Treatment at the front end of the criminal justice continuum: the association between arrest and admission into specialty substance abuse treatment

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

Characteristics of facilities with specialized programming for drinking drivers and for other criminal justice involved clients: analysis of a national database

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

Social location and cumulative adversity in multiply traumatized women.

This study assessed a relatively homogeneous group of poor mothers to determine whether differences in exposure to trauma account for variation in the diagnosis of posttraumatic stress disorder (PTSD). It also explored whether the personality characteristic of cynicism mediates exposure and diagnosis. Pathological sequelae to trauma exposure are typically attributed to individual vulnerability without considering variation in exposure. However, since exposure to both interpersonal and organizational stressors varies according to social location, assessment across a stress continuum is more appropriate. Once cumulative adversity is considered, individual differences can then be examined. Personality characteristics have been shown to mediate the effects of stressors on mental health outcomes, either enhancing resiliency or vulnerability. The sample of 79 women convicted of a felony drug charge after 1996 was found through court records in one Midwestern County. Most women were interviewed in their homes; the remainder in drug treatment centers, jail and prison. Face to face interviews were conducted using standardized measures to assess trauma (CIDI), employment discrimination, and difficult life circumstances (such as removal of a child, current battering relationship, and housing concerns). PTSD was evaluated using criteria in the DSM IV. Cynical hostility was measured with a modification of the Cook-Medley Hostility scale, as well as open-ended questions. Scale responses were compared to narrative responses to evaluate the construct in this population. Logistic regression was used to test direct effects and mediational models of the impact of single and multiple predictors on PTSD. The analysis demonstrated that the probability of PTSD increased exponentially for each trauma experienced, and that the addition of chronic stressors into the model increased the probability of PTSD, explaining over one-third of the total variance. No relationship was found between cynicism and trauma or other stressful life events, but the construct of cynicism was validated for use in this population. These findings support the use of cumulative adversity models in the assessment of PTSD as well as the need for a comprehensive assessment of stressors based on social location. These findings have implications for researchers, clinicians and public policy.Ph.D.Clinical psychologyCriminologyPsychologySocial SciencesSocial workWomen's studiesUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/123256/2/3068942.pd

Comparing credentialing requirements of substance abuse treatment staff by funding source

Photograph of a scene at Lucille Hamons' Historic Highway Gas Station along Route 66

Reporting Sexual Victimization During Incarceration: Using Ecological Theory as a Framework to Inform and Guide Future Research

The U.S. Department of Justice estimates that between 149,200 and 209,400 incidents of sexual victimization occur annually in prisons and jails. However, very few individuals experiencing sexual victimization during incarceration report these incidents to correctional authorities. Federal-level policy recommendations derived from the Prison Rape Elimination Act suggest mechanisms for improving reporting as well as standards for the prevention, investigation, and prosecution of prison-based sexual victimization. Despite these policy recommendations, sexual assault persists in prisons and jails, with only 8% of prisoners who experience sexual assault reporting their victimization. This review focuses on gaps in the existing research about what factors influence whether adult victims in incarcerated systems will report that they have been sexually assaulted. Using ecological theory to guide this review, various levels of social ecology are incorporated, illuminating a variety of factors influencing the reporting of sexual victimization during incarceration. These factors include the role of individual-level behavior, assault characteristics, the unique aspects and processes of the prison system, and the social stigma that surrounds individuals involved in the criminal/legal system. This review concludes with recommendations for future research, policy, and practice, informed by an ecological conceptualization of reporting