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This paper provides a focused summary of the relative contribution of addiction intervention outcomes to total economic benefit, based upon a compilation of published economic studies from the United States. The relevant literature was searched extensively, and 11 economic studies were selected for review. The selected addiction interventions address both alcohol use/abuse and illicit drug use/abuse and represent various treatment modalities, including a brief physician intervention and long-term residential programs. Study participants included community-based drug users, pregnant and/or parenting women, problem drinkers, and criminal offenders. These studies estimated the economic benefits of an addiction intervention(s) in terms of one or more of the following outcome domains: criminal activity, health services utilization, employment earnings, and expenditures on illicit drugs and alcohol. The primary finding of this review was that avoided criminal activity was the greatest economic benefit of addiction interventions and contributed more, as a separate outcome domain, to the total economic benefit of addiction interventions than any other outcome domain. Reduced utilization of health care services was also a noteworthy economic benefit of addiction interventions. This study provides a detailed exposition of economic benefits estimation and highlights the potential impact of individual outcomes, thus providing a useful resource for substance abuse researchers and administrators as they design and evaluate future interventions. [ABSTRACT FROM AUTHOR]

Background and aims Treatment for opioid use disorders (OUD) reduces the risk of mortality and infectious disease transmission; however, opportunities to quantify the potential economic benefits of associated decreases in drug-related crime are scarce. This paper aimed to estimate the costs of crime during and after periods of engagement in publicly funded treatment for OUD to compare total costs of crime during a hypothetical 6-month period following initiation of opioid agonist treatment (OAT) versus detoxification. Design Retrospective, administrative data-based cohort study with comprehensive information on drug treatment and criminal justice systems interactions. Setting Publicly funded drug treatment facilities in California, USA (2006-10). Participants A total of 31 659 individuals admitted for the first time to treatment for OUD, and who were linked with criminal justice and mortality data, were followed during a median 2.3 years. Median age at first treatment admission was 32, 35.8% were women and 37.1% primarily used prescription opioids. Measurements Daily costs of crime (US$2014) were calculated from a societal perspective and were composed of the costs of policing, court, corrections and criminal victimization. We estimated the average marginal effect of treatment engagement in OAT or detoxification adjusting for potential fixed and time-varying confounders, including drug use and criminal justice system involvement prior to treatment initiation. Findings Daily costs of crime during treatment compared with after treatment were $126 lower for OAT [95% confidence interval (CI) = $116, $136] and $144 lower for detoxification (95% CI = $135, $154). Summing the costs of crime during and after treatment over a hypothetical 6-month period using the observed median durations of OAT (161 days) and detoxification (19 days), we estimated that enrolling an individual in OAT as opposed to detoxification would save $17 550 ($16 840, $18 383). Conclusions In publicly funded drug treatment facilities in California, USA, engagement in treatment for opioid use disorders is associated with lower costs of crime in the 6 months following initiation of treatment, and the economic benefits were far greater for individuals receiving time-unlimited treatment. [ABSTRACT FROM AUTHOR]

Aims Britain's first wave of non-therapeutic drug users during the 1960s were more likely to come into contact with the criminal courts than previous, therapeutic, drug users. This paper recounts the untold history of probation officers' work with drug misusing offenders in the United Kingdom during the 1960s. Methods Using 'snowballing' to source participants (in which study subjects recruit future subjects from among their acquaintances) and in-depth interviews as a means of eliciting information, probation officers who had supervised drug users during this time were interviewed about their experiences. Interviews were transcribed verbatim and a thematic data set produced. Results Front-line probation officers in the United Kingdom in the 1960s had considerable contact with drug-misusing offenders. In explaining drug addiction, officers tended to draw upon a psychotherapeutic interpretation, and in terms of intervention they relied heavily upon the psychiatric services to deliver treatment. Probation officers did not always make the connection between addiction and an increase in criminality. Conclusion In Britain's first wave of non-therapeutic drug users in the 1960s, probation officers appear not to have made a connection with criminality, which may have limited how far they developed a formalized approach to applying the expertise of the Probation Service. [ABSTRACT FROM AUTHOR]

Aims: Building upon an existing methodology and conceptual framework for estimating the association between the use of substances and crime, we calculated attributable fractions that estimate the proportion of crimes explained by alcohol and six other categories of psychoactive substances. Design Cross‐sectional surveys. Setting: Canadian federal correctional institutions. Participants: Canadian men (n = 27 803) and women (n = 1335) offenders who began serving a custodial sentence in a Canadian federal correctional institution between 2006 and 2016. Measurements Offenders completed the computerized assessment of substance abuse, a self‐report tool designed to assess (1) whether the offence for which they were convicted would have occurred had they not been intoxicated from alcohol or another substance, (2) whether they committed the offence to support their alcohol or other substance use and (3) whether they were dependent on alcohol (alcohol dependence scale) or another substance (drug abuse screening test). Offences were grouped into four mutually exclusive categories: violent crimes, non‐violent crimes, impaired driving and substance‐defined crimes. This study focused on violent and non‐violent crime categories. Substances assessed were: alcohol, cannabis, opioids, other central nervous system (CNS) depressants, cocaine, other CNS stimulants and other substances. Findings According to offender self‐report, 42% of all violent and non‐violent crime would probably not have occurred if the perpetrator had not been under the influence of, or seeking, alcohol or other substances. Between 2006 and 2016, 20% of violent crimes and 7% of non‐violent crimes in Canada were considered attributable to alcohol. In contrast, all other psychoactive substance categories combined were associated with 26% of all violent crime and 25% of non‐violent crime during the same time‐frame. Conclusions: Attributable fraction analyses show that more than 42% of Canadian crime resulting in a custodial sentence between 2006 and 2016 would probably not have occurred if the perpetrator had not been under the influence of or seeking alcohol or other drugs. Attributable fractions for alcohol and substance‐related crime are a potentially useful resource for estimating the impact of alcohol and other substances on crime. [ABSTRACT FROM AUTHOR]

Aim: To examine the specific deterrent effect of offender supervision on the risk of a further offence by persons convicted of amphetamine use and/or possession. Design Observational study of two groups matched on a wide range of factors using augmented inverse probability of treatment weighting. Setting: New South Wales (NSW), Australia. Participants: A total of 2099 persons convicted of amphetamine use and/or possession and placed on either a supervised good behaviour bond (1004) or a bond without supervision (1096). Measurements Conviction for another amphetamine use/possession offence, any drug offence, assault or theft within 48 months free time after the index court appearance. Findings Only two of the treatment estimates were consistent with a deterrent effect. Where the outcome was an assault offence, the estimated reduction in risk of re‐offending was 1%. Where the outcome was a theft offence, the estimated reduction in the risk of reoffending was 0.07%. Neither result was statistically significant. The coefficients measuring the effect of supervision on the remaining two outcomes (use/possess amphetamine and use/possess any drug) were both positive and not statistically significant. Conclusion: Correctional supervision does not appear to have been effective in New South Wales, Australia, in reducing the risk of reoffending among people convicted of amphetamine use/possession. [ABSTRACT FROM AUTHOR]

Background and Aims: Most homicide studies focus upon 'acute' situational intoxication as opposed to 'chronic' substance misuse. The aims of the study were to: (1) determine the extent of homicide offenders' alcohol and drug use in the year preceding the homicide; (2) compare the individual characteristics of homicide offenders across levels of problematic substance use; and (3) compare homicide incident characteristics across levels of problematic substance use. Design and Setting: Observational study using data collected through face‐to‐face interviews in custodial and community correctional settings across Australia. Participants were recruited through an opt‐in process. Participants: The data consist of 302 individuals convicted of murder or manslaughter. Measurements We used the Alcohol Use Disorder Identification Test and Drug Abuse Screening Test to determine problematic alcohol or drug use. We also used a range of self‐report measures to ascertain offender characteristics [socio‐demographics, developmental experiences, criminal history, personality] and incident characteristics (who was killed, and situational intoxication). Findings Of the sample, 38.8% displayed high levels of alcohol problems and 30.8% displayed high levels of drug problems. Those displaying high levels of alcohol and/or drug problems were more likely than those without high levels of alcohol and/or drug problems to report adverse developmental experiences, low education, financial difficulties, extensive criminal histories and high levels of trait anger, impulsivity and risk‐seeking. In addition, offenders with problematic substance use were more likely to have killed non‐family and to have used substances at the time of the homicide. Conclusions: High proportions of homicide offenders in Australia appear to have problematic substance use in the year preceding the homicide offence, and such use appears to be associated with a range of other challenging factors, including adverse childhoods, criminal involvement, low socio‐economic factors and low self‐regulation. [ABSTRACT FROM AUTHOR]

Background and Aims Criminal justice-involved individuals are highly susceptible to opioid relapse and overdose-related deaths. In a recent randomized trial, we demonstrated the effectiveness of extended-release naltrexone (XR-NTX; Vivitrol®) in preventing opioid relapse among criminal justice-involved US adults with a history of opioid use disorder. The cost of XR-NTX may be a significant barrier to adoption. Thus, it is important to account for improved quality of life and downstream cost-offsets. Our aims were to (1) estimate the incremental cost per quality-adjusted life-year (QALY) gained for XR-NTX versus treatment as usual (TAU) and evaluate it relative to generally accepted value thresholds; and (2) estimate the incremental cost per additional year of opioid abstinence. Design Economic evaluation of the aforementioned trial from the taxpayer perspective. Participants were randomized to 25 weeks of XR-NTX injections or TAU; follow-up occurred at 52 and 78 weeks. Setting Five study sites in the US Northeast corridor. Participants A total of 308 participants were randomized to XR-NTX ( n = 153) or TAU ( n = 155). Measurements Incremental costs relative to incremental economic and clinical effectiveness measures, QALYs and abstinent years, respectively. Findings The 25-week cost per QALY and abstinent-year figures were $162 150 and $46 329, respectively. The 78-week figures were $76 400/QALY and $16 371/abstinent year. At 25 weeks, we can be 10% certain that XR-NTX is cost-effective at a value threshold of $100 000/QALY and 62% certain at $200 000/QALY. At 78 weeks, the cost-effectiveness probabilities are 59% at $100 000/QALY and 76% at $200 000/QALY. We can be 95% confident that the intervention would be considered 'good value' at $90 000/abstinent year at 25 weeks and $500/abstinent year at 78 weeks. Conclusions While extended-release naltrexone appears to be effective in increasing both quality-adjusted life-years (QALYs) and abstinence, it does not appear to be cost-effective using generally accepted value thresholds for QALYs, due to the high price of the injection. [ABSTRACT FROM AUTHOR]

Background and Aims Naloxone is an opioid antagonist used for emergency resuscitation following opioid overdose. Prisoners with a history of heroin injection have a high risk of drug-related death soon after release from prison. The NALoxone InVEstigation (N-ALIVE) pilot trial (ISRCTN34044390) tested feasibility measures for randomized provision of naloxone-on-release (NOR) to eligible prisoners in England. Design. Parallel-group randomized controlled pilot trial. Setting English prisons. Participants A total of 1685 adult heroin injectors, incarcerated for at least 7 days pre-randomization, release due within 3 months and more than 6 months since previous N-ALIVE release. Intervention Using 1 : 1 minimization, prisoners were randomized to receive on release a pack containing either a single 'rescue' injection of naloxone or a control pack with no syringe. Measurements Key feasibility outcomes were tested against prior expectations: on participation (14 English prisons; 2800 prisoners), consent (75% for randomization), returned prisoner self-questionnaires (RPSQs: 207), NOR-carriage (75% in first 4 weeks) and overdose presence (80%). Findings Prisons (16) and prisoners (1685) were willing to participate [consent rate, 95% confidence interval (CI) = 70-74%]; 218 RPSQs were received; NOR-carriage (95% CI = 63-79%) and overdose presence (95% CI = 75-84%) were as expected. We randomized 842 to NOR and 843 to control during 30 months but stopped early, because only one-third of NOR administrations were to the ex-prisoner. Nine deaths within 12 weeks of release were registered for 1557 randomized participants released before 9 December 2014. Conclusions Large randomized trials are feasible with prison populations. Provision of take-home emergency naloxone prior to prison release may be a life-saving interim measure to prevent heroin overdose deaths among ex-prisoners and the wider population. [ABSTRACT FROM AUTHOR]

Background and aims Since 2012 four US states have legalized the retail sale of cannabis for recreational use by adults, and more are likely to follow. This report aimed to (1) briefly describe the regulatory regimes so far implemented; (2) outline their plausible effects on cannabis use and cannabis-related harm; and (3) suggest what research is needed to evaluate the public health impact of these policy changes. Method We reviewed the drug policy literature to identify: (1) plausible effects of legalizing adult recreational use on cannabis price and availability; (2) factors that may increase or limit these effects; (3) pointers from studies of the effects of legalizing medical cannabis use; and (4) indicators of cannabis use and cannabis-related harm that can be monitored to assess the effects of these policy changes. Results Legalization of recreational use will probably increase use in the long term, but the magnitude and timing of any increase is uncertain. It will be critical to monitor: cannabis use in household and high school surveys; cannabis sales; the number of cannabis plants legally produced; and the tetrahydrocannabinol (THC) content of cannabis. Indicators of cannabis-related harms that should be monitored include: car crash fatalities and injuries; emergency department presentations; presentations to addiction treatment services; and the prevalence of regular cannabis use among young people in mental health services and the criminal justice system. Conclusions Plausible effects of legalizing recreational cannabis use in the United States include substantially reducing the price of cannabis and increasing heavy use and some types of cannabis-related harm among existing users. In the longer term it may also increase the number of new users. [ABSTRACT FROM AUTHOR]

The author comments on P. Friedmann and colleague's article "Collaborative behavioral management among parolees: drug use, crime and re-arrest in the Step'n Out randomized trial." The author is critical of the study's finding of the efficacy of contingency management (CM) to produce substantial reductions in drug-use, and its sample size of marijuana users which was only 16% of the entire sample. The author notes the need for further research on collaborative behavioral management (CBM).

Aims To examine gradual change in debt problems, divorce and income among men in Finland before and after a first conviction for driving under the influence ( DUI). Design and Setting A register-based longitudinal study conducted in Finland between 1999 and 2013. Participants A nationally representative sample of 70 659 Finnish males born between 1918 and 1983, and a subsample of males ( n = 1782) who had their first DUI conviction during 2005-2012. Measurements Descriptive statistics showing the socio-demographic and economic determinants of DUI. The main analysis was based on a longitudinal, within-individual setting. The impact of DUI on debt problems, divorce and income was analysed using random effects regression models. Findings DUI offenders were more likely to be younger and to have lower education and income than the non- DUI group. Criminal convictions were also more common among DUI offenders. Debt problems, divorce and loss of income were more likely after the DUI incident than before. The already increasing level of debt problems accelerated after the incident and divorce rates increased after the DUI incident, whereas the decrease in income was gradual over the whole observation period. Conclusions Among men in Finland, DUI offences are more common among vulnerable social groups. The first drunk-driving conviction among men in Finland constitutes a significant life event that appears to increase the likelihood of financial problems and divorce. [ABSTRACT FROM AUTHOR]

Aims To compare the incidence, timing and risk factors for substance-related death between Indigenous and non-Indigenous ex-prisoners in Queensland, Australia. Design Retrospective cohort study. Setting All adult prisons in the state of Queensland, Australia, linked to deaths registered in Australia. Participants/cases We obtained records for all adults released from prison in Queensland, Australia from 1 January 1994 to 31 December 2007. Among this cohort of 42 015 individuals we observed 82 315 releases from prison and 2158 deaths in the community by the end of 2007, of which 661 were substance-related deaths. Measurements Incarceration data were obtained from Queensland Corrective Services and linked probabilistically with deaths recorded in the Australian National Death Index. Findings In the first year after release, Indigenous ex-prisoners were more likely to die from alcohol-related causes [hazard ratio ( HR) = 1.9, 95% confidence interval ( CI) = 1.1-3.1)] but less likely to die of drug-related causes ( HR = 0.34, 95% CI = 0.21-0.53) than were non-Indigenous ex-prisoners. Among non-Indigenous prisoners only, the risk of substance-related death was significantly higher in the first 4 weeks [relative risk ( RR) = 5.1, 95% CI = 3.7-6.9] when compared with the risk after 1 year post-release. Most evaluated risk factors for substance-related death were similar for Indigenous and non-Indigenous ex-prisoners; however, the hazard of death increased with age more for Indigenous ex-prisoners ( HR = 1.7 per decade of age, 95% CI = 1.4-2.1) than for non-Indigenous ex-prisoners ( HR = 1.3, 95% CI = 1.2-1.4). Conclusions In Australia, patterns of substance-related death in ex-prisoners differ markedly according to Indigenous status. Efforts to prevent substance-related deaths in ex-prisoners should consider heterogeneity in the target population and tailor responses accordingly. [ABSTRACT FROM AUTHOR]

Aims Studies of offending among people who use drugs typically focus upon small and potentially unrepresentative samples. We examined an entire population of opioid-dependent clients' contact with the criminal justice system to develop more accurate population-wide measures of offending among opioid-dependent people in Australia. Design Retrospective data linkage study. Setting All entrants to opioid substitution therapy ( OST) for opioid dependence in New South Wales, Australia, between 1985 and 2010, with data on court appearances from 1 December 1993 to 31 March 2011. Participants All 48 069 valid cohort members who received OST between 1985 and 2010. Measurements Person-years ( PY) of observation and charge rates for major crime categories estimated by sex, age and time. Findings A total of 638 545 charges were laid against cohort members between 1993 and 2011. Eight in 10 males (79.7%) and 67.9% of females had at least one charge; rates were 94.15 per 100 PY [95% confidence interval ( CI) = 93.89-94.41] among males, and 53.19 per 100 PY (95% CI = 52.91-53.46) among females, and highest at 15-19 years [175.74/100 PY males (95% CI = 174.45-177.03), 75.60/100 PY females (95% CI = 74.46-76.76)] and 20-24 years [144.61/100 PY males (95% CI = 143.70-145.53), 84.50/100 PY females (95% CI = 83.53-85.48)]. The most frequent charges were theft (24.5% of charges), traffic/vehicle (16.3%), offences against justice (10.5%), illicit drug (10.0%), intentional injury (9.9%) and public order offences (8.9%). Overall, 20.8% of the cohort accounted for 67.4% of charges. The most frequently appearing 5.6% of the cohort accounted for 24.3% of costs ($75.5 million). Conclusions Among opioid-dependent people in Australia, a minority account for the majority of the criminal justice contact and levels of offending are not consistent over time, sex or age. [ABSTRACT FROM AUTHOR]

Aims World-wide, more than 30 million people move through prisons annually. Record linkage studies have identified an increased risk of death in ex-prisoners. In order to inform preventive interventions it is necessary to understand who is most at risk, when and why. Limitations of existing studies have rendered synthesis and interpretation of this literature difficult. The aim of this study was to describe methodological characteristics of existing studies and make recommendations for the design, analysis and reporting of future studies. Methods Systematic review of studies using record linkage to explore mortality in ex-prisoners. Based on analysis of these studies we illustrate how methodological limitations and heterogeneity of design, analysis and reporting both hamper data synthesis and create potential for misinterpretation of findings. Using data from a recent Australian study involving 42 015 ex-prisoners and 2329 observed deaths, we quantify the variation in findings associated with various approaches. Results We identified 29 publications based on 25 separate studies published 1998-2011, mainly from the United Kingdom, United States and Australia. Mortality estimates varied systematically according to features of study design and data analysis. A number of common, avoidable and significant methodological limitations were identified. Substantial heterogeneity in study design, methods of data analysis and reporting of findings was observed. Conclusions Record linkage studies examining mortality in ex-prisoners show widely varying estimates that are influenced substantially by avoidable methodological limitations and reducible heterogeneity. Future studies should adopt best practice methods and more consistent methods of analysis and reporting, to maximize policy relevance and impact. [ABSTRACT FROM AUTHOR]

Aims To examine the barriers and facilitators to effective operation of a regional tobacco control coordinator working within and across criminal justice and public health, whose goal was to raise tobacco control awareness and support the development of smoking cessation treatment for offenders. Design A reflexive, mixed-methods case study approach using in-depth interviews, project reports and observation of advisory board meetings. Setting The coordinator worked with prisons, probation and police custody, where there are high levels of social disadvantage and smoking. Participants Interviews ( n = 34) at different stages of project with the coordinator, project advisers and local stakeholders from criminal justice and public health. Measurements Analysis of facilitators and barriers and the coordinator role from different perspectives. Findings Readiness to develop cessation services was a critical predictor of different criminal justice settings' engagement with the coordinator role. The coordinator enhanced cessation service delivery in individual prisons where there was a requirement and infrastructure in place to provide such services. In police custody, where there was no central guidance or pre-existing requirements, efforts to establish smoking cessation on the local agenda proved ineffective. In probation settings, the coordinator documented examples of good practice and supported brief intervention training. Variability in willingness to engage limited the project's ability to create joined-up working across criminal justice settings. Conclusions In the English criminal justice system, the prison service appears to provide a favourable context for development of smoking cessation support and a means of accessing hard-to-reach groups. Other criminal justice settings, most specifically police custody, appear less responsive to such activity. A coordinator role can improve smoking cessation support in the prison setting, and develop local improvements in tobacco control interventions in other settings such as probation, but as configured here, does not have the capacity to effect change across the criminal justice system. [ABSTRACT FROM AUTHOR]

Aims This retrospective study compared drinking histories of 283 men and 413 women convicted of driving while impaired ( DWI) in New Mexico and interviewed 15 years following a first conviction and screening referral. Design We characterized drinking course and plotted drinking status (stable abstainers, abstainers, moderate or risky drinkers) from age 15 to 60 years. Setting Pacific Institute for Research and Evaluation, Albuquerque, New Mexico. Participants Community sample of previously convicted DWI offenders. Measurements Psychiatric disorders from the Comprehensive International Diagnostic Interview; drinking histories from the Cognitive Lifetime Drinking History. Findings Risky drinking was prevalent at all ages for both genders. Almost half the population reported either a life-time drinking course of risky drinking (19%) or resumed risky drinking after at least one interval of abstinence or moderate drinking (25%), while about one-fifth followed a never risky or risky to moderate drinking course. Offenders with a life-time diagnosis of substance dependence more often transitioned to risky drinking, and those with life-time alcohol dependence were more prone to transition to abstinence. Across time, those who began risky drinking at age 15 years or later quit at double the rate of those who began before age 15 years. Women's and men's drinking courses were similar, but women began risky drinking at a later age and moved to abstinence more often. Conclusions Among people convicted of driving while impaired in the United States, younger age of initiation of drinking and co-occurrence of psychiatric and substance use appear to be associated with a poorer trajectory of subsequent risky drinking behaviour. Women who are convicted of driving while impaired appear to start drinking later in life and be more likely to subsequently become abstainers. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims To determine whether collaborative behavioral management (CBM) reduces substance use, crime and re-arrest among drug-involved parolees. Design Step'n Out was a randomized behavioral trial of CBM versus standard parole (SP) during 2004-08. CBM adapted evidence-based role induction, behavioral contracting and contingent reinforcement to provide parole officer/treatment counselor dyads with positive tools in addition to sanctions to manage parolees' behavior over 12 weeks. Setting Six parole offices in five states in the USA. Participants Parolee volunteers with a mandate for addiction treatment and a minimum of 3 months of parole ( n = 476). Follow-up was 94% at 3 months and 86% at 9 months. Measurements Drug use and crime in a given month from calendar interviews 3 and 9 months after parole initiation, and re-arrests from criminal justice administrative data. Findings The CBM group had fewer months in which they used their primary drug [adjusted risk ratio (ARR) 0.20, 95% confidence interval (CI): 0.05, 0.78, P = 0.02] and alcohol (ARR 0.38, 95% CI: 0.22, 0.66, P = 0.006) over follow-up. CBM had its greatest effects among parolees who reported marijuana or another 'non-hard' drug as their primary drug; parolees who preferred stimulants or opiates did not benefit. No differences were seen in total crime, re-arrests or parole revocations. Conclusions Collaborative behavioral management may reduce substance use among primary marijuana or other 'non-hard' drug-using parolees without increasing revocations. Because the majority of drug violation arrests in the United States are for marijuana, these findings have important implications for the management of a substantial proportion of the US community correctional population. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims To review evidence on the effectiveness of opioid maintenance treatment (OMT) in prison and post-release. Methods Systematic review of experimental and observational studies of prisoners receiving OMT regarding treatment retention, opioid use, risk behaviours, human immunodeficiency virus (HIV)/hepatitis C virus (HCV) incidence, criminality, re-incarceration and mortality. We searched electronic research databases, specialist journals and the EMCDDA library for relevant studies until January 2011. Review conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results Twenty-one studies were identified: six experimental and 15 observational. OMT was associated significantly with reduced heroin use, injecting and syringe-sharing in prison if doses were adequate. Pre-release OMT was associated significantly with increased treatment entry and retention after release if arrangements existed to continue treatment. For other outcomes, associations with pre-release OMT were weaker. Four of five studies found post-release reductions in heroin use. Evidence regarding crime and re-incarceration was equivocal. There was insufficient evidence concerning HIV/HCV incidence. There was limited evidence that pre-release OMT reduces post-release mortality. Disruption of OMT continuity, especially due to brief periods of imprisonment, was associated with very significant increases in HCV incidence. Conclusions Benefits of prison OMT are similar to those in community settings. OMT presents an opportunity to recruit problem opioid users into treatment, to reduce illicit opioid use and risk behaviours in prison and potentially minimize overdose risks on release. If liaison with community-based programmes exists, prison OMT facilitates continuity of treatment and longer-term benefits can be achieved. For prisoners in OMT before imprisonment, prison OMT provides treatment continuity. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims This study investigates changes in criminal involvement among patients in opioid maintenance treatment (OMT) over a 7-year period prior to, during and after treatment, particularly in relation to differences in treatment engagement. Design, setting and participants Treatment data on all patients who started OMT in Norway between 1997 and 2003 ( n = 3221) were cross-linked with national criminal records. The period of observation was divided into four phases; pre-treatment, in-treatment, between treatments and post-treatment. Findings During OMT, rates of criminal convictions for the cohort were reduced to fewer than half of waiting-list levels [incidence rate (IR) 0.63 versus 1.57]. Patients in continuous treatment had the fewest convictions (IR 0.47) during treatment. The highest rates were found among patients out of treatment after several treatment episodes (IR 1.52). All groups had significantly fewer criminal convictions during treatment compared to before treatment. Staying in OMT for 2 years or more was associated with significantly reduced rates of convictions during treatment. Younger age and pre-treatment criminal convictions were associated with significantly ( P < 0.001) more convictions during treatment. Those who left treatment, permanently or temporarily, relapsed into high levels of convictions outside treatment. Conclusions Criminal activity appears to be reduced in Norway during opiate maintenance treatment. Younger age and prior history of criminal activity are important risk factors for continued criminal activity during treatment. [ABSTRACT FROM AUTHOR]

ABSTRACT For more than 40 years the Texas Institute of Behavioral Research (IBR) has given special attention to assessment and evaluation of drug user populations, addiction treatment services and various cognitive and behavioral interventions. Emphasis has been on studies in real-world settings and the use of multivariate methodologies to address evaluation issues within the context of longitudinal natural designs. Historically, its program of addiction treatment research may be divided into three sequential epochs-the first era dealt mainly with client assessment and its role in treatment outcome and evaluation (1969-89), the second focused upon modeling the treatment process and the importance of conceptual frameworks (1989-2009) in explaining the relationships among treatment environment, client attributes, treatment process and outcome, and the third (and current) era has expanded into studying tactical deployment of innovations and implementation. Recent projects focus upon adapting and implementing innovations for improving early engagement in adolescent residential treatment settings and drug-dependent criminal justice populations. Related issues include the spread of human immunodeficiency virus/acquired immune deficiency syndrome and other infectious diseases, organizational and systems functioning, treatment costs and process related to implementation of evidence-based practices. [ABSTRACT FROM AUTHOR]

Few studies have examined the statistical association between methamphetamine/amphetamine use and acquisitive crime. Both methamphetamine/amphetamine and cannabis use have been implicated by New Zealand Police as factors in acquisitive offending among active criminal populations. The aim of our study was to examine the statistical association between spending on methamphetamine/amphetamine and cannabis and earnings from acquisitive crime among police detainees in New Zealand. Four police stations in different regions. A sample of 2125 police detainees were interviewed about their drug use and acquisitive crime. Statistical models were developed to predict involvement in acquisitive crime using spending on methamphetamine/amphetamine and cannabis for personal use, and to examine associations between the level of spending on methamphetamine/amphetamine and cannabis for personal use and level of dollar earnings from acquisitive crime. Self-reported spending on drug use and self-reported earnings from acquisitive crime in the past 30 days. Spending on cannabis and methamphetamine/amphetamine could predict involvement in acquisitive crime. Level of spending on methamphetamine/amphetamine and cannabis was associated positively with the level of earnings from property crime. Level of spending on methamphetamine/amphetamine was also associated positively with level of earnings from drug dealing. There was a largely negative association between level of spending on cannabis and level of earnings from drug dealing. High spending on methamphetamine/amphetamine is associated statistically with higher earnings from acquisitive crime among police detainees. Further research into this association, and in particular the causal nature of the association, is required to obtain clear policy recommendations. [ABSTRACT FROM AUTHOR]

The conduct of drug and alcohol research involves a wide range of research methods, many of which require face-to-face interviews with and the collection of biological samples from, research participants. These participants are drawn from diverse backgrounds, representing a broad spectrum of people. Many are drug dependent, a disorder that disrupts normal motivational pathways possibly resulting in behaviour that may have otherwise been considered unacceptable. Significant proportions are likely to have criminal histories, comorbid psychiatric conditions and a range of physical health problems, including blood-borne viral infections.

The evidence base of prevention research appears to comprise predominantly chance findings that emerge from flexible data analysis practices motivated by confirmation bias. This area needs to urgently adopt the kinds of mandatory pre-registration practices required of clinical trials as a first step to creating a credible evidence base. [ABSTRACT FROM AUTHOR]