The Role of Controlled Substance Use in Diversion Outcomes Among Mentally Ill Offenders: A Pilot Study

2017 ◽  
Vol 62 (9) ◽  
pp. 2709-2725
Author(s):  
Jennifer K. Boland ◽  
Barry Rosenfeld
Keyword(s):  
New York ◽  
Substance Abuse ◽  
Substance Use ◽  
Psychotic Disorders ◽  
Mentally Ill Offenders ◽  
Program Participation ◽  
Diversion Programs ◽  
Diversion Program ◽  
Drug History

Diversion programs offer opportunities to offenders with substance abuse or mental illness to attend treatment as an alternative to incarceration. The present study identified variables associated with drug relapse and recidivism and the moderating role of substance use on recidivism in a diversion sample. Data were collected from 80 clients with psychotic disorders from a diversion program in New York City. Outcomes were examined after 6 and 12 months of program participation. Individuals who used controlled substances other than alcohol or cannabis were more likely to have a positive toxicology result than those who used alcohol or cannabis only or those with no alcohol/drug history. Individuals with schizoaffective disorder were more likely to be rearrested than individuals with other diagnoses, as were those with a violent offense (e.g., assault, robbery). Positive toxicology results were unrelated to rearrest and did not moderate recidivism, suggesting substance abuse may be only indirectly related to rearrest among diverted offenders.

Examining the Role of Substance Abuse in Elder Mistreatment: Results From Mistreatment Investigations

2016 ◽  
Vol 34 (2) ◽  
pp. 366-391 ◽  
Author(s):  
Kendon J. Conrad ◽  
Pi-Ju Liu ◽  
Madelyn Iris
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Physical Abuse ◽  
Emotional Abuse ◽  
Risk Identification ◽  
Elder Mistreatment ◽  
Cross Sectional ◽  
Substance Use Problems ◽  
Financial Exploitation

Substance abuse has long been identified as a risk factor for elder mistreatment, yet research on the topic remains sparse. This study tested hypotheses whether perpetrator and victim substance use problems were associated with financial exploitation, physical abuse, emotional abuse, and neglect versus no abuse. Cross-sectional data were collected on 948 cases with yes/no substantiation decisions where 357 cases had no abuse in elder mistreatment investigations. Hypotheses were tested using odds ratios, bivariate, and multiple linear regression analyses including a control for victim vulnerability. Of 948 alleged victims, 42 (4.4%) exhibited signs of substance use problems. Among the 323 alleged perpetrators, 87 (26.9%) were reported to have substance use problems. Substance use problems by alleged perpetrators were associated ( p < .01) with financial exploitation, physical abuse, and emotional abuse but not neglect. Substance use problems by alleged victims were associated with neglect, but not the other types. Alleged perpetrators with substance use problems tended to commit multiple forms of abuse, were male and not caregivers. Except for the findings on neglect, the associations with elder mistreatment were stronger for alleged perpetrators with substance use problems, than for alleged victims. Clarification of the role of perpetrator risk factors such as substance abuse should improve risk identification and subsequent intervention.

scholarly journals Effectiveness of a Jail Diversion Program in Linking Participants to Federal Entitlements and Stable Housing

2005 ◽  
Vol 3 (2) ◽  
pp. 84-98 ◽  
Author(s):  
Sabrina W. Tyuse
Keyword(s):  
Mentally Ill ◽  
Self Report ◽  
Mentally Ill Offenders ◽  
Diversion Programs ◽  
Jail Diversion ◽  
Diversion Program ◽  
Symptom Index ◽  
Stable Housing ◽  
The Government ◽  
Housing Outcomes

Jail diversion programs are designed to prevent the incarceration of mentally ill offenders and to facilitate their entrance into appropriate community-based treatment, while also guarding the safety of the general public. This study sought to determine the effectiveness of one such program. Initial outcomes are described for mentally ill offenders who participated in the program. A total of 50 participants completed the following self-report measures: the Government Performance and Result Act (GPRA) instrument, and the Colorado Symptom Index. Participants were interviewed again at 6 and 12 months. Results indicate the program significantly assisted participants in obtaining income supports such as Medicaid, Social Security, and Food Stamp benefits, but had little impact on housing outcomes.

What Did You Expect? Substance Use Expectancies Mediate the Relationships Between Dark Triad Traits, Substance Use, and Substance Preference

2018 ◽  
Vol 121 (5) ◽  
pp. 831-852 ◽  
Author(s):  
Adam Jordan Gott ◽  
Melanie D. Hetzel-Riggin
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Cognitive Enhancement ◽  
Dark Triad ◽  
Clinical Implications ◽  
Online Questionnaire ◽  
Specific Substance ◽  
Substances Of Abuse

This study explores the role of substance use expectancies as mediators between the Dark Triad of personality, substance use, and substance use preferences. A sample of college students ( M = 19.38, SD = 2.63, N = 207) completed an online questionnaire that assessed the Dark Triad traits, substance use history, substance preferences, and substance use expectancies. Three specific substance use expectancies—increased confidence, tension reduction, and cognitive enhancement—were shown to either partially or fully mediate the relationships between the Dark Triad and substance use behaviors and preference for certain substances of abuse. These findings may hold clinical implications for the treatment of substance use disorders and further the understanding of factors contributing to the etiology and progression of substance abuse and substance use disorders.

Comorbidity of substance abuse and schizophrenia: the role of pre-morbid adjustment

1992 ◽  
Vol 22 (2) ◽  
pp. 379-388 ◽  
Author(s):  
Stephan Arndt ◽  
Gary Tyrrell ◽  
Michael Flaum ◽  
Nancy C. Andreasen
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Common Factor ◽  
Clinical History ◽  
Psychotic Illness ◽  
Co Morbidity ◽  
Schizophrenic Patients ◽  
The Individual ◽  
Subsequent Onset

SYNOPSISCo-morbid substance use and abuse is common in schizophrenic patients, and the role of substance abuse in initiating and maintaining psychosis has important definitional and aetiological implications. We investigated the issue in a cohort of 131 schizophrenic patients. We found non-users (N = 67) were similar to pathological users (N = 64) in current symptomatology and clinical history. The pathological users did, however, have better pre-morbid adjustment levels. Only alcohol use and to some extent cannabis use contributed to this effect; use of stimulants or hallucinogens did not. These results indicate the importance of evaluating the various types of substance used when attempting to explore the significance of co-morbidity. The results also suggest that co-morbidity of substance abuse and schizophrenia may be explained by a common factor antecedent to both: better pre-morbid adjustment. A two-stage model is proposed to explain these findings: increased sociability increases exposure to opportunities of substance use in a subset of patients; subsequent onset of psychotic illness accelerates the use to a pathological level as the individual attempts to cope with the stress of the developing mental illness.

PP013 Pain Management And Substance Abuse In Sickle Cell Disease Patients

2017 ◽  
Vol 33 (S1) ◽  
pp. 73-74
Author(s):  
Mariana Santos ◽  
Diego Travi ◽  
Camila Ribeiro ◽  
Thiago Pianca ◽  
Indara Saccilotto ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Psychotic Disorders ◽  
Negative Consequences ◽  
Cell Disease ◽  
Convenience Sample ◽  
Alcohol And Drugs ◽  
Self Reporting Questionnaire

INTRODUCTION:Drug abuse is a social and public health problem because of its negative consequences of emotional and physical development in individuals. There are few studies evaluating substance abuse by individuals with sickle cell disease (SCD). These patients have severe and recurrent pain crises (1), frequently needing opioids to control it (2). The compromised quality of life can predispose this population to the occurrence of non-psychotic disorders such as depression, making them vulnerable to substance abuse (3).METHODS:We evaluated the consumption of alcohol and drugs in a cohort followed at the Sickle Cell Disease Reference Center (CRAF), at Hospital de Clínicas de Porto Alegre, estimating the percentage of patients in treatment of SCD who abuse alcohol and drugs, mainly opioids. A cross-sectional study was of a convenience sample of 139 patients with SCD treated at CRAF. The pattern of substance use was evaluated using the Brazilian version of Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The exposure to opioids was measured by their use and prescription in the 24 months before the interview. The Self-Reporting Questionnaire (SRQ-20) was used to estimate the occurrence of non-psychotic disorders in this population. Descriptive analyses were performed using absolute and relative frequencies. The association between the variables was verified using the chi-square test or Fisher's exact test.RESULTS:The prevalence of abusive use was 1.5 percent for alcohol and 3.0 percent for tobacco, with no abusive use of any other substance including opioids was identified. Of note was the pattern for substance use that was not influenced by exposure to substances or the presence of non-psychotic disorders.CONCLUSIONS:Our data shows that use of opioid analgesics for the management of SCD painful crises is safe and does not induce substance abuse. Regular follow-up of these patients is recommended. The results of this study might be useful in other countries.

scholarly journals Neuroimmune Mechanisms as Novel Treatment Targets for Substance Use Disorders and Associated Comorbidities

2021 ◽  
Vol 15 ◽  
Author(s):  
Mark D. Namba ◽  
Jonna M. Leyrer-Jackson ◽  
Erin K. Nagy ◽  
M. Foster Olive ◽  
Janet L. Neisewander
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Nervous System ◽  
Synaptic Plasticity ◽  
Substance Use Disorders ◽  
Immune Signaling ◽  
Treatment Targets ◽  
Novel Treatment ◽  
The Brain

Recent studies examining the neurobiology of substance abuse have revealed a significant role of neuroimmune signaling as a mechanism through which drugs of abuse induce aberrant changes in synaptic plasticity and contribute to substance abuse-related behaviors. Immune signaling within the brain and the periphery critically regulates homeostasis of the nervous system. Perturbations in immune signaling can induce neuroinflammation or immunosuppression, which dysregulate nervous system function including neural processes associated with substance use disorders (SUDs). In this review, we discuss the literature that demonstrates a role of neuroimmune signaling in regulating learning, memory, and synaptic plasticity, emphasizing specific cytokine signaling within the central nervous system. We then highlight recent preclinical studies, within the last 5 years when possible, that have identified immune mechanisms within the brain and the periphery associated with addiction-related behaviors. Findings thus far underscore the need for future investigations into the clinical potential of immunopharmacology as a novel approach toward treating SUDs. Considering the high prevalence rate of comorbidities among those with SUDs, we also discuss neuroimmune mechanisms of common comorbidities associated with SUDs and highlight potentially novel treatment targets for these comorbid conditions. We argue that immunopharmacology represents a novel frontier in the development of new pharmacotherapies that promote long-term abstinence from drug use and minimize the detrimental impact of SUD comorbidities on patient health and treatment outcomes.

Diversion Programs for Individuals Who Use Substances: A Review of the Literature

2021 ◽  
pp. 002204262110003
Author(s):  
Robin Lindquist-Grantz ◽  
Peter Mallow ◽  
Leah Dean ◽  
Michelle Lydenberg ◽  
Jennifer Chubinski
Keyword(s):  
Substance Use ◽  
Program Implementation ◽  
Psychosocial Functioning ◽  
Empirical Studies ◽  
Diversion Programs ◽  
Diversion Program ◽  
Criminal Sanctions ◽  
Program Retention ◽  
Program Characteristics ◽  
Study Designs

Diversion programs connect individuals to treatment instead of criminal sanctions and are used more frequently to address substance use. This systematic scoping review included 31 published empirical studies to examine evaluations of diversion programs that address substance use and misuse. We assessed the program characteristics and implementation settings, as well as the outcomes measured and study methods used. We identified five prevalent study outcomes categories: (a) Service utilization (program retention and completion), (b) Recidivism/criminality, (c) Substance use, (d) Psychosocial functioning, and (e) Other outcomes (e.g., trauma, quality of life, and housing). Findings demonstrated limited but promising evidence for improvements in recidivism, substance use, and psychosocial outcomes. The limited evidence may be partly due to heterogeneity in diversion program implementation, study designs used, and differences among subpopulations. Most studies examined postbooking diversion programs; therefore, further examination of alternative approaches such as prebooking diversion programs is needed to fully understand diversion program impacts.

scholarly journals A retrospective chart review of the clinical and psychosocial profile of psychotic adolescents with co-morbid substance use disorders presenting to acute adolescent psychiatric services at Tygerberg Hospital

2012 ◽  
Vol 18 (2) ◽  
pp. 8 ◽  
Author(s):  
Anusha Lachman ◽  
Rene Nassen ◽  
Sue Hawkridge ◽  
Robin A Emsley
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Dual Diagnosis ◽  
Chart Review ◽  
Psychotic Disorders ◽  
Drugs Of Abuse ◽  
Treatment Guidelines ◽  
Psychiatric Treatment ◽  
Retrospective Chart Review ◽  
First Episode

<p><strong>Background.</strong> A large number of adolescents meet criteria for ‘dual diagnosis’ (a psychiatric disorder plus co-morbid substance use disorder (SUD), which prolongs treatment response and complicates intervention strategies. The current service model in Cape Town divides the care of such patients into psychiatric treatment and a separate substance use intervention. Child and adolescent mental health services face the challenge of high rates of readmission of adolescents into psychiatric facilities before utilisation of community-based substance abuse services.</p><p><strong>Objective.</strong> There is a scarcity of available treatment guidelines for dual-diagnosis adolescents, and a lack of systematically documented epidemiological and clinical data in South African adolescent populations.</p><p><strong>Method.</strong> A retrospective chart review of adolescent psychiatric admissions to the Tygerberg Adolescent Psychiatric Unit during 2010 was conducted. Relevant epidemiological, clinical and demographic data for those presenting with a dual diagnosis (specifically psychotic disorders and SUD) was recorded.<strong> </strong></p><p><strong>Results.</strong> Results suggest a high prevalence of SUD among adolescents presenting with a first-episode psychosis. Statistically significant correlations with lower levels of education were found in those with ongoing substance abuse (specifically cannabis and methamphetamine), and a significant relationship between choice of debut drug and ongoing drug use was also demonstrated. Risk factors for SUD (psychosocial adversities, childhood trauma, family and community exposure to substances, early debut drug ages), risky sexual behaviours, and clinical psychiatric profiles of adolescents with dual diagnosis are described.</p><p><strong>Conclusions.</strong> This cohort had an enhanced risk as a result of genetic vulnerability and environmental availability of substances, and the findings emphasise the differences in presentation, choice of drugs of abuse and psychosocial difficulties of adolescents with a dual diagnosis presenting to a psychiatric facility. We aim to influence role-players to provide more integrated services, and highlight the need for future prospective studies in this adolescent group to assist in improving outcomes.</p>

The Role of Sexual Abuse in Trauma Symptoms, Delinquent and Suicidal Behaviors, and Criminal Justice Outcomes Among Females in a Juvenile Justice Diversion Program

2017 ◽  
Vol 24 (8) ◽  
pp. 973-993 ◽  
Author(s):  
Krystel Tossone ◽  
Madison Wheeler ◽  
Fredrick Butcher ◽  
Jeff Kretschmar
Keyword(s):  
Sexual Abuse ◽  
Substance Use ◽  
Juvenile Justice ◽  
Behavioral Health ◽  
Psychological Trauma ◽  
Trauma Symptoms ◽  
Diversion Program ◽  
Future Directions ◽  
Running Away

Female juvenile justice–involved (JJI) youth experience more sexual abuse (SA) than their non-JJI counterparts or their male JJI counterparts. This study examines SA’s role among JJI females ( N = 1,307) in a behavioral health diversion program. Results indicate that SA increases the risk of psychological trauma, particularly posttraumatic stress and depression. SA also increases the odds of suicidal behavior, running away, and substance use. SA females have the same odds of successfully completing behavioral health diversion and being charged with any offense or misdemeanor after termination as non-SA females. Implications of research and future directions are discussed.

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