Drug use and crime: a historical review of research conducted by the UCLA Drug Abuse Research Center

Disordered alcohol and substance use in Irish farmers: A cross-sectional survey

PURPOSE

Farming is a high-pressure occupation. Populations of farmers face significant health risks, including injury, mental illness, and in some cases, heavy alcohol use. However, there is little research on farmers' use of substances beyond alcohol. This study examines factors relating to Irish farmers' disordered alcohol and substance use.

METHODS

In accordance with STROBE guidelines for cross-sectional research and reporting, we examined disordered alcohol and substance use in 351 Irish farmers using the Alcohol Use Disorders Identification Tool (AUDIT) and Drug Use Disorders Identification Tool (DUDIT).

FINDINGS

While 28% of farmers did not drink, 40% of those who did drink exceeded the AUDIT threshold for disordered use. Similarly, while 95% of farmers did not use substances, 78% of farmers who did use substances exceeded the DUDIT threshold for disordered use. Age was the most important risk factor for disordered alcohol and substance use and correlated with other main risk factors: lower income, no children, part-time farmer, and full-time off-farm roles. Disordered drinking was highest in farmers engaged in full-time education.

CONCLUSIONS

This population of Irish farmers report broadly healthy alcohol and substance use behaviors. Irish farmers may serve as a model group whose strengths can be utilized in interventions within and beyond the Irish farming community. Our results confirm the importance of analyzing demographic factors in farmers' drinking and identify younger farmers as especially at-risk for harmful alcohol and substance use.

Examining the Coevolution of Drug Use Variety and Different Types of Offending Frequency Among Justice-Involved Adolescents

Past research demonstrates a strong link between drug use and crime among justice-involved adolescents, yet little is known about the joint development between drug use variety and various types of criminal offending frequencies from adolescence to young adulthood. Using a sample of male adolescent offenders ( N = 842), this article examines the coevolution of drug use variety and three separate types of offending frequencies. First, four group-based trajectory models identify unique group developmental patterns for drug use variety, drug sales offending, property offending, and violent offending. Next, three dual-trajectory models examine the coevolution between drug use variety and each type of criminal offending. Findings reveal a general pattern of desistance for both drug use and offending, while also illustrating notable variability in group trajectory patterns for drug use variety and criminal behavior. This article concludes that adolescents with elevated drug use variety make up a large proportion of frequent offenders.

Journeying with fear: Young people's experiences of cannabis use, crime and violence before treatment entry

PROBLEM

The experiences of crime and policing from the perspective of adolescent cannabis users before treatment entry are not often understood by practitioners.

METHODS

A qualitative design within an interpretivist paradigm was used. Data were collected using one-to-one semi-structured interviews. A convenience sample was recruited through two treatment centers in Dublin, Ireland in 2015. A deductive thematic analysis was used.

FINDINGS

In-depth interviews with eight young people were conducted. At the individual level, there was a common theme of naïve crimes with the introduction of debt and developing violence. Young people often stole from their families and obtained credit from dealers. Policing was initially viewed as benign. Families suffered as a result of the drug debts but young people also spoke of intergenerational drug use. As the young person's use progressed, the oppressed became the oppressor, young people were entrapped, violence escalated and real fear of incarceration and remorse was expressed.

CONCLUSION

Findings highlight the commonality of fear and the seriousness of personal and familial violent harms. The need for targeted developmental preventions in vulnerable settings is proposed. Parents and professionals need to have an awareness of money in the home and the role of intergenerational substance use.

Longitudinal Associations among Depression, substance Abuse, and Crime: A Test of competing Hypotheses for Driving Mechanisms

PURPOSE

Crime, depression, and substance abuse, often co-occur. This study examined competing models considering each problem domain individually as a driving mechanism for the other problems to better understand etiology and inform prevention efforts. Gender differences were also examined.

METHODS

Data were drawn from the Seattle Social Development Project, a multiethnic and gender-balanced urban panel of 808 participants constituted in 1985. Cross- lagged models examined prospective assessments of early (grades 7 & 8) and late (grades 9-12) adolescent internalizing problems, substance use, and delinquency, as well as measures of depression, substance dependence, and crime at early adulthood (ages 21-24) and later adulthood (ages 27-30).

RESULTS

Comparisons of nested models by gender showed (a) continuity in internalizing behaviors/depression, substance use/dependence, and delinquency/crime for both women and men; (b) accounting for continuity, depression did not consistently drive other problems for either women or men; (c) among women, both substance abuse and crime appeared to be important driving mechanisms; and (d) among men, crime emerged as the most pertinent driving mechanism.

CONCLUSION

Findings suggest that externalizing problems may be more important driving mechanisms for depression than vice versa. Preventing crime and substance abuse may have the important added benefit of reducing early adult depression.

Criminal justice measures for economic data harmonization in substance use disorder research

BACKGROUND

The consequences of substance use disorders (SUDs) are varied and broad, affecting many sectors of society and the economy. Economic evaluation translates these consequences into dollars to examine the net economic impact of interventions for SUD, and associated conditions such as HCV and HIV. The nexus between substance use and crime makes criminal justice outcomes particularly significant for estimating the economic impact of SUD interventions, and important for data harmonization.

METHODS

We compared baseline data collected in six NIDA-funded Seek, Test, Treat and Retain (STTR) intervention studies that enrolled HIV-infected/at-risk individuals with SUDs (total n = 3415). Criminal justice measures included contacts with the criminal justice system (e.g., arrests) and criminal offenses. The objective was to develop a list of recommended measures and methods supporting economic data harmonization opportunities in HIV and SUD research, with an initial focus on crime-related outcomes.

RESULTS

Criminal justice contacts and criminal offenses were highly variable across studies. When measures grouped by offense classifications were compared, consistencies across studies emerged. Most individuals report being arrested for property or public order crimes (> 50%); the most commonly reported offenses were prostitution/pimping, larceny/shoplifting, robbery, and household burglary.

CONCLUSIONS

We identified four measures that are feasible and appropriate for estimating the economic consequences of SUDs/HIV/HCV: number of arrests, number of convictions, days of incarceration, and times committing criminal offenses, by type of offense. To account for extreme variation, grouping crimes by offense classification or calculating monthly averages per event allows for more meaningful comparisons across studies.

The costs of crime during and after publicly funded treatment for opioid use disorders: a population-level study for the state of California

BACKGROUND AND AIMS

Treatment for opioid use disorders (OUD) reduces the risk of mortality and infectious disease transmission; however, opportunities to quantify the potential economic benefits of associated decreases in drug-related crime are scarce. This paper aimed to estimate the costs of crime during and after periods of engagement in publicly funded treatment for OUD to compare total costs of crime during a hypothetical 6-month period following initiation of opioid agonist treatment (OAT) versus detoxification.

DESIGN

Retrospective, administrative data-based cohort study with comprehensive information on drug treatment and criminal justice systems interactions.

SETTING

Publicly funded drug treatment facilities in California, USA (2006-10).

PARTICIPANTS

A total of 31 659 individuals admitted for the first time to treatment for OUD, and who were linked with criminal justice and mortality data, were followed during a median 2.3 years. Median age at first treatment admission was 32, 35.8% were women and 37.1% primarily used prescription opioids.

MEASUREMENTS

Daily costs of crime (US$2014) were calculated from a societal perspective and were composed of the costs of policing, court, corrections and criminal victimization. We estimated the average marginal effect of treatment engagement in OAT or detoxification adjusting for potential fixed and time-varying confounders, including drug use and criminal justice system involvement prior to treatment initiation.

FINDINGS

Daily costs of crime during treatment compared with after treatment were $126 lower for OAT [95% confidence interval (CI) = $116, $136] and $144 lower for detoxification (95% CI = $135, $154). Summing the costs of crime during and after treatment over a hypothetical 6-month period using the observed median durations of OAT (161 days) and detoxification (19 days), we estimated that enrolling an individual in OAT as opposed to detoxification would save $17 550 ($16 840, $18 383).

CONCLUSIONS

In publicly funded drug treatment facilities in California, USA, engagement in treatment for opioid use disorders is associated with lower costs of crime in the 6 months following initiation of treatment, and the economic benefits were far greater for individuals receiving time-unlimited treatment.

Monitoring the Use of Illicit Drugs in Four Countries Through the International Arrestee Drug Abuse Monitoring (I-Adam) Program

The International Arrestee Drug Abuse Monitoring (I-ADAM) program is a network of researchers from different countries following similar protocols for collecting urinalysis and self-reported data on drug use from detained arrestees. This article introduces the research community to this new program through basic descriptive findings. The focus of this article is not to analyze the differences found in drug use patterns in different nations. Rather, we demonstrate similarities and differences in findings in order to raise questions for future research, and to provide policy makers with information about the potential value and limitations of the I-ADAM system. Using I-ADAM data for 2000 from four countries (Australia, England, South Africa and the United States), we examine the rates of detainees testing positive for drugs and arrestee self-reports of past 12-month illicit drug use. This is followed by a comparison of results from the four different countries in terms of drugs used and offenses committed. I-ADAM has great potential to be a platform for researchers to broaden their study of the relationship between drug use and crime and examine variations in illicit drug use and their associated risk factors that are not country, nor culturally, specific.

Drug Courts and Contingency Management

Drug courts have become an increasingly popular response to the increased burden placed on the criminal justice system by substance abuse. However, evaluation findings have been less than consistent with respect to the ability of drug courts to have the desired impact on drug use and criminal behavior. This paper reviews the literature describing the growth, operations, and evaluations of drug courts. It concludes that, contrary to most “models,” drug courts emphasize punishment (e.g., graduated sanctions) and make limited positive, or at least inconsistent, use of reinforcement to promote behavior change and abstinence from drug use. Contingency management techniques that involve the systematic application of reinforcement based on the performance of specified behaviors are presented and reviewed. The success of this model in promoting pro-social behavior and abstinence from illicit drug use suggests that drug courts could benefit substantially from the integration of contingency management-based interventions.

Effectiveness of Using Incentives to Improve Parolee Admission and Attendance in Community Addiction Treatment

This study is a randomized effectiveness trial of the use of incentives to improve treatment utilization among parolees in community treatment. In prison, Admission phase parolees were randomized to Admission Incentive (N=31) or Education (N=29). Attendance phase parolees entering community treatment were randomized to Attendance Incentive (N=104) or Education (N=98). There was no main effect for incentives in either study phase. Neither admission to community treatment (Incentive 60%, Education 64%; p =.74), nor intervention completion (Incentive 22%; Education 27%; p =.46) appeared to be impacted. Time-in-treatment was predicted by age, first arrest age, and type of parole status (Cox regression p<.05), but not by treatment group. Providing incentives did not increase the likelihood that parolees enrolled in or stayed in community treatment. In light of this finding, criminal justice practitioners who are considering incentives to increase admission or retention should be aware that they may not produce the desired outcomes.

Gender as a moderator in predicting re-arrest among treated drug-involved offenders

The primary aim of the current study is to explore gender differences on the relationships of pre-treatment risk factors and psychosocial functioning with time to re-arrest following termination from prison. The sample consisted of 384 males and 313 females who were admitted to four prison-based substance abuse treatment programs. Results showed that female inmates experienced a longer time to re-arrest than male inmates. Higher self-reported ratings of decision making confidence and peer support were associated with a lower likelihood of re-arrest for males. Males with higher self-esteem ratings were more likely to be re-arrested than males who reported lower self-esteem. Females with more self-reported criminal involvement had a higher rate of re-arrest than did those with less criminal involvement. In contrast to males, females with relatively high self-reported self-esteem had a lower rate of re-arrest than their counterparts who reported low self-esteem. Clinical implications include the importance of enhancing decision-making confidence and peer support for males and self-esteem for females.

Understanding the Mechanisms Through Which an Influential Early Childhood Program Boosted Adult Outcomes

A growing literature establishes that high quality early childhood interventions targeted toward disadvantaged children have substantial impacts on later life outcomes. Little is known about the mechanisms producing these impacts. This paper uses longitudinal data on cognitive and personality traits from an experimental evaluation of the influential Perry Preschool program to analyze the channels through which the program boosted both male and female participant outcomes. Experimentally induced changes in personality traits explain a sizable portion of adult treatment effects.

Offender diversion into substance use disorder treatment: the economic impact of California's proposition 36

OBJECTIVES

We determined the costs and savings attributable to the California Substance Abuse and Crime Prevention Act (SACPA), which mandated probation or continued parole with substance abuse treatment in lieu of incarceration for adult offenders convicted of nonviolent drug offenses and probation and parole violators.

METHODS

We used individually linked, population-level administrative data to define intervention and control cohorts of offenders meeting SACPA eligibility criteria. Using multivariate difference-in-differences analysis, we estimated the effect of SACPA implementation on the total and domain-specific costs to state and county governments, controlling for fixed individual and county characteristics and changes in crime at the county level.

RESULTS

The additional costs of treatment were more than offset by savings in other domains, primarily in the costs of incarceration. We estimated the statewide policy effect as an adjusted savings of $2317 (95% confidence interval = $1905, $2730) per offender over a 30-month postconviction period. SACPA implementation resulted in greater incremental cost savings for Blacks and Hispanics, who had markedly higher rates of conviction and incarceration.

CONCLUSIONS

The monetary benefits to government exceeded the additional costs of SACPA implementation and provision of treatment.

The Long and Winding Road to Desistance from Crime for Drug-Involved Offenders: The Long-Term Influence of TC Treatment on Re-Arrest

Earlier research by Inciardi and colleagues established the long-term positive effects of a therapeutic community (TC) continuum of treatment for drug-involved offenders. Using data from his original longitudinal study and archival records of criminal justice re-arrest and recidivism, this paper extends these analyses to examine the effects of TC treatment on the long-term success of offenders, up to 18 years after release from prison. Multivariate trajectory analysis is used to examine patterns of re-arrest and desistance among a sample of 1363 clients followed up in person for five years and subsequently with record checks through state and NCIC criminal justice systems. Results indicate significant reductions in new arrests for those who received TC treatment in each of the five trajectories modeled for patterns of persistence and desistance. Discussion centers on the strengths of the relationships in each modeled trajectory and the implications for long-term understanding of drug offenders and criminal behavior.

Does heavy adolescent marijuana use lead to criminal involvement in adulthood? Evidence from a multiwave longitudinal study of urban African Americans

While marijuana use is common during adolescence, it can have adverse long-term consequences, with serious criminal involvement being one of them. In this study, we utilize longitudinal data from the Woodlawn Study of a community cohort of urban African Americans (N=702) to examine the effects of heavy adolescent marijuana use (20 or more times) on adult criminal involvement, including perpetration of drug, property and violent crime, as well as being arrested and incarcerated. Utilizing propensity score matching to take into account the shared risk factors between drug use and crime, regression analyses on the matched samples show that heavy adolescent marijuana use may lead to drug and property crime and criminal justice system interactions, but not violent crime. The significant associations of early heavy marijuana use with school dropout and the progression to cocaine and/or heroin use only partially account for these findings. Results suggest that the prevention of heavy marijuana use among adolescents could potentially reduce the perpetration of drug and property crime in adulthood, as well as the burden on the criminal justice system, but would have little effect on violent crime.

Influence of perceived coercion and motivation on treatment completion and re-arrest among substance-abusing offenders

The effects of perceived coercion and motivation on treatment completion and subsequent re-arrest were examined in a sample of substance-abusing offenders assessed for California's Substance Abuse and Crime Prevention Act (SACPA) program. Perceived coercion was measured with the McArthur Perceived Coercion Scale; motivation was measured with the subscales of the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES). At treatment entry, clients were more likely to believe that they had exercised their choice in entering treatment than that they had been coerced into treatment. SACPA clients scored relatively low on Recognition and Ambivalence regarding their drug use but relatively high on Taking Steps to address their drug problem. Correlations between perceived coercion and motivation measures at treatment entry indicated that these are separate constructs. In logistic regression models, the Recognition subscale of the SOCRATES significantly predicted "any re-arrest," and Ambivalence and Taking Steps predicted "any drug arrest."

Buprenorphine and methadone maintenance in jail and post-release: a randomized clinical trial

Buprenorphine has rarely been administered as an opioid agonist maintenance therapy in a correctional setting. This study introduced buprenorphine maintenance in a large urban jail, Rikers Island in New York City. Heroin-dependent men not enrolled in community methadone treatment and sentenced to 10-90 days in jail (N=116) were voluntarily randomly assigned either to buprenorphine or methadone maintenance, the latter being the standard of care for eligible inmates at Rikers. Buprenorphine and methadone maintenance completion rates in jail were equally high, but the buprenorphine group reported for their designated post-release treatment in the community significantly more often than did the methadone group (48% vs. 14%, p<.001). Consistent with this result, prior to release from Rikers, buprenorphine patients stated an intention to continue treatment after release more often than did methadone patients (93% vs. 44%, p<.001). Buprenorphine patients were also less likely than methadone patients to withdraw voluntarily from medication while in jail (3% vs. 16%, p<.05). There were no post-release differences between the buprenorphine and methadone groups in self-reported relapse to illicit opioid use, self-reported re-arrests, self-reported severity of crime or re-incarceration in jail. After initiating opioid agonist treatment in jail, continuing buprenorphine maintenance in the community appears to be more acceptable to offenders than continuing methadone maintenance.

Violent Victimization and the Routine Activities/Lifestyle of Active Drug Users

The present study examines violent victimization among a sample of active drug users. Two theoretical perspectives are combined to form the underlying conceptual framework of the study: One draws upon routine activities/lifestyle theory and the other incorporates the street addict role theory. While routine activities/lifestyle theory addresses victimization in general, the street addict role theory explains the specific lifestyle characteristics of an active drug abuser which are relevant to the victimization of illicit drug users. We find the prevalence of violent victimization to be high. Approximately 22% of respondents reported being victimized within a 30 day period. We also find support for combining the two perspectives to help explain violent victimization. Demographic, personal networks, drug use, and street business domain factors are associated with violent victimization for this high risk population. Our study extends the investigation of violent victimization among illicit drug users by identifying characteristics that differentiate drug users who are recent victims of violence from others who have not been similarly victimized.

Trends in methamphetamine use in young injection drug users in San Francisco from 1998 to 2004: the UFO Study

AIMS

To describe temporal trends in methamphetamine use among young injection drug users (IDU) in San Francisco.

DESIGN AND METHODS

Secondary analysis of cross-sectional baseline data collected for a longitudinal study of young IDU from 1998 to 2004. Participants were 1445 young IDU (<30 years old) who reported injection in the previous month, English-speaking, and recruited by street outreach methods. We examined trends for: lifetime (ever) and recent (30-day) methamphetamine use, including injected and non-injected, and by age group and sexual risk behaviour [men who have sex with men injecting drug users (MSM-IDU), male IDU (non-MSM) and female IDU].

RESULTS

In 1998, 1999, 2000, 2001, 2003 and 2004 we interviewed 237, 276, 431, 310, 147 and 44 participants, respectively. Overall, median age was 22 years [interquartile range (IQR) 20-25], 30.3% were women and median duration of injecting was 4.4 years (IQR 2-7). Prevalence of methamphetamine use was high, with 50.1% reporting recent injection, but overall there were no temporal increases in reported 'ever' injected use. Recent methamphetamine injection (past 30 days) increased significantly, and peaked at 60% in 2003. MSM-IDU had higher methamphetamine injection ever (92.3%) and recently (59.5%) compared to heterosexual male (non-MSM) IDU (81.6% and 47.3%, respectively) and to female IDU (78.4% and 46.1%, respectively).

CONCLUSIONS

Despite reports of ubiquitous increases in methamphetamine use, there were no significant increases in 6 years in ever injecting methamphetamine overall among young IDU. MSM-IDU who reported the highest methamphetamine use overall reported some increases in recent injected use. The methamphetamine 'epidemic' was probably under way among young IDU earlier than other populations.

Substance Use, Drug Treatment, and Crime: An Examination of Intra-Individual Variation in a Drug Court Population

This study examines the association between substance use and crime by modeling change within subjects over an 11 month period in a sample of 157 chronic drug-using offenders. For this sample, increased substance use—cocaine or heroin use as well as alcohol use—was significantly related to increases in self-reports of income generating but not violent crime. The study also demonstrates a significant effect of drug treatment in the last month on income generating crime, but not on violent crime and that the effect of drug treatment on income generating crime is mediated by reductions in drug use. This work refines prior work by showing that drug use effects vary by crime type and by providing further evidence that drug treatment reduces cocaine and heroin use, which leads to a reduction in property crime. It is the first study to examine variability over time in all three components (drug treatment, drug use, and crime) while adequately controlling for individual level propensity variables.

Criminal justice itreatment admissions for methamphetamine use in California: a focus on Proposition 36

Methamphetamine (MA) use is considered as one of the nation's most pressing drug problems. In California, MA use has outstripped all other drugs in epidemiological extent, law enforcement activities, and treatment services demand. An opportunity for further study of MA use and its treatment emerged from a change in offender sentencing options introduced by California's Substance Abuse and Crime Prevention Act of 2000 (SACPA). Results indicate that statewide admissions for MA rose from 8.4% in FY 1992/1993 to 34.6% in FY 2004/2005, a four-fold increase over the 13 years. From the year before SACPA implementation to the year after, the percentage of treatment admissions due to MA use increased from 18.8% to 25.6%, an increase largely due to the fact that SACPA admissions were over 50% MA users. With the exception of alcohol, MA users entering treatment through SACPA had higher completion rates (about one third) from community based treatment than users of other primary drugs. This result held true for demographic and other subgroups of MA users. Multivariate regression results illuminate the relative importance of the variables examined. Implication of the findings for policy, intervention services, and research are discussed.

Female recidivists speak about their experience in drug court while engaging in appreciative inquiry

Eleven female drug-court participants looked at current and past experiences to assess their program and envision future program innovations. From these women's perspective, the strongest component of drug court was being surrounded by staff dedicated to their progress and recovery. Graduated supervision and accurate drug testing were appreciated rather than resented when the participants were not humiliated and were treated with respect. Wraparound services, resources, and referral; treatment facilities that accepted children; and individualized treatment plans and therapy with offenders who are ex-addicts, and preferably females, allowed for greater involvement and active participation in recovery. Progressing through three phases, acquiring skills, a job, and visitation rights to see their children or regaining custody, increased these women's sense of self-efficacy perception and confidence in their ability to lead a drug-free, meaningful life. Findings show the importance of qualitative criteria in evaluating drug-court participants' progress and the process of recovery.

Substance abuse treatment and criminal justice involvement for SSI recipients: results from Washington state

This study examined the association between receiving substance abuse treatment and subsequent criminal justice involvement. The sample consisted of Supplemental Security Income (SSI) recipients in the state of Washington that were determined to be in need of treatment. Fifty-two percent of those clients entered substance abuse treatment during the study period, while 48% did not. Arrests, felony convictions and convictions for less serious crimes were tracked for 8343 adults for one year following the end of an index treatment episode. Results showed that entering treatment was associated with reduced risks for each outcome. In addition, further analyses were conducted just on those entering treatment. Among that subset of the study population, the completion of treatment and having an episode of treatment lasting at least 90 days were both associated with reduced criminal justice risks. These results suggest that efforts to provide substance abuse treatment for SSI recipients have the potential to provide substantial public benefits.

Illicit opioid use and its key characteristics: a select overview and evidence from a Canadian multisite cohort of illicit opioid users (OPICAN)

OBJECTIVES

To summarize key characteristics and consequences of illicit opioid use from the literature and to present corresponding data from a multisite sample of illicit opioid users in 5 Canadian cities (OPICAN study).

METHOD

We undertook an overview of recent literature from North America, Australia, and Europe. We obtained data from the multicity OPICAN cohort study, which consisted of an interviewer-administered questionnaire, a standardized mental health instrument (the Composite International Diagnostic Interview Short Form for depression), and saliva-antibody tests for infectious disease (that is, HIV and hepatitis C virus). The baseline sample (n=679) was collected in 2002.

RESULTS

Illicit opioid use in Canada and elsewhere is becoming increasingly heterogeneous in terms of opioid drugs used, with heroin playing an increasingly minor role; further, it predominantly occurs in a context of polydrug use (for example, cocaine-crack or benzodiazepines). Large proportions of illicit opioid users have physical and (or) mental health comorbidities, including infectious disease and (or) depression, and therefore require integrated interventions. Finally, morbidity risks among illicit opioid users are often predicted by social marginalization factors, for example, housing status or involvement in

CONCLUSIONS

Given the epidemiologic profile and high disease burden associated with contemporary forms of illicit opioid use, more effective treatment approaches are urgently needed in Canada and elsewhere. Specifically, treatment must adjust to the extensive polysubstance use realities, yet it must also more effectively address the complex physical and (or) mental health comorbidities presented by this high-risk population.

Contextual barriers to successful reentry of recovering drug offenders

Recidivism among recovering ex-offenders is usually conceptualized as an outcome of the interplay between personal traits and treatment interventions. This focus on the individual, to the exclusion of the sociolegal context in which recovery and reintegration take place, has limited extant policy initiatives. Recidivism data from 440 drug-abusing felons who had successfully completed long-term residential treatment were examined. All else being equal, recovering offenders who began their reentry during times of high unemployment, low risk of incarceration for new offenses, or both, were found to be more likely to recidivate during their first year in the community. These findings highlight the promise of blending effective drug abuse treatment with credible sanctions against drug offenses as well as the need for job training, placement, and advocacy services.

Methamphetamine treatment: trends and predictors of retention and completion in a large state treatment system (1992-2002)

This report describes trends in treatment admissions for methamphetamine/amphetamine (MA) abuse from 1992 to 2002 in California and assesses predictors of treatment retention and completion. Results show such admissions increasing fivefold and representing a growing proportion of overall treatment admissions. Patients admitted for MA abuse were increasingly diverse in race/ethnicity, older in age, and more frequently under legal supervision status over time. There was a decrease in injection drug use. Several user characteristics played consistent roles as risk factors for noncompletion and shorter treatment retention for both residential and outpatient admissions: having lower than a high school education, being younger at treatment admission, having a disability, having greater severity of MA use, and using injection drugs. Consistently, those with legal supervision status at admission had higher completion rates and longer retention than those reporting no legal status. Overall, findings suggested that clients with greater socioeconomic disadvantage and more severe problems may require greater efforts (e.g., services) to be retained in treatment.

Identifying predictors of treatment outcome in a drug court program

Drug courts are popular for dealing with drug-abusing offenders. However, relatively little is known about participant characteristics that reliably predict either success or failure in these treatment settings. In this article, we report on 99 individuals who were enrolled in a drug court program (approximately one-half of whom successfully completed the program). Using, logistic regression techniques we identified 2 significant predictors of outcome. First, individuals who were employed at the time of their enrollment into the drug court program were more likely to successfully complete the treatment program. Second, individuals with a history of illicit intravenous drug use were less likely to complete the program.

Understanding treatment impact on drug-addicted offenders

This study examines variables that could predict treatment perseverance and impact for offenders (N = 124) admitted to one of five rehabilitation centers for alcoholics/drug addicts representing different regions of the province of Quebec. Information was collected on time spent in treatment, alcohol/drug use-related problems, motivation to change, criminal profile, subject's perception of judicial pressure, subjective assessment of importance/probability of judicial consequences tied to treatment dropout or substance use, quality of the therapeutic relationship, assessment of client commitment to treatment, and social support. Results indicate that judicial pressure only have impact on retention into treatment for those who are not already sentenced but this "forced" retention is not linked with positive results. The study's limitations are noted.

A comparison of voucher exchanges between criminal justice involved and noninvolved participants enrolled in voucher-based contingency management drug abuse treatment programs

This report compares requests for goods or services made by participants in two clinical trials of contingency management for the treatment of substance abuse. One trial was for participants involved with the criminal justice system and one was for participants who were not involved with the criminal justice system. In both trials, participants earned vouchers that could be exchanged for goods or services. Results indicated that the criminal justice group used the majority of their vouchers for paying fees or fines related to the criminal justice system while the other group used only a small portion of their vouchers for paying costs related to the criminal justice system. However, when the costs for the criminal justice system are removed, the proportion of vouchers exchanged for various goods and services are similar between the two groups. The results suggest that for those substance abusers involved in the criminal justice system, assistance in paying fines and fees related to their criminal justice system involvement may be a potentially powerful source of reinforcement that could be used in creative treatment strategies.

Treating drug-abusing offenders. Initial findings from a five-county study on the impact of California's Proposition 36 on the treatment system and patient outcomes

Five counties (Kern, Riverside, Sacramento, San Diego, San Francisco) that demonstrate both variations and similarities in their implementation of Proposition 36 (e.g., treatment approaches, urine testing) and patient mix have been selected to participate in a study assessing how California's Proposition 36 is affecting the drug treatment system and patient outcomes. Except for San Francisco, treatment admissions increased during the first year of Proposition 36 implementation over the prior year (27% in Kern, 21% in Riverside, 17% in Sacramento, and 16% in San Diego), mostly in outpatient drug-free programs. Compared to non-Proposition 36 patients, Proposition 36 patients were more likely to be men, first-time admissions, treated in outpatient drug-free programs, employed full-time, and users of methamphetamine or marijuana. They were less likely to be treated in residential programs or methadone maintenance programs and fewer reported heroin use or injection drug use. Guided by the multilevel open systems framework, the study examines key issues of Proposition 36 that influence treatment systems and outcomes and empirically identifies "best practice" approaches in treating drug-abusing offenders.

Cumulative environmental risk in substance abusing women: early intervention, parenting stress, child abuse potential and child development

OBJECTIVE

To assess the relationship between cumulative environmental risks and early intervention, parenting attitudes, potential for child abuse and child development in substance abusing mothers.

METHOD

We studied 161 substance-abusing women, from a randomized longitudinal study of a home based early intervention, who had custody of their children through 18 months. The intervention group received weekly home visits in the first 6 months and biweekly visits from 6 to 18 months. Parenting stress and child abuse potential were assessed at 6 and 18 months postpartum. Children's mental and motor development (Bayley MDI and PDI) and language development (REEL) were assessed at 6, 12, and 18 months postpartum. Ten maternal risk factors were assessed: maternal depression, domestic violence, nondomestic violence, family size, incarceration, no significant other in home, negative life events, psychiatric problems, homelessness, and severity of drug use. Level of risk was recoded into four categories (2 or less, 3, 4, and 5 or more), which had adequate cell sizes for repeated measures analysis.

DATA ANALYSIS

Repeated measures analyses were run to examine how level of risk and group (intervention or control) were related to parenting stress, child abuse potential, and children's mental, motor and language development over time.

RESULTS

Parenting stress and child abuse potential were higher for women with five risks or more compared with women who had four or fewer risks; children's mental, motor, and language development were not related to level of risk. Children in the intervention group had significantly higher scores on the PDI at 6 and 18 months (107.4 vs. 103.6 and 101.1 vs. 97.2) and had marginally better scores on the MDI at 6 and 12 months (107.7 vs. 104.2 and 103.6 vs. 100.1), compared to the control group.

CONCLUSION

Compared to drug-abusing women with fewer than five risks, women with five or more risks found parenting more stressful and indicated greater inclination towards abusive and neglectful behavior, placing their infants at increased risk for poor parenting, abuse and neglect. Early home-based intervention in high-risk families may be beneficial to infant development.

Treating juvenile offenders for marijuana problems

AIMS

This study investigated the characteristics and substance abuse treatment experience of two differentially defined groups of juvenile offenders, those who were referred or otherwise involved with the legal system and those who reported recent criminal behavior.

DESIGN

Six hundred adolescents from the Cannabis Youth Treatment (CYT) Project were classified by criminal justice system involvement and recent criminal behavior. Multivariate and repeated-measures techniques explored substance use frequency, substance use problems, psychological and social risk factors and treatment outcomes as functions of criminal status.

FINDINGS

Adolescents reporting criminal justice system involvement were comparable to adolescents reporting no legal involvement. Adolescents reporting past crime presented with heavier substance use, more substance use problems and greater psychological and environmental risks. Criminally active adolescents had greater reductions in substance use frequency and substance use problems during the course of treatment.

CONCLUSION

Juvenile offender status, whether defined by criminal justice system involvement or criminal behavior, does not seem to mitigate the potential for adolescents to benefit from manual-guided outpatient treatments.

An Estimate of the Level and Determinants of Illicit Drug Use among Unauthorized Latino Immigrant Arrestees in California

Although justifications for a more restrictive U.S. immigration policy have increasingly relied on linking socially unacceptable behaviors such as welfare participation and illicit drug use with illegal entry, very few immigration impact studies separate respondents by foreign-born legal status. Applying a legal status prediction equation to 1994–1996 CALDUF data, this paper (1) estimates the relative level of illicit drug use (IU) among unauthorized Latino immigrant arrestees (ULIAs) in California and (2) investigates how individual-demographic and institutional-structural factors influence IU. ULIAs were underrepresented, with a smaller proportion testing positive for IU and having experienced or desired drug treatment. Regression results suggest (1) ULIA status had an independent negative effect on IU; and (2) higher earnings may have decreased, and public assistance recipiency and the percent of one's income obtained illegally may have increased, the likelihood of IU. We conclude by discussing implications for various policy instruments.

Substance abuse and criminal recidivism: a prospective study of adolescents

Studies of substance abuse among delinquents have shown mixed results on criminal recidivism. The present study evaluates personality traits associated with substance abuse and recidivism among delinquent boys, and prospectively determines the extent to which these factors are predictive of criminal recidivism. 134 incarcerated boys (x = 15.9 +/- 1.1) completed the Weinberger Adjustment Inventory and the Substance Abuse Screening Inventory. Youth were prospectively followed for up to 4.5 years following release. Among incarcerated delinquents, personality traits are predictive of a positive substance abuse screen and recidivism. A trend indicating a possible interaction between personality and treatment is observed. If these findings are replicated, personality traits may play a role in predicting substance abuse as well as individual delinquent responses to treatment.