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This chapter examines the relationship between substance abuse and crime within a behavioral framework and considers various intervention strategies that .
Table of contents

Prev Index Next. What is drug addiction treatment? How effective is drug addiction treatment? Is drug addiction treatment worth its cost? How long does drug addiction treatment usually last? What helps people stay in treatment? How do we get more substance-abusing people into treatment? How can family and friends make a difference in the life of someone needing treatment? Where can family members go for information on treatment options? How can the workplace play a role in substance abuse treatment?

What are the unique needs of women with substance use disorders? What are the unique needs of pregnant women with substance use disorders? What are the unique needs of adolescents with substance use disorders? Are there specific drug addiction treatments for older adults? Can a person become addicted to medications prescribed by a doctor? Is there a difference between physical dependence and addiction?

How do other mental disorders coexisting with drug addiction affect drug addiction treatment? Is the use of medications like methadone and buprenorphine simply replacing one addiction with another? Where do step or self-help programs fit into drug addiction treatment? Can exercise play a role in the treatment process? Ordering Publications Call or:. Cite this article. Specifically, tailored interventions are required to assess the effectiveness of interventions for drug-using offenders with co-occurring mental health problems. This systematic review stems from a previous Cochrane review which evaluated the effectiveness of interventions for drug using offenders anonymised author and web link.

The original Cochrane review was updated to produce three further reviews which explored the effectiveness of interventions aimed at reducing drug use and criminal activity in, i drug using female offenders Perry et al. This paper summarises the review findings of offenders with co-occurring mental health problems and in addition reports on mental health outcomes and diagnoses. A systematic review of 62 surveys found that prisoners were several times more likely to have a diagnoses of psychosis or major depression and ten times more likely to have an antisocial personality disorder than the general population Fazel and Danesh The provision of mental health care in US jails was found to be poor with most providing only intake screening, mental health evaluations and suicidal prevention services Steadman and Veysey In addition, the evidence suggests that people who suffer from a mental health problems are disproportionately more likely to be arrested when compared with offenders without mental health problems Lamb and Weinberger ; Lovell et al.

Reasons for this include limited support in the community, poor co-ordination of services and treatment on release, problems accessing treatment, and police and societal attitudes Cloyes et al. Large numbers of offenders also suffer from substance misuse problems and have been consistently reported as a major contributing factor in the increasing population of women offenders Greenfeld and Snell ; Staton-Tindall et al.

The relationship between drugs and crime is also complex. The literature has discussed the issue of whether drug use leads people into criminal activity or whether those who use drugs are already predisposed to such activity. Whilst the majority of women offenders have a history of drug use and drug-related offenses the research evidence suggests that only a small proportion of both men and women receive appropriate treatment and supervision Taxman The combination of drug use and offending behaviour has a substantial economic impact on society and specifically on formal service resources Byford et al.

They argue that the cost of treating drug abuse including health costs, hospitalizations, and government specialty treatment was a fraction of the overall societal costs. Treatment has also shown to reduce the costs associated with lost productivity, crime, and incarceration across various settings and populations.

  • Prisons and the criminal justice system.
  • Physics Reports vol.200.
  • Criminal justice responses to drug related crime in Scotland;

The largest economic benefit of treatment is seen in avoided costs of crime incarceration and victimization costs. Policy initiatives in the US and UK, show a renewed recognition that the criminal justice system CJS is not always the best place to manage people suffering from mental health problems.

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In the case of less serious offenders, several diversionary schemes have been established to provide a mechanism for diverting individuals with mental health problems into treatment programmes instead, or combined with incarceration Clarke ; Sarteschi et al.

Findings from such studies generally show positive improvements on a small number of clinical outcomes.

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However, the certainty of any causal link is often restricted by type of research design i. Evidence from previous systematic reviews have tended to investigate the effectiveness of interventions for either i drug using offenders, or ii offenders with mental health problems. Evidence supporting the case for treatment include a range of different treatment options.

Some examples include case management, therapeutic community models, cognitive skills and behavioural management and motivational interviewing. Case management evolved to address the needs of prisoner re-entry programmes covering employment, education, health, housing and family support via assessment and connecting clients with the appropriate services Austin and McClelland Similar findings have been found when using cognitive-behavioural approaches. Such programmes tend to include a number of different techniques including self-monitoring, goal setting, self-control training, interpersonal skills training, relapse prevention, group work and lifestyle modification.

These have also shown signs of success with offenders in the general prison population Lipsey et al. Acceptance and commitment therapy ACT is an intervention in the form of CBT focussing on an individual accepting personal events rather than attempting to change them and addresses goals for behaviour change.

A recent meta-analysis found ACT outperformed control, treatment as usual and waitlist control conditions with individuals with mental health problems in the general population A-Tjak et al. Motivational Interviewing MI also has a proven theoretical background showing that such techniques can lead to improved retention in treatment, enhanced motivation to change and reduced offending, McMurran ; Smedslund et al.

Miller and Rollnick developed MI as a process to motivate change in substance abusers. The technique uses strategies to encourage expressing empathy, avoiding arguing for change and working on ambivalence to strengthen commitment to change.

Meta-analyses evidence supports the use of MI as a stand-alone treatment and in combination with more intensive programmes e. A similar approach used also with people suffering from drug misuse interpersonal psychotherapy: IPT problems shows some success in reducing drug misuse with non-criminal justice settings, Johnson and Zlotnick IPT and MI are similar in approach with both focussing on building skills to deal with social situations and conflict, as well as additional support for substance use. MI was initially developed for substance abusers with the main focus being client motivation to facilitate change in health-related behaviours Miller and Rollnick Whilst IPT was initially developed as a structured therapy for people with depression, with the main focus being the ability to understand psychological symptoms as a response to everyday situations and difficulties de Mello et al.

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Therapeutic communities TCs have been used in the US since the s and more recently in the UK to rehabilitate offenders over a relatively long period of time. Residents are instrumental in running the TC and supporting each other through the process and this encompasses the transition between prison and working within the community e.

Evaluations of TC interventions using previous meta-analyses and systematic reviews show modest effects in the reduction of recidivism and drug use in male adult offenders e. Therapeutic communities can be tailored to meet the needs of specific groups. Personal reflections is an example of a modified TC treatment, which involves the inclusion of a cognitive behavioural element for individuals with mental health problems and substance use disorders Sacks et al.

We found one previous systematic review of 16 randomised controlled trials RCTs comprising adult offenders with mental health problems.

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The findings showed that clozapine was favoured over alternative treatments for improving psychiatric symptoms. The review identified limited evidence to show that discharge planning with benefit application assistance and the use of mental health services on release from incarceration was effective. The authors called for more comparative trials to increase their confidence in the findings Fontanarosa et al.

Other systematic reviews have evaluated interventions and conducted meta-analyses based on single treatment components Martin et al. Two reviews focused purely on pharmacological treatments Griffiths et al. The previous evidence demonstrates varied success with reductions in mental health, crime and drug outcomes but we know little about how interventions for drug using offenders and co-occurring mental health problems can help address treatment and rehabilitation opportunities.

For this reason, we believe a systematic evaluation of the existing evidence might help add to the current body of evidence by identifying specific interventions for this group of people. We are also interested in learning more about how such individuals are identified, what diagnoses they are given and how much such interventions might cost. The review addressed the following questions: 1 Does any treatment for drug-using offenders with co-occurring mental health problems reduce drug use? This review stems from an original Cochrane review insert anonymised reference.

The results of this update meant that we began our searching where the previous review finished insert anonymous reference.

Introduction to the Drug Abuse as Public Health v. Criminal Justice Value Debate

We searched 14 databases and identified records between and May Footnote 1 Specified search strategies were developed for each database to include randomised controlled trials RCTs of any language. The following are examples of the search terms used in the searches; prison, offender, substance or drug and reoffend. The search terms and strategies are documented in full in the following publication, insert anonymised reference.