Factors Associated with Probation Officers' Use of Criminal Justice Coercion to Mandate Alcohol Treatment

Alcohol problems are widespread among individuals in county criminal justice probation systems. However, it is unclear why only a small fraction of these problem drinkers receive treatment. In this study, self‐administered questionnaires were mailed to 145 probation officers in nine California counties to identify factors that predicted probation officers' use of coercion to mandate alcohol treatment. The questionnaire measured characteristics of probation officers, characteristics of their caseloads, and perceptions about their departments. Principle components analysis combined some of the items into six factor‐based scales. Multiple regression analyses identified two significant predictors of use of coercion into treatment: a belief that treatment was effective and a belief that one's peers in the department were using coercion frequently. Implications for increasing treatment entry of probationers with drinking problems include educating probation officers about the effectiveness of substance abuse treatment in general and about coerced treatment in particular. Probation departments are encouraged to develop management styles that facilitate shared normative beliefs about assessing and managing alcohol problems among probationers.     

HIV risk behaviors, knowledge, and prevention education among offenders under community supervision: a hidden risk group.

Numerous studies have established that incarcerated populations are at substantial risk for HIV infection. In response, many jails and prisons have increased HIV prevention and related services. However, although twice as many offenders are under community supervision as are incarcerated at any given time, HIV prevention needs have been largely ignored among probationers and parolees, and little is known about their HIV risk behaviors or HIV prevention needs. Compared with inmates, probationers and parolees have substantially greater opportunities to engage in HIV risk behaviors. In the present study, we describe HIV risk behaviors, knowledge, and prevention education experiences of probationers and parolees in New York City. We find that probationers and parolees have high rates of unprotected sex, and limited current exposure to effective HIV education and prevention interventions. Probation and parole departments need to improve HIV training for officers and make HIV risk reduction services more available.     

Gender differences in substance use treatment and substance use among adults on probation

Background: Although many formal and informal substance use treatment programs were originally designed for men, no studies have investigated how gender affects the use of substance use treatment modalities, and how gender differences in treatment utilization impact substance use in the unique probation context. Objective: To describe gender differences in use and effectiveness of substance use treatment modalities (formal and informal) among probationers. Methods: Longitudinal data were obtained from 335 individuals (93 women) who participated in the Motivational Assessment Program to Initiate Treatment (MAPIT) study. Timeline follow-back measures were used to quantify daily substance use and treatment modality (formal treatment included inpatient and outpatient treatment; informal treatment included self-help, religious, and all other group meetings). Multivariate generalized estimating equations were used to examine relationships between gender, treatment, and substance use. Results: Gender was not associated with alcohol use. Use of formal treatment programs reduced the odds of alcohol use by 15%. The probability of alcohol use was the lowest (8%) for men who participated in formal treatment. For men using informal treatment programs, the probability of alcohol use was 11%. The probability of alcohol use for women was similar regardless of the type of treatment utilization (15–16%). No differences in illicit drug use by gender or type of treatment were detected. Conclusion: This research found limited evidence of a relationship between gender, substance use treatment modality, and alcohol use. These findings have clinical significance in that both formal and informal treatment approaches are similarly effective across both men and women.     

Substance Abuse Treatment Characteristics of Probation‐Referred Young Adults in a Community‐Based Outpatient Program

Although rates of substance abuse continue to rise among young adults ages 18–25, there is little information on the clinical characteristics of young adults referred to treatment, their readiness to change substance use behaviors, and treatment outcomes. These aspects were examined in young (18–25 years old) and older adult (26–45 years old) substance abusers entering treatment at a large, urban, outpatient substance abuse treatment facility. All clients were referred for outpatient treatment by the local Offices of Adult Probation during 1998–1999. The demographic and substance use characteristics, motivation level/readiness to change substance use behaviors, treatment attendance, completion, and “drug‐free” status based on patient self‐report and urine/breathalyzer data were assessed. Results. Substance‐abusing young adult probationers were more likely to be African‐American, with a significantly earlier age of onset of primary substance use. They were more likely to have a marijuana use disorder as compared with older adults, who in turn, were more likely to meet criteria for alcohol use disorders. Furthermore, as compared with older adults, young adults had significantly higher scores on precontemplation, and significantly lower scores on contemplation, determination, action, and maintenance subscales of motivation/change readiness. A significantly higher number of young adults did not complete outpatient treatment and were “drug‐positive” at discharge, as compared with older adults. Conclusions. Young adult probationers referred to substance abuse treatment show significantly different substance abuse and treatment characteristics as compared with their older adult counterparts. The findings suggest that specialized treatment approaches that focus on enhancing treatment readiness and motivation to change substance use behaviors may be of particular benefit to substance abusing young adults.     

Substance abuse treatment characteristics of probation-referred young adults in a community-based outpatient program

Although rates of substance abuse continue to rise among young adults ages 18-25, there is little information on the clinical characteristics of young adults referred to treatment, their readiness to change substance use behaviors, and treatment outcomes. These aspects were examined in young (18-25 years old) and older adult (26-45 years old) substance abusers entering treatment at a large, urban, outpatient substance abuse treatment facility. All clients were referred for outpatient treatment by the local Offices of Adult Probation during 1998-1999. The demographic and substance use characteristics, motivation level/readiness to change substance use behaviors, treatment attendance, completion, and "drug-free" status based on patient self-report and urine/breathalyzer data were assessed. Results. Substance-abusing young adult probationers were more likely to be African-American, with a significantly earlier age of onset of primary substance use. They were more likely to have a marijuana use disorder as compared with older adults, who in turn, were more likely to meet criteria for alcohol use disorders. Furthermore, as compared with older adults, young adults had significantly higher scores on precontemplation, and significantly lower scores on contemplation, determination, action, and maintenance subscales of motivation/change readiness. A significantly higher number of young adults did not complete outpatient treatment and were "drug-positive" at discharge, as compared with older adults. Conclusions. Young adult probationers referred to substance abuse treatment show significantly different substance abuse and treatment characteristics as compared with their older adult counterparts. The findings suggest that specialized treatment approaches that focus on enhancing treatment readiness and motivation to change substance use behaviors may be of particular benefit to substance abusing young adults.     

Rapid HIV Testing for Individuals on Probation/Parole: Outcomes of an Intervention Trial

Many probationers and parolees do not receive HIV testing despite being at increased risk for obtaining and transmitting HIV. A two-group randomized controlled trial was conducted between April, 2011 and May, 2012 at probation/parole offices in Baltimore, Maryland and Providence/Pawtucket, Rhode Island. Male and female probationers/parolees were interviewed (n = 1,263) and then offered HIV testing based on random assignment to one of two conditions: (1) On-site rapid HIV testing conducted at the probation/parole office; or (2) Referral for rapid HIV testing off site at a community HIV testing clinic. Outcomes were: (1) undergoing HIV testing; and (2) receipt of HIV testing results. Participants were significantly more likely to be tested on-site at a probation/parole office versus off-site at a HIV testing clinic (p < 0.001). There was no difference between the two groups in terms of receiving HIV testing results. Findings indicate that probationers/parolees are willing to be tested on-site and, independent of testing location, are equally willing to receive their results. Implications for expanding rapid HIV testing to more criminal justice related locations and populations are discussed.     

Drinking,Alcohol Use Disorder,and Treatment Access and Utilization Among U.S. Racial/Ethnic Groups

Data from approximately 140 articles and reports published since 2000 on drinking, alcohol use disorder (AUD), correlates of drinking and AUD, and treatment needs, access, and utilization were critically examined and summarized. Epidemiological evidence demonstrates alcohol‐related disparities across U.S. racial/ethnic groups. American Indians/Alaska Natives generally drink more and are disproportionately affected by alcohol problems, having some of the highest rates for AUD. In contrast, Asian Americans are less affected. Differences across Whites, Blacks, and Hispanics are more nuanced. The diversity in drinking and problem rates that is observed across groups also exists within groups, particularly among Hispanics, Asian Americans, and American Indians/Alaska Natives. Research findings also suggest that acculturation to the United States and nativity affect drinking. Recent studies on ethnic drinking cultures uncover the possible influence that native countries’ cultural norms around consumption still have on immigrants’ alcohol use. The reasons for racial/ethnic disparities in drinking and AUD are complex and are associated with historically rooted patterns of racial discrimination and persistent socioeconomic disadvantage. This disadvantage is present at both individual and environmental levels. Finally, these data indicate that admission to alcohol treatment is also complex and is dependent on the presence and severity of alcohol problems but also on a variety of other factors. These include individuals’ sociodemographic characteristics, the availability of appropriate services, factors that may trigger coercion into treatment by family, friends, employers, and the legal system, and the overall organization of the treatment system. More research is needed to understand facilitators and barriers to treatment to improve access to services and support. Additional directions for future research are discussed.     

A Study of Substance Use in Women in the West Texas U.S. Probation and Pretrial Services System

Previous studies have shown an association between substance use in the corrections population and, though the overall probation population has been declining, the percentage of women on probation has significantly increased. This study collected data on the factors associated with substance use and criminality among West Texas women who were sentenced to the U.S. Probation and Pretrial Services System (USPPSS). Intake records for USPPSS adult women spanning 3 years were reviewed. Among all age distributions and demographics, alcohol use was found to be prevalent. A significant positive correlation was found between immediate and extended family use of alcohol or drugs. Approximately one third of women reported a lifetime history of psychiatric treatment and three fourths reported a lifetime history of emotional/verbal, physical, and/or sexual abuse. The significant association with alcohol and substance use among these women should be addressed when determining probation planning and social services. Furthermore, the high incidence of emotional/verbal, physical and/or sexual abuse, and suicidality in this population would recommend an approach that includes provision of adequate mental health services.     

Minimizing Alcohol Related Offences by Enforcement of the Existing Licensing Legislation

Two parallel investigations were conducted to assess the involvement of alcohol in police work. In the first, all persons arrested were asked whether they had taken alcohol in the four hours prior to the commission of their offence. The results confirm the belief that a considerable proportion of police work is alcohol, related. In the second study, the effect of a new polity on the supervision of licensed premises was assessed. The results indicated that this new practice may have been responsible for a drop in the commission of illegal behaviours. The implications of both studies, in terms of police practice and education of police officers about alcohol, are considered.     

A comparison of alcohol and drug treatment clients: are they from the same population?

As part of the Alcohol Research Group's Community Epidemiology Laboratory, representative samples of clients from a northern California county's public alcohol and drug treatment systems were interviewed. This paper compares clients in alcohol treatment agencies (N = 381) with those in drug treatment agencies (N = 307). In the United States the traditional separation of the two systems is in question, as there is a belief that most clients of both systems have dual alcohol and drug problems. This study found that while large numbers of clients reported use of both alcohol and other drugs, important differences were found between the two treatment systems. Alcohol treatment clients reported significantly higher alcohol consumption rates and lower drug use than did drug treatment clients. However, a higher proportion of alcohol treatment clients reported consuming alcohol with other drugs and attributing problems to both alcohol and drugs than did drug treatment clients. Discriminant function analysis found sociodemographic characteristics, problems attributed to alcohol, and problems attributed to drugs to provide significant contributions in predicting membership in the alcohol versus the drug treatment system.     

Socially sanctioned coercion mechanisms for addiction treatment

Coercion as a strategy for treatment of addiction is an effective but often negatively perceived approach. The authors review current policies for involuntary commitments and explore coercive dimensions of treating alcohol and drug dependence in the workplace, sports, and through professional licensure. Gender-specific issues in coercion are considered, including evidence for improved treatment retention among pregnant and parenting women coerced via the criminal justice system. Social security disability benefits represent an area where an opportunity for constructive coercion was missed in the treatment of primary or comorbid substance use disorders. The availability of third-party funding for the voluntary treatment of individuals with substance use disorders has decreased. This unmet need, coupled with the evidence for positive clinical outcomes, highlights the call for implementing socially sanctioned mechanisms of coercion.     

Workshop F

The authors examine a model which specifies the relationships among criminality and the use of alcohol and other drugs. A pattern is hypothesized: The initiation of alcohol/drug use tends to progress from legal to illicit drugs; the early initiation of drugs increases the current use of drugs; and criminality is affected by the initiation/use patterns. Analyses based on data collected from individuals in jails, drinking driver programs, alcoholism treatment centers, and on probation indicate that the early onset of legal drug use induces the onset of illicit drug use. Criminality is affected by the current use of alcohol and cocaine. Comparison and contrast of findings from the four groups are provided.     

Substance use before and during pregnancy: links to intimate partner violence

Although some research has found links between women's experiences of intimate partner violence and their use of substances, little research has examined how this potential relationship changes when women become pregnant. Furthermore, most of the past research examining women's experiences of intimate partner violence and their use of substances has focused on only one type of violence, typically, physical assault. Thus less is known concerning how other important forms of violence, such as psychological aggression and sexual coercion, may be related to women's substance use and substance abuse disorders. This research studies 85 prenatal care patients to describe the women's use of alcohol and illicit drugs, both before and during pregnancy, in relation to their experiences of various types of intimate partner violence before and during pregnancy (including psychological aggression, physical abuse, and sexual coercion). The Conflict Tactics Scales 2 was used to assess the women's experiences of intimate partner violence. The women were asked about their frequency of alcohol use, and alcohol using women were administered a short version of the Michigan Alcohol Screening Test to assess the women for symptoms of alcohol disorder. The women's use of illicit drugs was assessed by asking the women about their frequencies of various types of drug use and drug using women were administered the Drug Abuse Screening Test to assess the women for symptoms of drug disorder. The results showed that before pregnancy, women who were physically assaulted by their partners were somewhat more likely to drink alcohol and use illicit drugs compared with women who did not experience such violence, even though these differences did not reach the traditional level of statistical significance; however, among the substance using women, those who experienced each type of violence were more likely to be frequent users of substances compared with the non-victims, and they evidenced a greater number of substance disorder symptoms compared with the non-victims. After the women became pregnant, the links between women's experiences of intimate partner violence and their use of substances became stronger, with the women who experienced each type of partner violence being more likely to use both alcohol and illicit drugs. Furthermore, among the substance-using women, those who were psychologically and physically abused had somewhat elevated levels of substance disorder symptoms during pregnancy compared with women who did not suffer such victimization. These findings underscore the importance of providing routine screening for various types of violent victimization and substance use within the context of many types of women's health care settings, including substance abuse treatment programs, domestic violence programs, and prenatal care services.     

Enforcing the minimum drinking age: state, local and agency characteristics associated with compliance checks and Cops in Shops programs

AIMS: To identify state, local and organizational characteristics associated with local law enforcement agencies' implementation of two dramatically different approaches to enforcement of underage drinking laws: compliance checks and Cops in Shops programs. Compliance checks use underage decoys to attempt to purchase alcohol from retail merchants, while Cops in Shops programs deploy undercover law enforcement officers in alcohol outlets to detect and cite persons under the age of 21 who attempt to purchase alcohol. DESIGN: Cross-sectional telephone interview conducted as part of the Tobacco Enforcement Study (TES), which examined enforcement of laws related to youth access to tobacco. SETTING: Data were collected in 1999 among law enforcement agencies in all 50 states of the United States. PARTICIPANTS: Representatives of city police departments, departments of public safety, sheriffs or county police were included (n = 920 local agencies). MEASUREMENTS: Alcohol compliance checks and Cops in Shops programs were the primary outcomes. Covariates included state level policies (e.g. beer tax), agency resources (e.g. number of sworn officers) and community demographics (e.g. college dormitory population). FINDINGS: Local enforcement agencies were more likely to perform alcohol compliance checks than to have a Cops in Shops program (73.9% compared to 41.1% in cities > 25 000 and 55.7% compared to 23.9% in cities < or = 25 000). Conducting compliance checks for tobacco age-of-sale laws was positively associated with alcohol compliance checks and Cops in Shops (OR 3.30, P < 0.001; OR 1.84, P = 0.001, respectively). Having a Drug Abuse Resistance Education (DARE) officer was negatively related to conducting compliance checks (OR 0.67, P = 0.03). Special community policing units were associated with departments having Cops in Shops programs (OR 1.80, P = 0.006). CONCLUSIONS: This study used a nationally representative sample of communities to better understand state and local factors that shape local law enforcement agencies' use of two distinct approaches to underage drinking enforcement. The strong link observed between tobacco and alcohol compliance checks may indicate a culture within some law enforcement agencies supporting strict enforcement of age-of-sale laws.     

Substance misuse and social work qualifying training in the British Isles: a survey of CQSW courses

In 1989, all Certificate of Qualification in Social Work (CQSW) courses in the British Isles were included in a survey of the training offered social work students on responding to psychoactive substance misuse. There was a 74% response rate. Eleven per cent of the courses that responded provided no formal substance misuse training. Those that offered training provided a median of 8 hours, with over 70% of students receiving less than 11 hours, indicating that many students were being given the briefest of overviews. Outside of four or five ‘centres of excellence’, social workers and probation officers training in 1988–89 received less than adequate preparation to work with people with alcohol– and drug–related problems, despite evidence that they account for a large and growing proportion of their caseloads.     

Frequency of use of diazepam in individuals on probation and in methadone maintenance programs

During the spring of 1977 a survey was taken of drug analysis results for over 17,500 urine samples from Los Angeles County probationers and over 8,500 urine samples from Los Angeles County methadone clinic enrollees to determine the frequency of diazepam (Valium) use. The probation department specimens were found to contain diazepan less frequently than the methadone clinic specimens as a group. There were, however, wide variations in use frequency between the seven methadone clinics.     

Readiness to Change as a Predictor of Drug-Related Behaviors in a Sample of Rural Felony Probationers

Objective: Relationships between readiness to change and common drug-related behaviors were explored in a sample (N = 776) of rural probationers in the state of Kentucky. Methods: Self-reported data was gathered on measures of readiness to change, frequency of marijuana use, possession of drugs/related paraphernalia, and driving while under the influence of drugs/alcohol at time periods before and after arrest. Results: Independent of the influence of demographic characteristics such as age, gender, race, and treatment history, increases in readiness to change scores were accompanied by reductions in all three drug-related behaviors. Conclusion: Readiness to change has important implications for treatment involving rural probationers.     

Substance Use Before and During Pregnancy: Links to Intimate Partner Violence

Although some research has found links between women's experiences of intimate partner violence and their use of substances, little research has examined how this potential relationship changes when women become pregnant. Furthermore, most of the past research examining women's experiences of intimate partner violence and their use of substances has focused on only one type of violence, typically, physical assault. Thus less is known concerning how other important forms of violence, such as psychological aggression and sexual coercion, may be related to women's substance use and substance abuse disorders. This research studies 85 prenatal care patients to describe the women's use of alcohol and illicit drugs, both before and during pregnancy, in relation to their experiences of various types of intimate partner violence before and during pregnancy (including psychological aggression, physical abuse, and sexual coercion). The Conflict Tactics Scales 2 was used to assess the women's experiences of intimate partner violence. The women were asked about their frequency of alcohol use, and alcohol using women were administered a short version of the Michigan Alcohol Screening Test to assess the women for symptoms of alcohol disorder. The women's use of illicit drugs was assessed by asking the women about their frequencies of various types of drug use and drug using women were administered the Drug Abuse Screening Test to assess the women for symptoms of drug disorder. The results showed that before pregnancy, women who were physically assaulted by their partners were somewhat more likely to drink alcohol and use illicit drugs compared with women who did not experience such violence, even though these differences did not reach the traditional level of statistical significance; however, among the substance‐using women, those who experienced each type of violence were more likely to be frequent users of substances compared with the non‐victims, and they evidenced a greater number of substance disorder symptoms compared with the non‐victims. After the women became pregnant, the links between women's experiences of intimate partner violence and their use of substances became stronger, with the women who experienced each type of partner violence being more likely to use both alcohol and illicit drugs. Furthermore, among the substance using women, those who were psychologically and physically abused had somewhat elevated levels of substance disorder symptoms during pregnancy compared with women who did not suffer such victimization. These findings underscore the importance of providing routine screening for various types of violent victimization and substance use within the context of many types of women's health care settings, including substance abuse treatment programs, domestic violence programs, and prenatal care services.