Incarcerated Persons with Substance Use Disorders

This webpage identifies the major literature in the field of family court and criminal justice involvement: incarcerated persons with substance use disorders. The time frame is from January 2000 through December 2014.

Bahr, S. J., Masters, A. L., & Taylor, M. B. (2012). What works in substance abuse treatment programs for offenders? The Prison Journal, 92(2), pp. 155-174. DOI: 10.1177/0032885512438836

This article reviews empirical research published after the year 2000 on the effectiveness of drug treatment programs for prisoners, parolees, and probationers. Results of their empirical research reflects that cognitive-behavioral therapy (CBT), therapeutic communities, and drug courts had lower rates of drug use and crime than comparable individuals who did not receive treatment. Individuals who received contingency management tended to use drugs less frequently, particularly if they also received cognitive behavioral therapy. Researchers reported that drug use and crime were lower among individuals who received aftercare services after treatment completion. Effective treatment programs tend to (a) focus on high-risk offenders, (b) provide strong inducements to receive treatment, (c) include several different types of interventions simultaneously, (d) provide intensive treatment, and (e) include an aftercare component.

Binswanger, I. A., Merrill, J. O., Kreuger, P. M., Whilte, M. C., Booth, R. E., & Elmore, J. G. (2010). Gender differences in chronic medical, psychiatric, and substance-dependence disorders among jail inmates. American Journal of Public Health, 100(1), pp. 476-482. DOI: 10.2105/AJPH.2008.149591

This article presents the findings of a study seeking to examine gender differences in chronic medical, psychiatric, and substance-dependence disorders among jail inmates and whether substance dependence mediated those differences if any. Results showed that compared with men, women had a significantly higher prevalence of all medical and psychiatric conditions, and drug dependence, but women had a lower prevalence of alcohol dependence. Gender differences persisted after adjustment for sociodemographic factors and substance dependence. The authors found that women in jail had a higher burden of chronic medical disorders, psychiatric disorders, and drug dependence, including conditions found more commonly in men in the general population. Thus, there is a need for targeted attention to the chronic medical, psychiatric, and drug-treatment needs of women at risk for incarceration, both in jail and after release.

Carlson, B. E., & Shafer, M. S. (2010). Traumatic histories and stressful life events of incarcerated parents: Childhood and adult trauma histories. The Prison Journal, 90(1), pp. 475-493.

Abuse and trauma are common in the histories of prison inmates. This article presents the results of research on the trauma histories and stressful life events experienced by 2,279 male and female inmate parents in Arizona, with a particular focus on gender and ethnic differences across inmates. A sample of 838 incarcerated fathers and 1,441 mothers completed anonymous questionnaires regarding traumatic and stressful events experienced as children and/or adults. This study found high rates of exposure to childhood and adult traumatic events, especially child abuse, for both males and females and across ethnic groups.

Carlson, B. E., Shafer, M. S., & Duffee, D. E. (2010). Events of incarcerated parents II: Gender and ethnic differences in substance abuse and service needs. The Prison Journal, 90(1), pp. 494-515.

This article presents findings on substance abuse and service needs of male and female inmate parents in Arizona, with a particular focus on gender and ethnic differences across inmates. A sample of 838 incarcerated fathers and 1,441 mothers completed anonymous questionnaires regarding traumatic and stressful events experienced as children and/or adults, including addiction. Exposure to childhood and adult traumatic events, especially child abuse, was related to self-reported alcohol and drug problems for both males and females. Mothers reported significantly more post release service needs than fathers. The authors discuss implications for practice and policy.

Caudy, M.S., Tang, L., Wooditch, A., & Taxman, F.S. (2014). Short-term trajectories of substance use in a sample of drug-involved probationers. Journal of Substance Abuse Treatment, 46(2), pp. 202-213.

This study estimates trajectories of illegal substance in 251 drug-involved probationers in order to identify risk profiles. The results reflected five patterns of drug use during probation supervision. Age and type of drug were the strongest predictors of involvement in illicit drug use while on probation. This study suggests heterogeneity amongst drug users and emphasizes the importance of identifying trajectories of drug use during supervision can help identify individuals who may be more likely to persist in drug use.

Evans, E., Jaffe, A., Urada, D., & Anglin, D. M. (2012). Differential Outcomes of Court-Supervised Substance Abuse Treatment Among California Parolees and Probationers. International Journal of Offender Therapy and Comparative Criminology, 56(1), pp. 539-556.

This study explored the effectiveness of court-supervised drug treatment for California parolees, as well as examined and contrasted offender characteristics, treatment experiences, and outcomes. The analysis used statewide administrative data on 4,507 parolees and 22,701 probationers referred to treatment by Proposition 36 during fiscal year 2006-2007. Parolee problems were more severe at treatment entry, more were treated in residential settings, treatment retention was shorter, and fewer completed treatment compared to probationers. Regarding outcomes, fewer parolees were successful at treatment discharge and more recidivated over 12-months post admission. Both groups improved in many areas by treatment discharge, but improvements were generally smaller among parolees. Significant interaction effects indicated that parolees benefited from residential care and more treatment days, even after controlling for covariates. According to the authors court-supervised drug treatment for parolees can “work;” however, parolees have more frequent and diverse needs, and their outcomes are enhanced by more intensive treatment. Findings suggest methods for optimizing the effectiveness of criminal-justice supervised programs for treating drug-dependent offenders.

Friestad, C., Ase-Bente, R., & Kjelsberg, E. (2014). Adverse childhood experiences among women prisoners: Relationships to suicide attempts and drug abuse. International Journal of Social Psychiatry, 60(1), pp. 40-46. DOI: 10.1177/0020764012461235

This article examines the prevalence of adverse childhood experiences (ACE) and the relationship between such experiences and suicide attempts and drug use among incarcerated women in Norway. The main outcome variables of the study were attempted suicide and adult drug abuse. This study reflects that the number of ACEs increased the risk of attempted suicide and current drug abuse. The authors make the association between early life trauma and later health risk behavior and a need for early prevention.

Hanlon, T. E., O’Grady, K. E., Bennett-Sears, T., & Callaman, J. M. (2005). Incarcerated drug-abusing mothers: Their characteristics and vulnerability. American Journal of Drug and Alcohol Abuse, 31(1), pp. 59-77.

This study provides treatment-relevant information on the early life circumstances and developmental experiences of incarcerated substance-abusing women; examines the extent to which risk and protective factors derived from these early circumstances and experiences were associated with the adjustment and functioning of the mothers as adults; and contributes to an understanding of the general emotional adjustment of the mothers and their perceptions of themselves as parents. Findings show that there was a high level of emotional attachment between the mothers and their children, yet many of the incarcerated mothers lacked confidence in their parenting skills. Many of the children in the sample, reflected protective factors through a strong kinship environment. The above listed considerations should be taken into account in planning interventions targeting mothers dependent on substances. The first priority in assisting these mothers should involve the provision of a drug abuse treatment intervention, both prior to and following their release from custody that highlights the incompatibility of drug abuse and successful parenting practices. In addition, in this and/or supplemental clinical services, the mothers should be given specific assistance in developing their parenting skills, in reestablishing relationships with their children, and in addressing present family circumstances having a direct bearing on her reintegration within the family that includes input from both the current caretakers and the children.

Hiller, M. L., Narevic, E., Webster, J. M., Rosen, P., Staton, M., Leukefeld, C., Garrity, T. F., & Kayo, R. (2009). Problem severity and motivation for treatment in incarcerated substance abusers. Substance Use & Misuse, 44(1), pp. 28-41.

This article presents the findings of a study seeking to examine predictors of treatment motivation using data collected from 661 male drug-involved inmates during in-depth interviews that include components of the Addiction Severity Index, TCU Motivation Scale, and the Heath Services Research Instrument. Findings showed treatment motivation can be measured effectively in prison-based settings. Motivation scores were not significantly different between individuals in a prison-based treatment program and those in the general prison population. Furthermore, higher motivation for treatment scores were associated with greater levels of problem severity, suggesting that individuals with more drug-use related life problems may recognize this need and desire help for beginning long-term recovery.

Messina, N., Grella, C. E., Cartier, J., & Torres, S. (2010). A randomized experimental study of gender-responsive substance abuse treatment for women in prison. Journal of Substance Abuse Treatment, 38(1), pp. 97-107.

This experimental pilot study compared post-release outcomes for 115 women who participated in prison-based substance abuse treatment. Women were randomized to a gender-responsive treatment (GRT) program using manualized curricula (Helping Women Recover and Beyond Trauma) or a standard prison-based therapeutic community. Data was collected from the participants at prison program entry and 6 and 12 months after release. Results indicate that both groups improved in psychological well-being; however, GRT participants had greater reductions in drug use, were more likely to remain in residential aftercare longer (2.6 vs. 1.8 months, p b .05), and were less likely to have been re-incarcerated within 12 months after parole (31% vs. 45%, respectively; a 67% reduction in odds for the experimental group, p b .05). Findings show the beneficial effects of treatment components oriented toward women's needs and support the integration of GRT in prison programs for women.

Oser, C., Knudsen, H., Staton-Tindall, M., & Leukefeld, C. (2009). The adoption of wraparound services among substance abuse treatment organizations serving criminal offenders: The role of a women-specific program. Drug & Alcohol Dependence, 103, pp. S82-S90.

This article presents findings from a study using data from the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) research cooperative’s National Criminal Justice Treatment Practices Survey (NCJTPS), a nationally representative sample of community-based treatment programs serving predominantly criminal offenders who received wraparound services. Results reflect that larger organizations that utilized a greater number of treatment approaches and believed that treatment could reduce crime were more likely to offer a greater assortment of wraparound services. In an effort to improve behavioral treatment outcomes, it is imperative to examine organizational-level contextual factors that shape the availability of wraparound services for female offenders in community-based substance abuse treatment settings.

Phillips, S., Leathers, S., & Erkanli, A. (2009). Children of probationers in the child welfare system and their families. Journal of Child & Family Studies, 18(2), pp. 183-191.

This study describes changes over a 36-month period in the lives of children of probationers who were subjects of reports of maltreatment. Data on a nationally representative sample of reported victims of maltreatment were used to examine probationer-parents’ contact with the criminal justice system, and concurrent changes in their children’s households, risk exposure, and emotional and behavioral problems. Results show that 36 months after coming in contact with the child welfare system, about 40% of probationer’s children no longer lived with their probationer-parents. During the same period, children’s exposure to risk (i.e., parental substance abuse, mental illness, and domestic violence) dropped markedly; however, there was an upward trend in the prevalence of child emotional and behavioral problems. These problems ultimately declined among very young children, but persisted among elementary school age children. Suggestions for further studies include a better understanding the confluence of factors affecting the outcomes of probationers’ children.

Redman, D. (2008). Coping-related substance use motives and stressful life experiences among people with a history of incarceration. Journal of Social Work Practice in the Addictions, 8(4), pp. 490-510.

This mixed methods quantitative-qualitative study examined coping-related motives for substance use among 68 men and women with a history of incarceration. Qualitative analyses yielded 3 principal motivational categories: coping, social reinforcement, and enhancement. Discriminant analyses revealed that coping motives were associated with greater drinking frequency and quantity, along with a broader variety of adverse consequences, alcohol dependence, parental divorce or separation, later onset of childhood neglect, and experiencing conditions perceived as analogous to war. Practice implications include a comprehensive motivational assessment at the initiation of treatment, and the prevention or mitigation of stressful events during childhood and adult life.

Robbins, C. A., Martin, S. S., & Surratt, H. L. (2009). Substance abuse treatment, anticipated maternal roles, and reentry success of drug-involved women prisoners. Crime & Delinquency, 55(3), pp. 388-411.

This article reports analyses of recidivism and relapse experiences of substance-abusing women inmates as they reenter the community. Outcomes compared results for women who completed a work-release therapeutic community program, women who entered but did not complete the program, and those who did not receive work-release therapeutic community treatment. Additionally, this article compares women who anticipated living with their children following release to those who did not have children with whom they expected to live. Women who completed the treatment program were more likely to remain arrest-free during the first 18 months following prison, and they used drugs less frequently. Women who expected to live with their minor children were significantly more likely to enter the treatment program, but maternal role expectations had no direct effect on reentry outcomes once treatment experience and background factors were controlled.

Rowe, M., Benedict, P., Sells, D., Dinzeo, T., Garvin, C., Schwab, L., et al. (2009). Citizenship, community, and recovery: A group- and peer-based intervention for persons with co-occurring disorders and criminal justice histories. Journal of Groups in Addiction & Recovery, 4(4), pp. 224-244. DOI: 10.1080/15560350903340874

Group interventions for persons with co-occurring disorders of serious mental illness (SMI) and alcohol or other substance use disorders may positively affect participants' substance use, criminal justice contacts, and transition to community supports and community living. We report on a group intervention with wraparound peer support that, in earlier research, has shown promise regarding these domains. We provide a detailed description and discussion of the intervention, including case vignettes. We also discuss future research on this intervention and offer recommendations for additional research in this area and with this target population.

Smith, A., Krisman, K., Strozier, A. L., & Marley, M. A. (2004). Breaking through the bars: Exploring the experiences of addicted incarcerated parents whose children are cared for by relatives. Families in Society, 85(2), pp. 187-195.

Through this study, the authors sought to clarify the issues encountered by incarcerated parents, their children, and relative caregivers in an attempt to develop recommendations for a multidisciplinary, wraparound approach to designing services for these families during and after incarceration. Results reflected that many children had continuously resided with relative caregivers for a long period of time beginning before the parent’s incarceration and that many of the incarcerated parents had not seen their children since being incarcerated, and of the need for a multidisciplinary, wraparound approach to designing services for affected parents, children, and caregivers.

Straussner, S. L., & Fewell, C. (Eds). (2011). Children of substance-abusing parents: Dynamics and treatment. Begun, A.L., & Rose, S.J. (Ch.12) Programs for children of parents incarcerated for substance-related problems. Springer Publishing Company: New York, NY.

Children whose parents abuse substances are subject to many challenges, as explored through this book and elsewhere. Professionals assume that increased vulnerability and risk factors experienced by these children result in an increased probability of developing substance use disorders in the future. Children of substance-abusing parents are exposed to many concomitant and co-occurring challenges that affect their behavioral, learning, social, physical, and mental health outcomes. Because parental substance abuse often results in contact with federal, state, or local criminal justice systems, their children incur additional risks and vulnerabilities during periods of parental incarceration in jails and prisons, as well as during community reentry. This chapter concerns the population of children who experience a parent’s incarceration for offenses related to alcohol and other substances. Following a brief definition of terms, the chapter includes discussions of (1) the population of parents incarcerated for substance-related offenses; (2) how children’s caretaking needs are met while parents are incarcerated; (3) how parental incarceration might affect the other aspects of child well-being; and, (4) practice implications.

Taxman, F. S., & Kitsantas, P. (2009). Availability and capacity of substance abuse programs in correctional settings: A classification and regression tree analysis. Drug & Alcohol Dependence, 103, pp. S43-S53.

The purpose of this study was to investigate the structural and organizational factors that contribute to the availability and increased capacity for substance abuse treatment programs in correctional settings. Results show that the two most important variables in predicting the availability of all three types of services were stronger working relationships with other organizations and the adoption of a standardized substance abuse screening tool by correctional agencies. Findings showed that when administrators use an organizational learning strategy and a substance abuse screening tool, capacity increases. The authors propose advancing treatment practices in correctional settings, including further work to test theories on how to better understand access to intensive treatment services. This study presents the first phase of understanding capacity-related issues regarding treatment programs offered in correctional settings.

Tripodi, S. J., & Pettus-Davis, C. (2012). Histories of childhood victimization and subsequent mental health problems, substance use and sexual victimization for a sample of incarcerated women in the US. International Journal of Law and Psychiatry, 36(1), pp. 30-40.

This article seeks to understand the prevalence of childhood victimization and its association with adult mental health problems, substance abuse disorders, and further sexual victimization. The research team interviewed 125 women prisoners to gather information on their childhood physical and sexual victimization, mental health and substance abuse problems as adults. The study indicates that in this sample of women, those who were both physically and sexually victimized as children, were more likely to be hospitalized as an adult for a psychological or emotional problem. Women sexually victimized or both physically and sexually victimized were more likely to attempt suicide. Women with a history physical victimization as children and women with a history of physical and sexual victimization are more likely to have a substance use disorder and women sexually abused as children or both physically and sexually victimized were more likely to be sexually abused in the year preceding prison.

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