for former prisoners with substance use disorders: Conceptual framework and program model. Journal of Criminal Justice 39(6): 479-488, 2011. (71 refs.)

Purpose: Naturally-occurring social support is underutilized in interventions with former prisoners with substance use disorders. This paper proposes a conceptual framework followed by a program model to inform the development of naturally-occurring social support interventions with former prisoners with substance use disorders. Methods: We reviewed all published social support interventions designed for former prisoners and people with substance use disorders over a ten year period. Building on the implications of this review, empirical literature, professional experience, and theory, we propose a conceptual framework for naturally-occurring social support programs. Results: Few published programs exist that actively incorporate social support providers into the program model. Of these, even fewer use naturally-occurring support. Expanding on gaps in theory and program approaches, the conceptual model posits that it is the appropriate match of support needs and provision that reinforces emotions, cognitions, and behaviors, that in turn, promote adaptive outcomes. Conclusions: With mounting pressure to identify interventions that will reduce high re-incarceration rates, this paper draws attention to a neglected, potentially effective, and low cost resource -- naturally-occurring social support. The described program, Support Matters, illustrates how social support interventions can be used with former prisoners to promote reduced relapse to substance misuse and crime.

Copyright 2011, Elsevier Science


Phillips D. Wellbutrin (R): Misuse and abuse by incarcerated individuals. Journal of Addictions Nursing 23(1): 65-69, 2012. (19 refs.)

Misuse and abuse of prescription medications is increasing across both socioeconomic and age parameters. This article includes a review of the uses of Wellbutrin (R), and its current misuse/abuse within the correctional setting. It includes a discussion regarding the pharmacodynamics involved in substance abuse. A review of current literature includes both academic research and public forums regarding this topic. It also discusses the role of dopamine in both Wellbutrin (R) and substance use. The author identifies the lack of current research regarding this topic and poses ethical questions for the provider.

Copyright 2012, Informa Healthcare


Plant G; Taylor PJ. Recognition of problem drinking among young adult prisoners. Behavioral Sciences & the Law 30(2, special issue): 140-153, 2012. (30 refs.)

Alcohol is a preventable cause of illness, offending and other adversities worldwide. Prisoners are especially vulnerable. The aim of this study was to test the hypotheses that younger adult male prisoners are more likely to be hazardous drinkers than their older peers, but less likely to recognize this. The study cohort comprised 100 male prisoners aged 18-20 years and 157 aged 21 and over, who were interviewed and completed standard alcohol and drug questionnaires just after reception into prison. It was found that younger men were significantly more likely to be hazardous drinkers than their older peers but less likely to recognise this, even at scores on the Alcohol Use Disorders Identification Test (AUDIT) indicating dependency. They were also less likely to experience withdrawal symptoms, the main factor associated with problem drinking recognition at any age. Younger prisoners were less likely to be depressed, more likely to rate their social support as good and less likely to be dependent drug users. We conclude that reliance on younger prisoners to recognise their hazardous drinking would identify about one-fifth of them. With a lower likelihood of withdrawal symptoms than older men, they are probably still metabolizing alcohol more effectively. Given their similarities to older prisoners in terms of any previous imprisonment and likely personality disorder, formal screening for hazardous drinking might prevent decline into problem drug use, depression, reoffending, re-imprisonment, and social disconnection.

Copyright 2012, Wiley-Blackwell


Prendergast ML. Issues in defining and applying evidence-based practices criteria for treatment of criminal-justice involved clients. Journal of Psychoactive Drugs 2011(7): 10-18, 2011. (39 refs.)

Evidence-based practice (EBP) applies the principles and techniques of evidence-based decision making to interventions intended to improve, or ameliorate, the social or clinical problems of affected individuals, including offenders with drug abuse problems. This article provides a general overview of EBP, particularly as it applies to treatment and other interventions for offenders with problems involving drugs (including alcohol). The discussion includes a definition of EBP, notes the implications of using EBPs to make policy and clinical decisions, lists the various efforts by government and academic organizations to identify practices that can be considered evidence-based, describes the criteria used by such organizations to evaluate programs as being evidence-based, raises some cautions about the use of EBPs, and ends with some challenges in disseminating and implementing EBPs.

Copyright 2011, Haight-Asbury Publishing


Proctor SL. Substance use disorder prevalence among female state prison inmates. American Journal of Drug and Alcohol Abuse 38(4): 278-285, 2012. (39 refs.)

Background: Substance use disorders (SUDs) are prevalent among female inmates. As the female state prison population continues to increase, describing the specific clinical and demographic characteristics of female prisoners remains of paramount importance to better define women's needs in the state prison system. Objectives: To determine the prevalence and patterns of current DSM-IV SUDs and explore whether particular demographic characteristics are more strongly associated with specific SUD categories. Methods: Data were derived from routine clinical assessments of 801 female inmates incarcerated in the Minnesota Department of Corrections state prison system. The Substance Use Disorder Diagnostic Schedule-IV (Hoffmann NG, Harrison PA. SUDDS-IV: Substance Use Disorder Diagnostic Schedule-IV. Smithfield, RI: Evince Clinical Assessments, 1995) was administered to all inmates as a computer-prompted interview on admission to the prison. Results: Of the inmates, 70.0% were dependent on at least one substance, and 7.9% met criteria for substance abuse. Alcohol dependence (30.2%) and cocaine dependence (30.1%) were the two most prevalent SUDs. The remaining substance dependence diagnoses that predominated were as follows: stimulant dependence, 24.1%; marijuana dependence, 15.6%; and heroin dependence, 9.6%. Over half (56.9%) were dependent on a substance other than alcohol. Prevalence of cocaine dependence [odds ratio (OR) 2.83, 95% confidence interval (CI) 1.92-4.16] was significantly higher among African Americans, whereas prevalence of stimulant dependence (OR 9.24, 95% CI 5.40-15.80) was significantly higher among Caucasians. Prevalence of alcohol (OR 2.12, 95% CI 1.38-3.25) and heroin (OR 2.67, 95% CI 1.50-4.77) dependence was significantly higher among Native Americans. Conclusions and Scientific Significance: SUDs in general, and illicit drug use disorders in particular, are prevalent among female inmates entering a state prison system. Membership to a particular ethnic group may identify a set of inmates at elevated risk for the presence of substance-specific dependence diagnoses.

Copyright 2012, Informa Healthcare


Proctor SL; Hoffmann NG. A brief alternative for identifying alcohol use disorders. Substance Use & Misuse 47(7): 847-860, 2012. (34 refs.)

This study sought to evaluate the clinical utility of a brief assessment interview in accurately classifying inmates manifesting an alcohol use disorder (AUD) based on a structured diagnostic assessment interview. Data were derived from routine clinical assessments of 7,672 inmates (89.6% male) incarcerated in the Minnesota Department of Corrections state prison system. An automated version of the Substance Use Disorder Diagnostic Schedule-IV (SUDDS-IV), which included a subset of the items comprising the Triage Assessment for Addictive Disorders (TAAD), was administered to all inmates from 2000 to 2003. Approximately 99% of the DSM-IV dependence and no diagnosis cases were appropriately classified by the TAAD. Although the TAAD identified nearly all cases with any diagnosis, 20%-24% of cases classified as abuse by the TAAD were found to be dependent by the longer instrument. Similar findings were noted when DSM-5 criteria were applied. The TAAD has the potential to provide a more clinically defensible means of identifying AUDs than brief screens when time constraints may preclude a comprehensive assessment. Limitations and implications for routine clinical practice are discussed.

Copyright 2012, Informa Healthcare


Reavy R; Stein LAR; Paiva A; Quina K; Rossi JS. Validation of the Delinquent Activities Scale for incarcerated adolescents. Addictive Behaviors 37(7): 875-879, 2012. (25 refs.)

Purpose: This study examined the validity of the Delinquent Activities Scale (DAS), based in part on the Self Reported Delinquency (SRD) scale. Method: Participants were 190 incarcerated adolescents (85.8% male; average age 17 years) at a juvenile correctional facility in the Northeast. While incarcerated, they were asked about substance use and delinquent activities in the 1 year prior to incarceration, as well as parental, peer, and demographic information. They were tracked at three months post-release, given the DAS, and assessed for post-release substance use. Results: Three factors of the DAS assess general, alcohol-involved, and marijuana-involved delinquent activities. Principal components analysis was used to develop subscales within each factor. Support was found for concurrent and predictive incremental validities of these factors and their subscales in predicting substance use, with stronger findings for the general and the alcohol-involved factors. Subscales related to stealing showed lower validity than those related to more aggressive behaviors. Conclusions: These analyses suggest that the factors and empirically derived subscales offer researchers and clinicians a psychometrically sound approach for the assessment of adolescent misbehaviors.

Copyright 2012, Elsevier Science


Richmond RL; Butler TG; Indig D; Wilhelm KA; Archer VA; Wodak AD. The challenges of reducing tobacco use among prisoners. Drug and Alcohol Review 31(5, special issue): 625-630, 2012. (28 refs.)

Issue. The prevalence of smoking among prisoners is exceptionally high and is often comorbid with alcohol and drug problems, mental illness and other health problems. This review paper summarises the literature and available research related to smoking prevalence and smoking cessation initiatives among prisoners and identifies areas of need for further research and intervention. Approach. This paper highlights three studies conducted in the New South Wales prison system which attempt to address these high rates of smoking including a feasibility study, a focus group study and a randomised controlled trial. Key Findings. The challenges of making systems-level changes to address these high rates of smoking are discussed including a recent National Summit on Tobacco Smoking in Prisons. Implications. Dissemination of research findings has assisted in highlighting the importance of tobacco smoking among prisoners and the need to develop culturally and setting appropriate smoking cessation initiatives for prisoners. Conclusions. As one of the most marginalised and socially disadvantaged populations in Australia, prisoners represent an important population to target for smoking cessation programs and interventions. This paper highlights a number of initiatives undertaken to address this problem and suggests directions for the future.

Copyright 2012, Wiley-Blackwell


Richmond RL; Wilhelm KA; Indig D; Butler TG; Archer VA; Wodak AD. Cardiovascular risk among Aboriginal and non-Aboriginal smoking male prisoners: inequalities compared to the wider community. BMC Public Health 11: e-783, 2011

Cardiovascular risk factors (CVRF) were collected as part of a randomised controlled trial of a multi-component intervention to reduce smoking among male prisoners. Cross-sectional baseline data on CVRF were compared among smoking male prisoners and males of similar age in the general population. 425 smoking prisoners were recruited (n = 407 in New South Wales; 18 in Queensland), including 15% of Aboriginal descent (mean age 33 years; median sentence length 3.6 years). We measured CVRF such as smoking, physical activity, blood pressure, risky alcohol use, symptoms of depression, and low socioeconomic status. We found that 39% of prisoners had 3+ CVRF, compared to 10% in a general community sample of most disadvantaged men of a similar age. Significantly more Aboriginal prisoners had 3+ CVRF than non-Aboriginal prisoners (55% vs 36%, p < 0.01) and were twice as likely to have 4+ CVRF (27% vs 12%). In addition to all prisoners in this study being a current smoker (with 70% smoking 20+ cigarettes per day), the prevalence of other CVRF was very high: insufficient physical activity (23%); hypertension (4%), risky drinking (52%), symptoms of depression (14%) and low socioeconomic status (SES) (44%). Aboriginal prisoners had higher levels of risky alcohol use, symptoms of depression, and were more likely to be of low SES. Prisoners are at high risk for developing cardiovascular disease compared to even the most disadvantaged in their community and should be the focus of specific public health interventions.

Copyright 2011, BioMed Central


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

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

Copyright 2011, Society for the Study of Addiction to Alcohol and Other Drugs


Ruiz MA; Douglas KS; Edens JF; Nikolova NL; Lilienfeld SO. Co-occurring mental health and substance use problems in offenders: Implications for risk assessment. Psychological Assessment 24(1): 77-87, 2012. (74 refs.)

We undertook a secondary data analysis to study issues relevant to co-occurring mental health and substance disorder in a combined sample of offenders (N = 3, 197). Using the Personality Assessment Inventory, we compared the frequency of depressive, traumatic stress, and personality disorder symptom elevations across offenders with and without substance problems, identified the extent to which co-occurring problems were accompanied by risk factors for suicide and aggression, and tested for gender differences. Offenders with substance problems were more likely than others to have increased mental health problems and risk factors for suicide or aggression. Women with substance problems, compared with men, had higher depression, traumatic stress, and borderline features, in addition to lower antisocial features. The frequency with which suicide and aggression risk factors were associated with mental health problems was generally similar across men and women. Measurement issues relevant to co-occurring disorder and risk assessment are discussed.

Copyright 2012, American Psychological Association


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

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

Copyright 2011, Wiley-Blackwell


Sered S; Norton-Hawk M. Whose higher power? Criminalized women confront the "Twelve Steps". Feminist Criminology 6(4): 308-332, 2011. (58 refs.)

Drawing on 3 years of fieldwork with a community of criminalized women in eastern Massachusetts, this article explores their ambivalent, often negative, relationship with and feelings about Alcoholics Anonymous/Narcotics Anonymous (AA/NA). We suggest that coerced participation in AA/NA undermines any potential value that these programs may have for other types of participants and that the Twelve Step ideology of personal responsibility and turning oneself over to a Higher Power fails to resonate for women who are homeless, poor, incarcerated, abused, and have had their children taken from them.

Copyright 2011, Sage Publications


Sharp SF; Peck BM; Hartsfield J. Childhood adversity and substance use of women prisoners: A General Strain Theory approach. Journal of Criminal Justice 40(3, special issue): 202-211, 2012. (67 refs.)

The current paper seeks to add to the literature on General Strain Theory (GST) in two ways. First, it tests the efficacy of the theory in a sample of incarcerated women, adding to our knowledge of the generality of the theory. Second, it examines whether specific individual measures of strain or an index of cumulative strain provide more information about the relationship between strain and deviance. To explore this issue, we examine the effects of individual strains versus the cumulative impact of strain on daily drug and alcohol use prior to incarceration using data from the 2008 and 2009 Oklahoma Study of Incarcerated Women and Their Children. Our measures of strain are drawn from the Adverse Childhood Experiences Study. The analyses indicate that certain tenets of GST do predict daily drug use in this sample, thus suggesting the theory is has applicability to an offending population. The analyses further suggest that the explanatory power is similar, whether the individual or cumulative measures of strain are employed. However, a few key stressors appear to account for most of the explanatory power of the index, and there are some variations in which strains are related to the type of substance used.

Copyright 2012, Elsevier Science


Sondhi A; Day E. An assessment of SERVQUAL as a measure of service quality in English male prisons: Perceptions and expectations of the Integrated Drug Treatment System (IDTS). Drugs: Education, Prevention and Policy 19(2): 171-180, 2012. (37 refs.)

Aims: Validated schedules such as the Treatment Perceptions Questionnaire or Patient Satisfaction Questionnaire quantify service user satisfaction levels as a quality of service measure. This study assesses whether the validated survey instrument SERVQUAL can be used to measure service user satisfaction levels of the Integrated Drug Treatment System (IDTS) in English prisons. Methods: In this study, 96 face-to-face prisoner interviews were undertaken using SERVQUAL across eight prisons in England. Expectations, perceptions and a gap analysis were undertaken. Statistical reliability and validity of SERVQUAL were tested using principal components analysis and service quality factors were examined using linear regression methods. Findings: Prisoners were shown to have high expectations of IDTS services. Apart from one domain (tangibles), prisoners perceived services as not meeting their expectations. Factor analysis demonstrated that SERVQUAL had poor construct validity as the five domains did not map as expected. Three new service quality factors were identified - interpersonal, treatment content and professional qualities - along with an inverse relationship with previous treatment experiences prior to prison. Conclusions: Perception-only schedules may mask dissatisfaction levels by excluding the role that expectations play in the treatment process. More nuanced schedules are required to quantify satisfaction levels with reference to previous treatment experiences. Interpersonal qualities and treatment content qualities should form domains that measure service users' satisfaction with treatment.

Copyright 2012, Informa Healthcare


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

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

Copyright 2011, Informa Health


Springer SA; Qiu JJ; Saber-Tehrani AS; Altice FL. Retention on buprenorphine is associated with high levels of maximal viral suppression among HIV-infected opioid dependent released prisoners. PLoS ONE 7(5): e-article 38335, 2012. (53 refs.)

Introduction: HIV-infected prisoners lose viral suppression within the 12 weeks after release to the community. This prospective study evaluates the use of buprenorphine/naloxone (BPN/NLX) as a method to reduce relapse to opioid use and sustain viral suppression among released HIV-infected prisoners meeting criteria for opioid dependence (OD). Methods: From 2005-2010, 94 subjects meeting DSM-IV criteria for OD were recruited from a 24-week prospective trial of directly administered antiretroviral therapy (DAART) for released HIV-infected prisoners; 50 (53%) selected BPN/NLX and were eligible to receive it for 6 months; the remaining 44 (47%) selected no BPN/NLX therapy. Maximum viral suppression (MVS), defined as HIV-1 RNA<50 copies/mL, was compared for the BPN/NLX and non-BPN/NLX (N = 44) groups. Results: The two groups were similar, except the BPN/NLX group was significantly more likely to be Hispanic (56.0% v 20.4%), from Hartford (74.4% v 47.7%) and have higher mean global health quality of life indicator scores (54.18 v 51.40). MVS after 24 weeks of being released was statistically correlated with 24-week retention on BPN/NLX [AOR = 5.37 (1.15, 25.1)], having MVS at the time of prison-release [AOR = 10.5 (3.21, 34.1)] and negatively with being Black [AOR = 0.13 (0.03, 0.68)]. Receiving DAART or methadone did not correlate with MVS. Conclusions: In recognition that OD is a chronic relapsing disease, strategies that initiate and retain HIV-infected prisoners with OD on BPN/NLX is an important strategy for improving HIV treatment outcomes as a community transition strategy.

Copyright 2012, Public Library of Science


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

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

Copyright 2011, Jacobs Institute of Women's Health


Staton-Tindall M; McNees E; Leukefeld C; Walker R; Oser C; Duvall J et al. Treatment utilization among metropolitan and nonmetropolitan participants of corrections-based substance abuse programs reentering the community. Journal of Social Service Research 37(4): 379-389, 2011. (39 refs.)

This study examines differences in drug use and recidivism outcomes at 12 months postrelease from jail or prison as a function of geographic location and treatment utilization. Participants (N = 700) were previously enrolled in drug treatment during the last 6 to 9 months of their incarceration and were released to the community on either parole or serve-out. Findings from this study indicated that offenders returning to metropolitan areas reported more use of community treatment services following release than offenders in nonmetropolitan areas. Although offenders in both metropolitan and nonmetropolitan areas who reported community treatment following release were less likely to be reincarcerated, community treatment utilization was not a significant correlate of relapse. Findings are discussed, and future directions include favorable outcomes when community treatment is utilized.

Copyright 2011, Taylor & Francis


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

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

Copyright 2011, Alcohol Research Documentation


Stemen D; Rengifo AF. Reconciling the multiple objectives of prison diversion programs for drug offenders: Evidence from Kansas' Senate Bill 123. Evaluation Review 35(6): 642-672, 2011. (40 refs.)

Background: In recent years, several states have created mandatory prison-diversion programs for felony drug possessors. These programs have both individual-level goals of reducing recidivism rates and system-level goals of reducing prison populations. Objective: This study examines the individual level and system level impact of Kansas' Senate Bill 123 (SB 123), which created mandatory probation/treatment sentences for felony drug possessors. Reseaarch Design: A nonrandomized quasi-experimental design was used to evaluate the recidivism rates of drug possessors sentenced to SB 123 relative to drug possessors sentenced to standard probation, intensive probation, or prison. Propensity score matching techniques were used to identify comparison groups. Changes in probabilities of prison sentences preimplementation and postimplementation were used to assess changes in prison admissions and prison populations. Subjects: The treatment group included all eligible drug possessors sentenced to SB 123 between November 1, 2003, and October 31, 2006. The comparison groups included all eligible drug possessors sentenced to standard probation, intensive probation, or prison during the same time period. Measures: Arrests, violations, revocation resulting in a prison sentence, and reconviction resulting in a prison sentence within 24 months of risk in the community served as the key individual-level outcome measures. Prison admissions and bed days served as the key system-level outcome measures. Results: At the individual level, SB 123 increased likelihood of recidivism compared to standard probation and had no significant effect compared to intensive probation or prison. At the system level, SB 123 diverted offenders from prison at sentencing but only marginally reduced prison admissions or saved bed days. Conclusions: Conflicting impacts are a consequence of program design-eligibility requirements diverting probation-bound offenders, mandatory sentencing requiring the same diversion sentence for all offenders, and diversion sentences longer than those imposed preimplementation. Results cast doubt on the effectiveness of mandatory diversion programs to achieve both individual-level and system-level impacts.

Copyright 2011, Sage Publications


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

[NB. From 1898 publication.]Author's Introduction: The object of the following paper is to present the result of a number of observations touching certain aspects of the question of habitual inebriety, notably the r�le of maternal alcoholism as an agent in race degeneracy. . . . I have selected from the female population of Liverpool Prison, amongst whom habitual inebriety is very prevalent, a series of cases of chronic drunkards who have borne children; and from the history of these children, and more particularly from the indications given by the infant mortality, I have sought to illustrate the mode in which the maternal intoxication appears to have reacted on the development of the offspring. In the selection I have endeavoured, as far as possible, to choose cases in which alcoholism occurred uncomplicated by other degenerative factors. Author's Conclusion: The observations which we have thus briefly analysed enable us to form a fairly clear idea of the mode in which maternal inebriety reacts upon the offspring. We are familiar with the fact, clearly established by Morel, that the chronic alcoholism of one or both parents frequently appears as the first moment in the degenerative career of a family; that it represents a state of artificial degradation of the organism, capable of transmission in augmented force to the descendants, and culminating in some four generations in the extinction of the stock. In the case of maternal inebriety we have the same mode of action to consider, but with it, and very much more potent, we have the continued toxic influence exercised on the developing embryo throughout pregnancy. The brilliant researches of F�r� in the field of experimental teratology have sufficiently demonstrated the gravity of this influence. We have, further, to bear in mind the possible effect of alcoholic excesses during lactation. Lastly, reinforcing all these modes of influence, we have the detrimental effects, positive and negative, of the deterioration of the milieu as an indirect consequence of the mother's drunkenness.

Copyright 2011, Oxford Press


Swartz JA. Chronic medical conditions among jail detainees in residential psychiatric treatment: A latent class analysis. Journal of Urban Health 88(4): 700-717, 2011. (44 refs.)

Studies of incarcerates with serious mental illnesses have found elevated rates of chronic medical conditions such as asthma and diabetes, and of infectious diseases such as tuberculosis compared with general population rates. This study explored the pattern of chronic medical conditions in a sample of adult detainees in psychiatric treatment in a large urban jail to develop a clinical profile encompassing the full range of medical conditions. A total of 431 male and female detainees were sampled with certainty from admissions to a residential psychiatric treatment program (overall recruitment rate = 67%). Interviews used the World Mental Health version of the Composite International Diagnostic Interview to assess psychiatric and substance use disorders per DSM-IV criteria and chronic medical conditions. Latent class analysis was conducted using 17 medical conditions as class indicators, yielding a 3-class model composed of: a latent class with a high to intermediate probability of multiple medical conditions (HMC; 12.5% of the sample); an intermediate class with a lower probability of having a smaller number of medical conditions (MMC; 43.2%); and a class with a low probability of any medical condition (44.3%). Those in the HMC class were more likely to report respiratory problems, severe headaches, musculoskeletal pain, hypertension, and arthritis, have greater functional impairment, and have a higher number of co-occurring psychiatric disorders. Being older (50+ years) and female were associated with higher odds of being in the HMC or MMC classes. The policy implications for providing medical care to incarcerates with complex mixtures of medical conditions and psychiatric disorders are considered.

Copyright 2011, Springer


van den Bergh BJ; Gatherer A; Fraser A; Moller L. Imprisonment and women's health: Concerns about gender sensitivity, human rights and public health. Bulletin of the World Health Organization 89(9): 689-694, 2011. (24 refs.)

The health of prisoners is among the poorest of any population group and the apparent inequalities pose both a challenge and an opportunity for country health systems. The high rates of imprisonment in many countries, the resulting overcrowding, characteristics of prison populations and the disproportionate prevalence of health problems in prison should make prison health a matter of public health importance. Women prisoners constitute a minority within all prison systems and their special health needs are frequently neglected. The urgent need to review current services is clear from research, expert opinion and experience from countries worldwide. Current provision of health care to imprisoned women fails to meet their needs and is, in too many cases, far short of what is required by human rights and international recommendations. The evidence includes a lack of gender sensitivity in policies and practices in prisons, violations of women's human rights and failure to accept that imprisoned women have more and different health-care needs compared with male prisoners, often related to reproductive health issues, mental health problems, drug dependencies and histories of violence and abuse. Additional needs stem from their frequent status as a mother and usually the primary carer for her children. National governments, policy-makers and prison management need to address gender insensitivity and social injustice in prisons. There are immediate steps which could be taken to deal with public health neglect, abuses of human rights and failures in gender sensitivity.

Copyright 2011, World Health Organization


Vicens E; Tort V; Duenas RM; Muro A; Perez-Arnau F; Arroyo JM et al. The prevalence of mental disorders in Spanish prisons. Criminal Behaviour and Mental Health 21(5): 321-332, 2011. (35 refs.)

Background: The prevalence of mental disorders among prisoners has been researched in a few countries worldwide but never previously in Spain. Aim Our aim was to estimate the lifetime and last month prevalence of mental disorders in a Spanish prison population. Methods: This is a descriptive, cross-sectional, epidemiological study of 707 male prisoners. Sociodemographic, clinical and offending data were collected by interviewers. Offending data were confirmed using penitentiary records. Mental disorders were assessed with the clinical version of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition Axis I Disorders, and personality disorders were assessed through the Spanish version of the International Personality Disorders Examination. Results The lifetime prevalence of mental disorder was 84.4%. Substance use disorder (abuse and dependence) was the most frequent disorder (76.2%) followed by anxiety disorder (45.3%), mood disorder (41%) and psychotic disorder (10.7%). The period (last month) prevalence of any mental disorder was 41.2%. Anxiety disorder was the most prevalent (23.3%) followed by substance use disorder (abuse and dependence; 17.5%), mood disorder (14.9%) and psychotic disorder (4.2%). Conclusion: Although period prevalence figures, which are those generally provided in research into rates of mental disorder among prisoners, are useful for planning improvements to services within prisons, the fact that almost all of these men had a lifetime prevalence of at least one mental disorder suggests a much wider need for improving services, including community services, for this group.

Copyright 2011, Wiley-Blackwell


Walker EK. Risk and protective factors in mothers with a history of incarceration: Do relationships buffer the effects of trauma symptoms and substance abuse history? Women & Therapy 34(4): 359-376, 2011. (58 refs.)

A Sobel analysis reveals that peer relational health and perceived mutuality in partnerships buffer the effects of trauma symptoms on self-esteem, and perceived quality of mother-child relationships buffers the impact of trauma symptoms and history of alcoholism on depression. Statistically and clinically significant results demonstrate the positive impact of a healthy mother-child relationship on depression symptoms, and the influence of healthy peer and partner relationships on raising self-esteem for previously incarcerated mothers. These results indicate that feminist relational theorists of psychological development and trauma are correct in hypothesizing that healthy relationships are essential to recovery from trauma and emotional well-being.

Copyright 2011, Taylor & Francis


White GD. Gender-responsive programs in U.S. prisons: Implications for change. Social Work in Public Health 27(3): 283-300, 2012. (22 refs.)

This research examines the need for programs that focus on mental health issues, parenting issues, and other unique needs of female offenders incarcerated throughout the United States. The Bureau of Justice Statistics showed that 84% of female offenders were living with their children prior to their arrest. This constitutes a crisis in our society today, which is manifest in overcrowded state and federal prisons, increased caseloads for the Department of Children and Family Services, the Foster Care System, and families of the offenders. The goal of this research is to determine what types of gender-responsive programs are effective in reducing recidivism. The methods used were qualitative data analysis, by comparing which programs are offered, either within the prison, or as a reentry postrelease program. A survey was used and interview data were analyzed by identifying and comparing common themes and patterns. The findings reveal the most effective gender-responsive programs are those that incorporate substance abuse treatment, education and job preparedness, parenting programs where contact with children is allowed and/or encouraged, and family reunification programs.

Copyright 2012, Taylor & Francis


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

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

Copyright 2011, Society for the Study of Addiction to Alcohol and Other Drugs


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

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

Copyright 2011, BioMed Central


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

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

Copyright 2011, Elsevier Science


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

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

Copyright 2011, Sage Publications