Evidence-Based Policies and Practices for Drug-Involved Offenders

Marlowe, Douglas B.

doi:10.1177/0032885511415223

Cited by 17 publications

(18 citation statements)

References 46 publications

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“…The differential intervention framework, advanced by the RNR model, has recently resulted in several different conceptual models that outline some priorities for assigning offenders to specific programming. Marlowe () offered a substance use disorder diagnosis (dependence or abuse) by criminal risk (high‐moderate and low) placement matching framework. In this framework, high‐ and moderate‐risk offenders with substance dependence are targets for highly structured drug treatment courts, status hearings, restrictive consequences, and positive reinforcements.…”

Section: Study Backgroundmentioning

confidence: 99%

Risk Tells Us Who, But Not What or How

Taxman

Caudy

2015

Criminology & Public Policy

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Research Summary The current study used latent class analysis (LCA) to identify profiles of criminogenic needs in a sample of 17,252 community‐supervised individuals from one state's probation system. The purpose of this research was to illustrate the complexity of offender need profiles to inform the development and implementation of correctional interventions. The LCA analyses revealed four classes of dynamic needs. Conditional item probabilities were examined to label the four classes based on their likelihood of presenting with static risk, criminogenic needs, and destabilizing factors (i.e., factors that indirectly relate to recidivism). The four classes were characterized by the following: a low probability of both risks and destabilizers (LN‐LD), a moderate probability of risk and criminogenic needs with a high probability of multiple destabilizers (MN‐HD), a high probability of risk and needs with moderate probabilities of destabilizers (HN‐MD), and a high probability of static and criminogenic needs and destabilizers (HN‐HD). Finally, the relationship between latent class membership and three separate recidivism outcomes was assessed. Consistent with study hypotheses, individuals in latent classes characterized by a greater probability of criminogenic needs and lifestyle destabilizers were more likely to experience subsequent criminal justice involvement, regardless of risk level. Policy Implications Simplifying the complexity of offender risk and need profiles through empirical classification has direct implications for policy and practice. First, it clarifies whether dynamic needs and/or risk should drive decision making. Second, the integration of dynamic risk factors into the case management process can inform strategies to mitigate static risk and inform the development of new and improved interventions. The current study findings provide insight into the clustering of dynamic risk factors within individuals. This classification structure has the potential to increase the precision of case management decisions by identifying targets for programming that are likely to co‐occur for many offenders. Specifically, programs can be developed to tailor components to specific static risk and need profiles.

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Section: Study Backgroundmentioning

confidence: 99%

Risk Tells Us Who, But Not What or How

Taxman

Caudy

2015

Criminology & Public Policy

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“…Further, SUD treatment programs within correctional institutions are often unwilling to adopt the use of medications to treat opioid use disorders (Kubiak et al, 2009;Rich et al, 2005;Smith-Rohrberg et al, 2004). In particular, the use of agonist SUD medications is limited by its being viewed in the criminal justice system as drug substitution (Friedmann et al, 2012;Marlowe, 2011;McMillan & Lapham, 2005;Walters et al, 2007). Other studies using samples of prisons, jails, or community corrections agencies indicate that MAT is rarely used (Friedmann et al, 2012;Matusow et al, 2013;Taxman et al, 2007).…”

Section: Barriers To the Adoption Of Injectable Naltrexonementioning

confidence: 99%

Adoption of Injectable Naltrexone in U.S. Substance Use Disorder Treatment Programs

Aletraris

Edmond

Roman

2015

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: Medication-assisted treatment for substance use disorders (SUDs) is not widely used in treatment programs. The aims of the current study were to document the prevalence of adoption and implementation of extended-release injectable naltrexone, the newest U.S. Food and Drug Administration-approved medication for alcohol use disorder (AUD), in U.S. treatment programs and to examine associations between organizational and patient characteristics and adoption. Method: The study used interview data from a nationally representative sample of 307 U.S. SUD treatment programs to examine adoption and implementation of injectable naltrexone. Results: Thirteen percent of programs used injectable naltrexone for AUD, and 3% of programs used it for opioid use disorder. Every treatment program that offered injectable naltrexone to its patients used it in conjunction with psychosocial treatment, particularly cognitive behavioral therapy. Multivariate logistic regression results indicated that adoption was positively associated with the provision of wraparound services, the percentage of privately insured patients, and the presence of inpatient detoxifi cation services. For-profi t status and offering inpatient services were negatively associated with adoption. Within adopting programs, an average of 4.1% of AUD patients and 7.1% of patients with opioid use disorder were currently receiving the medication, despite clinical directors' reports of positive patient outcomes, particularly for relapsers and for those who had been noncompliant with other medications. Cost was a signifi cant issue for the majority of adopting organizations. Conclusions: The rate of adoption of injectable naltrexone in U.S. treatment programs remains limited. Researchers should continue to examine patient, organizational, and external characteristics associated with the adoption and implementation of injectable naltrexone over time. (J. Stud. Alcohol Drugs, 76, 143-151, 2015)

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“…This finding was not unexpected, given the work of Kubiak and colleagues (2009) who surveyed state Department of Corrections leaders and found that medications were generally not a highly prioritized treatment service for these purchasers of treatment services. Historically, the criminal justice system has been slow to view MAT as an acceptable part of the treatment process (Chandler et al, 2009; Marlowe, 2011), and few correctional institutions have actively attempted to refer opioid-dependent offenders to MAT in the community (Rich et al, 2005; Nunn et al, 2009). Despite the consistency between our findings and these prior studies, more data are needed to develop an in-depth understanding of the reasons behind the limited adoption and implementation of medications for individuals involved with the criminal justice system.…”

Section: Discussionmentioning

confidence: 99%

Financial Factors and the Implementation of Medications for Treating Opioid Use Disorders

Knudsen

Roman

2012

Journal of Addiction Medicine

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Objectives Despite the established effectiveness of pharmacotherapies for treating opioid use disorders, implementation of medications for addiction treatment (MAT) by specialty treatment programs is limited. This research examined relationships between organizational factors and the program-level implementation of MAT, with attention paid to specific sources of funding, organizational structure, and workforce resources. Methods Face-to-face structured interviews were conducted in 2008-2009 with administrators of 154 community-based treatment programs affiliated with the National Institute on Drug Abuse’s Clinical Trials Network (CTN); none of these programs exclusively dispensed methadone without offering other levels of care. Implementation of MAT was measured by summing the percentages of opioid patients receiving buprenorphine maintenance, methadone maintenance, and tablet naltrexone. Financial factors included the percentages of revenues received from Medicaid, private insurance, criminal justice, the Federal block grant, state government, and county government. Organizational structure and workforce characteristics were also measured. Results Implementation of MAT for opioid use disorders was low. Greater reliance on Medicaid was positively associated with implementation after controlling for organizational structure and workforce measures, while the association for reliance on criminal justice revenues was negative. Conclusions The implementation of MAT for opioid use disorders by specialty addiction treatment programs may be facilitated by Medicaid, but may be impeded by reliance on funding from the criminal justice system. These findings point to the need for additional research that considers the impact of organizational dependence on different types of funding on patterns of addiction treatment practice.

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Evidence-Based Policies and Practices for Drug-Involved Offenders

Cited by 17 publications

References 46 publications

Risk Tells Us Who, But Not What or How

Risk Tells Us Who, But Not What or How

Adoption of Injectable Naltrexone in U.S. Substance Use Disorder Treatment Programs

Financial Factors and the Implementation of Medications for Treating Opioid Use Disorders

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