Improved HIV and Substance Abuse Treatment Outcomes for Released HIV-Infected Prisoners: The Impact of Buprenorphine Treatment

HIV-infected prisoners fare poorly after release. Though rarely available, opioid agonist therapy (OAT) may be one way to improve HIV and substance abuse treatment outcomes after release. Of the 69 HIV-infected prisoners enrolled in a randomized controlled trial of directly administered antiretroviral therapy, 48 (70%) met DSM-IV criteria for opioid dependence. Of these, 30 (62.5%) selected OAT, either as methadone (N = 7, 14.5%) or buprenorphine/naloxone (BPN/NLX; N = 23, 48.0%). Twelve-week HIV and substance abuse treatment outcomes are reported as a sub-study for those selecting BPN/NLX. Retention was high: 21 (91%) completed BPN/NLX induction and 17 (74%) remained on BPN/NLX after 12 weeks. Compared with baseline, the proportion with a non-detectable viral load (61% vs 63% log10 copies/mL) and mean CD4 count (367 vs 344 cells/mL) was unchanged at 12 weeks. Opiate-negative urine testing remained 83% for the 21 who completed induction. Using means from 10-point Likert scales, opioid craving was reduced from 6.0 to 1.8 within 3 days of BPN/NLX induction and satisfaction remained high at 9.5 throughout the 12 weeks. Adverse events were few and mild. BPN/NLX therapy was acceptable, safe and effective for both HIV and opioid treatment outcomes among released HIV-infected prisoners. Future randomized controlled trials are needed to affirm its benefit in this highly vulnerable population

Systematic review of non-custodial employment programs: Impact on recidivism rates of ex-offenders

Background: Over the last 25 years, many programs that were designed to increase employment for persons with a criminal history have been implemented and evaluated. The implicit, and often explicit, intent of these programs has been to reduce recidivism. Wilson et al. (1999, 2000) conducted a quantitative synthesis of 33 evaluations of educational, vocational, and work programs for persons in correctional facilities. To date, however, the evaluation literature on employment services programs for those with a recent criminal record who are not in custody has not been systematically reviewed. Objectives: To assess the effects of programs designed to increase employment through job training and/or job placement among formerly incarcerated persons (i.e., those recently released), aimed at improving employment and reducing recidivism. Search Strategy: Searches of literature reviews by the first author were augmented by structured searches of nine electronic data bases, including the Campbell SPECTR database of trials to identify random assignment studies conducted after 1970. Experts in the field were consulted and relevant citations were followed up. Selection Criteria: Selecting studies based on the original objective – to examine employment services interventions for recently released prisoners – did not produce a sufficient number of studies for analysis. Thus, the selection criteria were expanded to include studies that tested the effects of job training or job placement programs or both for persons who had been arrested, convicted or incarcerated in connection with a criminal charge. Only random assignment studies of adults or studies that combined older youth (ages 16-17) and adults were included. If the treatment or comparison groups included subjects who were not ex-offenders, the results must have been reported separately for the ex-offenders. Data Collection and Analysis: We report narratively on the eight eligible studies. More than 6,000 older youth (aged 16-17) and adults with prior contact with the criminal justice system participated in these studies. Two studies contributed two independent effect sizes for a total of ten effect sizes for the eight studies. We used arrests during the follow-up period (typically, 12 months) as the outcome measure. We ran three analyses: one with a mixture of dichotomized and continuous arrest measures, a second with logged odds ratio effect sizes, and a third splitting the sample into those with a conviction and those without a conviction. Main Results: The analyses show that employment-focused interventions for ex-offenders in these studies did not reduce recidivism, although this group of random assignment studies is highly heterogeneous both in the type of employment program delivered and the individuals enrolled in the program. Thus, the results should not be generalized to former prisoners who are enrolled in employment programs after release. The studies are also mostly out of date and the average subject was not typical of persons released from prison in the U.S. in the early 2000s. Reviewers’ Conclusions: We conclude that employment-focused interventions for former prisoners have not been adequately evaluated for their effectiveness using random assignment designs. After broadening the selection criteria to include individuals with criminal records, only eight studies, the majority of which are more than 10 years old, could be identified. Nonetheless, overall, the eight interventions had no significant effect on the likelihood that participants would be rearrested. Many employment-focused interventions for ex-offenders are being implemented. A new generation of rigorous evaluations is needed to provide direction to policymakers as to the most effective combination of employment-related services for specific types of ex-offenders

Planning for precarity? Experiencing the carceral continuum of imprisonment and reentry

Drawing on qualitative interviews with formerly imprisoned people in Canada, we show that most prisoners experience reentry into communities with little to no pre-release planning, and must rely upon their own resourcefulness to navigate fragmented social services and often informal supports. In this respect, our research findings contrast with U.S. punishment and society scholarship that highlights a complex shadow carceral state that extends the reach of incarceration into communities. Our participants expressed a critical analysis of the failure of the prison to address the needs of prisoners for release planning and supports in the community. Our findings concur with other empirical studies that demonstrate the enduring effects of the continuum of carceral violence witnessed and experienced by prisoners after release. Thus, reentry must be understood in relation to the conditions of confinement and the experience of incarceration itself. We conclude that punishment and society scholarship needs to attend to a nuanced understanding of prisoner reentry and connect reentry studies to a wider critique of the prison industrial complex, offering more empirical evidence of the failure of prisons

The Performance of Privately Operated Prisons: A Review of Research: Appendix 2

Includes bibliographic references. The authors considered evaluations of private prisons in nine states including Arizona (p. 13). The other featured states are Massachusetts, Kentucky, California, Tennesee, Louisiana, New Mexico, Florida, and Washington. The BOP study is also published in Private Prisons in the United States: An Assessment of Current Practice (Boston, MA: Abt Associates)

Festcarmen zum Namenstag von Abt Michael Fritz- St. Märgen 6

Handschrift auf Papie

Prison crowding research reexamined

Federal Bureau of Prisons or the Department of Justice. Dramatic increases in the United States ' inmate population has raised new concerns about prison crowding. Although growth in prison capacity has lagged slightly behind that of the inmate population, there is no consistent evidence that crowding is associated with mortality, morbidity (defined as clinic utilization), recidivism, violence, or other pathological behaviors. This paper reviews the major areas in which prison crowding has been examined. Conceptual, methodological, and empirical criticisms are raised concerning prison crowding and the areas of health, violence, and recidivism. The paper is divided into five sections: I. the political and social context of prison crowding research; II. ecological versus individual level differences in crowding; III. theoretical and empirical problem