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Introduction: Despite the rising availability and use of medical marijuana (MM) in the USA, little is known about the demographics, clinical characteristics, or quality of life of MM patients. This study describes the demographic characteristics and health-related quality of life (HRQoL) of MM patients who are initiating treatment in Pennsylvania. Methods: Two-hundred adults naive to MM and referred for any of the 23 state-approved qualifying conditions were recruited at three MM dispensaries in Pennsylvania between September 2020 and March 2021. All participants consented to the study; completed semi-structured interviews that included demographic questionnaires, the Short Form-36 (SF-36), and Generalized Anxiety Disorder-7 (GAD-7); provided height and weight measurements; and allowed access their dispensary medical records. Results: Participants had a mean age of 48.5 ± 15.6 years, predominantly identified as female (67.5%), and were most commonly referred for chronic pain (63.5%) and/or anxiety (58.5%). Additionally, 46.0% were living with obesity as determined by BMI. Relative to a normative sample, participants reported diminished HRQoL in several domains, most notably in role limitations due to physical health (M = 46.0 ± 42.0), role limitations due to emotional problems (M = 52.5 ± 42.3), energy and fatigue (M = 39.8 ± 20.2), and pain (M = 49.4 ± 26.0). Discussion/Conclusion: Patients initiating MM treatment experienced low HRQoL in multiple domains. Future studies could evaluate the relationship between HRQoL and patients' decisions to pursue MM treatment, as well as changes in HRQoL with MM use over time. Keywords: Medical marijuana, Health-related quality of life, Clinical characteristics, Author(s): Lydia S. Buonomano [a]; Matthew M. Mitnick [a]; Thomas R. McCalmont [a]; Paulina Syracuse [a]; Karen L. Dugosh [b]; David S. Festinger [a]; Michelle R. Lent [a] Introduction Medical [...]

This study evaluated a contingency management (CM) program in a drug court. Gift certificates for compliance were delivered at 4- to 6-week intervals (total value = $390.00). Participants in one condition earned gift certificates that escalated by $5.00 increments. Participants in a second condition began earning higher magnitude gift certificates, and the density of reinforcement was gradually decreased. No main effects of CM were detected, which appears to be attributable to a ceiling effect from the intensive contingencies already delivered in the drug court and the low density of reinforcement. Preplanned interaction analyses suggested that participants with more serious criminal backgrounds might have performed better in the CM conditions. This suggests that CM programs may be best suited for more incorrigible drug offenders. (Contains 2 tables and 2 figures.)

The drug court model assumes that most drug offenders are addicts, and that drug use fuels other criminal activity. As a result, drug court clients must satisfy an intensive regimen of treatment and supervisory obligations. However, research suggests that roughly one third of drug court clients do not have a clinically significant substance use disorder. For these clients, standard drug court services may be ineffective or even contraindicated. Instead, these clients may be best suited for a secondary prevention approach directed at interrupting the acquisition of addictive behaviors. Unfortunately, there are no established secondary prevention packages for adults in criminal justice settings. This article presents a conceptual framework for developing and administering secondary prevention services in drug courts and proposes a platform of prevention techniques that can be tailored in a clinically relevant manner for the sizeable population of drug court clients who are low risk. (Contains 1 figure.)

This article reports outcomes from a program of experimental research evaluating the risk principle in drug courts. Prior studies revealed that participants who were high risk and had (a) antisocial personality disorder or (b) a prior history of drug abuse treatment performed better in drug court when scheduled to attend biweekly judicial status hearings in court. In contrast, participants who were low risk performed equivalently regardless of the court hearings schedule. This study prospectively matches drug court clients to the optimal schedule of court hearings based on an assessment of their risk status and compares outcomes to clients randomly assigned to the standard hearings schedule. Results confirmed that participants who were high risk and matched to biweekly hearings had better during-treatment outcomes than participants assigned to status hearings as usual. These findings provide confirmation of the risk principle in drug courts and yield practical information for enhancing the efficacy and cost-efficiency of drug courts. (Contains 2 figures and 1 table.)

This pilot study (N = 30) experimentally examines the effects of an adaptive intervention in a misdemeanor drug court. The adaptive algorithm adjusted the frequency of court hearings and case management sessions according to prespecified criteria in response to participants' performance. Results reveal that the adaptive algorithm was acceptable to clients and staff, was feasible to implement with greater than 85% fidelity, and showed promise for eliciting substantial improvements in drug abstinence and graduation rates. Compared to drug court as usual, participants in the adaptive condition were more likely to receive responses from the drug court team for inadequate performance and received those responses after a shorter period. This suggests the adaptive algorithm more readily focused the team's attention on poorly performing individuals, allowing them to address problems before they developed too fully. These preliminary data justify further research evaluating the adaptive algorithm in a fully powered experimental trial. Keywords: drug court; adaptive treatment; criminal justice; antisocial personality disorder

In formulating policies for drug offenders, lawmakers must decide concrete questions about such matters as legal jurisdiction, burdens of proof, and reporting of progress information. Although these decisions may seem incidental to treatment and beyond the purview of science, they are based on empirically testable assumptions about the behavior of drug abusers and have a direct bearing on the efficacy of drug treatment interventions. Unfortunately, these assumptions have generally not been subjected to empirical inquiry. As a result, drug policy continues to be crafted by non-scientific advocates and subjected to popular vote by an insufficiently informed public. This article identifies several empirically answerable questions that underlie critical decision points in criminal statutes for drug offenders, reviews the available research evidence relevant to these questions, and encourages drug abuse researchers to conduct studies aimed squarely at informing these policy-relevant decisions. Keywords: Drug policy; Criminal justice; Policy research; Drug court; Offenders

This study investigated the social adjustment of female family members and significant others (FSOs) of illicit drug users in order to gain insight into the impact of drug use upon those close to the user. Using the Social Adjustment Scale-Self Report (SAS-SR), we examined the social adjustment self-ratings (overall and in seven specific role areas) of 41 female partners and 24 mothers of drug users. We compared these ratings to the ratings they reported for their drug-using partners or children, to each other, and to self-ratings drawn from community comparison samples. As expected, results showed that the female FSOs reported significantly better social adjustment than the drug users in most role areas. However, their social adjustment was compromised relative to the community samples. Partners of drug users reported poorer adjustment than parents of drug users overall and in the specific areas of marital and economic functioning. Further inquiry is needed to improve our understanding of the impact of drug use on the users' family members. Keywords: Social adjustment; Social functioning; Family members; Drug abuse; Women

A study of 116 clients contacting a cocaine treatment center showed that 72% of those who were able to be scheduled for an intake appointment within 24 hours actually came to their appointment. Only 38% of those who had to wait 7 days actually attended their session.

The effectiveness of offering same day appointments at an outpatient cocaine treatment program to increase intake attendance was examined. Seventy-eight clients were given standard or accelerated intake appointments. Significantly more clients who were given accelerated appointments attended the program. An accelerated intake procedure appears to be useful for enhancing enrollment in outpatient addiction treatment. (Author/CR)

This study examined whether voucher delivery arrangements affect treatment outcome. First, 90 cocaine-dependent adults were randomly assigned to behavioral counseling or counseling plus vouchers for cocaine-free urine samples. The value of each voucher was low at the beginning but increased as the patient progressed (Voucher Schedule 1). Voucher Schedule 1 produced no improvements relative to counseling only. Next, 23 patients received vouchers on either Voucher Schedule I or Voucher Schedule 2. Voucher Schedule 2 began with high voucher values, but requirements for earning vouchers increased as the patient progressed. Average durations of cocaine abstinence were 6.9 weeks on Voucher Schedule 2 versus 2.0 weeks on Voucher Schedule 1 (p = .02). This confirms that vouchers can assist in initiating abstinence and that voucher delivery arrangements are critical.

A retrospective analysis of factors influencing preintake dropouts in patients calling to make intake appointments for cocaine treatment reveals that prolonged time periods between initial telephone contact and subsequent appointment is inversely proportional to the chances of clients keeping their appointments. Maximum decline in initial attendance occurs on the first day after telephonic inquiry.