Substance Involvement and Probation Outcomes: Evidence From a Cohort Study

Substance use disorders are common among justice-involved populations, the majority of whom are under community supervision in the form of probation. Substance involvement can amplify the challenges of complying with requirements of probation supervision, violations of which can lead to incarceration. In this study, we assess the role of substance involvement in violations of probation conditions across 47 counties representing 70% of individuals sentenced to probation in the state of Pennsylvania. We also consider the role of court-ordered treatment. We conclude by estimating the consequences of resentencing for substance-involved individuals in Pennsylvania (in incarceration and supervision days). Results suggest that individuals who are substance-involved are at greater risk of technical violations. However, treatment may reduce some negative outcomes for substance-involved individuals. Court-ordered treatment was associated with a reduction in the likelihood of being resentenced for a new offense relative to individuals who were substance-involved but not ordered to treatment.

Long-acting injectable antipsychotics and their use in court-ordered treatment: A cross-sectional survey of psychiatric pharmacists' perceptions

Introduction People with serious mental illness may be subjected to “court-ordered treatment” (COT), per the mental health statutes of their respective state. COT enforces adherence to a psychiatric treatment regimen and may involve involuntary medication administration. Long-acting injectable (LAI) antipsychotics are frequently used in this setting, although little is known about the clinical effectiveness or patterns of use of these agents in the context of COT. Because psychiatric pharmacists are medication experts, we sought to characterize their perceptions and experiences on this topic. Methods A cross-sectional, electronic, 14-item survey was administered via the College of Psychiatric and Neurologic Pharmacists listserv from October 9, 2018, to November 9, 2018. The survey collected demographic information, experience and use of LAI antipsychotics at each practice site, and perception of LAI antipsychotics. Results Of 843 possible respondents, 72 completed the survey, yielding an 8.5% response rate. LAIs were perceived as underused or adequately used as a whole, with a significant difference in perception favoring the opinion that LAIs are underused versus overused for those respondents who perceived an adherence benefit (P = .042). We also found that LAIs were used disproportionately in the context of COT versus oral formulations (P = .03). Discussion The use of LAIs in the context of COT has not been studied, and it may expose this vulnerable population to adverse effects from medications they are legally compelled to take. Further research on the perceptions of other interdisciplinary team members and the clinical impact of LAI use in COT is needed.

Anti-libidinal medication among sex offenders: a descriptive study from a specialized outpatient unit in Bordeaux (France)

Enhancements in the treatment of sexual offenders has been taking place for over four decades. The development of pharmacological therapy has helped to reduce the risk of re-offense and has demonstrated its utility in combination with psychotherapy. However further studies to demonstrate the efficacy of these therapies are required. We conducted a retrospective study in a unit that provides care for sexual offenders (court ordered treatment or voluntary treatment). Among the 224 patients at ERIOS over the past 15 years, we identified 23 patients who had received anti-libidinal treatment (ALM) at some point in their care. The results, obtained from only 22 informative files, indicate that 16 patients presented no notion of deviant fantasy or behavioral relapse under medication. This study also highlights the comorbidities and offers a perspective regarding the improvement in prescribing this type of pharmacological therapy.