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Bright DA, Martire KA. Does Coerced Treatment of Substance‐Using Offenders Lead to Improvements in Substance Use and Recidivism? A Review of the Treatment Efficacy Literature. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/j.1742-9544.2012.00072.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- David A Bright
- School of Social Sciences, University of New South Wales
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Bromley E, Tarn DM, McCreary M, Hurley B, Ober AJ, Watkins KE. Attitudes about medications for alcohol use disorder among individuals with serious mental illness: A health belief model analysis. J Subst Abuse Treat 2020; 114:108007. [PMID: 32527506 DOI: 10.1016/j.jsat.2020.108007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 03/09/2020] [Accepted: 04/08/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Medications for alcohol use disorder (MAUD) are underutilized in mental health settings. Increasing use of MAUD requires increasing both the availability of these medications and the demand by individuals who could benefit. Few studies have explored the views of individuals with severe mental illness and alcohol use disorder about MAUD. We sought to examine, among individuals treated in publicly funded community mental health clinics, perceived need for and attitudes toward MAUD. METHODS We conducted 8 focus groups with 87 participants treated in public mental health clinics in Los Angeles County. We aimed to include individuals with a current or past AUD diagnosis and individuals helping others (e.g., a family member) who drink. We examined responses using domains associated with the Health Belief Model to identify factors that shape acceptance of MAUD. RESULTS Participants were 53% female; most were minorities. Average age was 47 years (SD = 11). Twenty-four reported never drinking, 13 of whom had a current or past diagnosis of AUD. Twenty-two reported drinking 4 or more times per week. Three-quarters had not heard of naltrexone. Participants understood that alcohol use has severe adverse consequences and perceived themselves to be highly susceptible to these consequences. Regarding attitudes toward MAUD, participants described an internal locus of control (e.g., their own desires, actions, and effort) as central to addressing problem drinking; this shaped their views that MAUD would have only modest benefits and potentially high burden. Those individuals who had tried MAUD expressed the most optimism about its effectiveness. CONCLUSIONS Participants worried MAUD would impede the development of self-control over drinking by fostering dependence on medication and undermining self-discipline. Client education and counseling that emphasizes MAUD as a tool to build clients' self-control may increase demand for these medications in mental health settings.
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Affiliation(s)
- Elizabeth Bromley
- Center for Health Services and Society, Jane and Terry Semel Institute, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 10920 Wilshire Blvd, Suite 300, Los Angeles, CA 90024, United States of America; RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, United States of America.
| | - Derjung M Tarn
- Department of Family Medicine, David Geffen School of Medicine at UCLA, 10880 Wilshire Blvd., Suite 1800, Los Angeles, CA 90024, United States of America
| | - Michael McCreary
- Center for Health Services and Society, Jane and Terry Semel Institute, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 10920 Wilshire Blvd, Suite 300, Los Angeles, CA 90024, United States of America
| | - Brian Hurley
- Department of Family Medicine, David Geffen School of Medicine at UCLA, 10880 Wilshire Blvd., Suite 1800, Los Angeles, CA 90024, United States of America; Los Angeles County Department of Health Services, 313 N Figueroa Street, Los Angeles, CA 90012, United States of America
| | - Allison J Ober
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, United States of America
| | - Katherine E Watkins
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, United States of America
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Urbanoski KA. Commentary on Pilarinos et al. (2020): Scientific realism and the study of coerced substance use treatment. Addiction 2020; 115:107-108. [PMID: 31709654 DOI: 10.1111/add.14832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 09/23/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Karen A Urbanoski
- Canadian Institute for Substance Use Research, University of Victoria, BC, Canada.,School of Public Health and Social Policy, University of Victoria, BC, Canada.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Bath K, Hawke LD, Skilling T, Chaim G, Henderson J. The service-seeking profiles of youth reporting a legal mandate or perceived coercion for substance use treatment. Addict Behav 2019; 90:27-34. [PMID: 30352342 DOI: 10.1016/j.addbeh.2018.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 10/05/2018] [Accepted: 10/06/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION There is paucity of research on treatment-related coercion in youth: most research focuses on adult populations and legally mandated treatment. This study aims to examine the service-seeking profiles of youth with substance misuse issues who report a legal mandate or perceived coercion to enter treatment. METHODS Differences between youth who were legally mandated and not legally mandated, and differences between youth reporting high and low perceived coercion, were examined for demographic characteristics, mental health and substance use profiles, motivation, and readiness to change. RESULTS Compared to participants reporting low perceived coercion, those experiencing high perceived coercion reported more substance use problems, greater mental health needs, and greater external and introjected motivation. Legally mandated youth reported fewer mental health issues, lower identified motivation, and greater readiness to change than those reporting no legal mandate. DISCUSSION Many youth who present for substance use services report experiencing a sense of coercion, which suggests the potential importance of considering youth-centered strategies for involving youth in treatment planning and the development of treatment goals. Youth seeking treatment also have multiple intersecting needs which may benefit from a collaborative and integrative approach.
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Wild TC, Yuan Y, Rush BR, Urbanoski KA. Client Engagement in Legally-Mandated Addiction Treatment: A Prospective Study Using Self-Determination Theory. J Subst Abuse Treat 2016; 69:35-43. [DOI: 10.1016/j.jsat.2016.06.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 04/26/2016] [Accepted: 06/06/2016] [Indexed: 11/29/2022]
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Cengisiz C, Deveci A, Yapici A. Effects of Depression on Treatment Motivation in Male Alcohol Dependence. Noro Psikiyatr Ars 2015; 52:412-416. [PMID: 28360749 DOI: 10.5152/npa.2015.9859] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 10/20/2014] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Treatment motivation in alcohol dependents is usually viewed as a strong predictor of seeking treatment and treatment success. The conditions affecting motivation in alcohol dependence, however, has not been clarified. In this study, it is aimed to determine the effects of depression on treatment motivation in male alcohol dependence. METHODS The present study included 34 male alcohol dependents presenting to outpatient clinics in Manisa Hospital of Mental Disorders and Hospital of Celal Bayar University. The patients underwent evaluation using the socio-demographic and clinical information form, DSM-IV SCID-I Clinical Version, Treatment Motivation Questionnaire (TMQ), and Hamilton Depression Rating Scale (HDRS). RESULTS A significant relationship was found between the total score of TMQ and HDRS (p=.039). CONCLUSION We believe that the present study, in which we examined the relationship between treatment motivation in male alcohol dependence and depression, would provide a significant contribution to literature. It is also important to investigate other factors that may affect treatment motivation in male alcohol dependence. Studies with larger samples are needed on this topic.
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Affiliation(s)
| | - Artuner Deveci
- Department of Psychiatry, Celal Bayar University Hospital, Manisa, Turkey
| | - Aslıhan Yapici
- Clinic of Psychiatry Manisa Psychiatric Hospital, Manisa, Turkey
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Gilbert F, Focquaert F. Rethinking responsibility in offenders with acquired paedophilia: punishment or treatment? INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2015; 38:51-60. [PMID: 25725545 DOI: 10.1016/j.ijlp.2015.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This article reviews the current neurobiological literature on the aetiology of developmental and acquired paedophilia and examines what the consequences could be in terms of responsibility and treatment for the latter. Addressing the question of responsibility and punishment of offenders with acquired paedophilia from a neurobiological perspective is controversial. Consequently it is essential to avoid hasty conclusions based strictly on neurobiological abnormality justifications. This study establishes a distinction between developmental and acquired paedophilia. The article investigates whether offenders who fulfil the diagnosis of acquired paedophilia should be held fully responsible, particularly in cases where the offender's conduct appears to result from volitionally controlled behaviour that is seemingly incompatible with a neurological cause. Moreover, the article explores how responsibility can be compromised when offenders with acquired paedophilia have (partially) preserved moral knowledge despite their sexual disorder. The article then examines the option of offering mandatory treatment as an alternative to imprisonment for offenders with acquired paedophilia. Furthermore, the article addresses the ethical issues related to offering any form of quasi-coercive treatment as a condition of release. This study concludes that decisions to fully or partially excuse an individual who fulfil the diagnosis of acquired paedophilia should take all relevant information into account, both neurobiological and other environmental evidence, and should proceed on a careful case by case analysis before sentencing or offering treatment.
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Affiliation(s)
- Frédéric Gilbert
- Ethics, Policy & Public Engagement (EPPE) ARC Centre of Excellence for Electromaterials Science (ACES), Faculty of Arts, University of Tasmania, Australia. https://sites.google.com/site/fredericgilbertt/home
| | - Farah Focquaert
- Bioethics Institute Ghent, Department of Philosophy and Moral Sciences, Ghent University, Belgium.
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McCormack RP, Williams AR, Goldfrank LR, Caplan AL, Ross S, Rotrosen J. Commitment to assessment and treatment: comprehensive care for patients gravely disabled by alcohol use disorders. Lancet 2013; 382:995-7. [PMID: 23602314 DOI: 10.1016/s0140-6736(12)62206-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Ryan P McCormack
- Department of Emergency Medicine, New York University School of Medicine, New York, NY, USA.
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Klingemann H, Schläfli K, Eggli P, Stutz S. Drinking Episodes during Abstinence-oriented Inpatient Treatment: Dual Perspectives of Patients and Therapists—A Qualitative Analysis†. Alcohol Alcohol 2013; 48:322-8. [DOI: 10.1093/alcalc/agt005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Malloch M, McIvor G. Criminal justice responses to drug related crime in Scotland. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2013; 24:69-77. [PMID: 22809480 DOI: 10.1016/j.drugpo.2012.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Revised: 05/28/2012] [Accepted: 06/06/2012] [Indexed: 10/28/2022]
Abstract
This article examines contemporary developments in criminal justice responses to drug related crime. Drawing on evaluations of initiatives which have been introduced in Scotland along with published statistical data, it considers the expansion of drug treatment through the criminal justice system and the implications this has for increasing access to services. Importantly, it considers the potential consequences of implementing 'treatment' requirements, underpinned by potential sanctions for non-compliance, at different stages of the criminal justice process. It is argued that the introduction of interventions at different points in the criminal justice process may have increased access to treatment services, though the extent of engagement with services is called into question, especially where treatment is voluntary or less obviously 'coerced'. Moreover, there is evidence that extending treatment through the criminal justice system may have had the effect of drawing some individuals further into the criminal justice process than would previously have been the case, despite limited evidence of the effectiveness of many such interventions on drug use, associated offending and wider aspects of individuals' lives.
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Affiliation(s)
- Margaret Malloch
- Scottish Centre for Crime and Justice Research, School of Applied Social Science, University of Stirling, Stirling FK9 4LA, Scotland, UK
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Israelsson M, Gerdner A. Compulsory commitment to care of substance misusers: international trends during 25 Years. Eur Addict Res 2012; 18:302-21. [PMID: 22964802 DOI: 10.1159/000341716] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Accepted: 07/09/2012] [Indexed: 11/19/2022]
Abstract
PURPOSE The study explores international trends in law on compulsory commitment to care of substance misusers (CCC), and two subtypes - civil CCC and CCC within criminal justice legislation - as well as maximum length and amount of applications of such care. METHOD The time period covers more than 25 years, and a total of 104 countries and territories. The study is based on available data in three times of observation (1986, 1999 and 2009). Applications of CCC in number of cases are studied on European level for the years 2002-2006. Trends are analyzed using nonparametric tests and general linear models for repeated measures. Findings are discussed from contextual analysis. RESULT There is a trend towards decrease in the number of countries worldwide having civil CCC legislation after the millennium, while CCC under criminal law has increased since the mid-1980s, resulting in some total net decrease. The shift results in longer mean duration of CCC and an increase in the number of cases sentenced. CONCLUSION There is a risk that the shift from civil CCC to penal CCC implies more focus on young out-acting males in compulsory treatment and that the societal responsibility for more vulnerable persons might be neglected.
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Affiliation(s)
- Magnus Israelsson
- Department of Social Work, Mid Sweden University, Östersund, Sweden.
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Stevens A. Drug policy, harm and human rights: a rationalist approach. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2011; 22:233-8. [PMID: 21481578 DOI: 10.1016/j.drugpo.2011.02.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Revised: 01/21/2011] [Accepted: 02/04/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND It has recently been argued that drug-related harms cannot be compared, so making it impossible to choose rationally between various drug policy options. Attempts to apply international human rights law to this area are valid, but have found it difficult to overcome the problems in applying codified human rights to issues of drug policy. METHOD This article applies the rationalist ethical argument of Gewirth (1978) to this issue. It outlines his argument to the 'principle of generic consistency' and the hierarchy of basic, nonsubtractive and additive rights that it entails. It then applies these ideas to drug policy issues, such as whether there is a right to use drugs, whether the rights of drug 'addicts' can be limited, and how different harms can be compared in choosing between policies. RESULT There is an additive right to use drugs, but only insofar as this right does not conflict with the basic and nonsubtractive rights of others. People whose freedom to choose whether to use drugs is compromised by compulsion have a right to receive treatment. They retain enforceable duties not to inflict harms on others. Policies which reduce harms to basic and nonsubtractive rights should be pursued, even if they lead to harms to additive rights. CONCLUSION There exists a sound, rational, extra-legal basis for the discussion of drug policy and related harms which enables commensurable discussion of drug policy options.
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Affiliation(s)
- Alex Stevens
- School of Social Policy, Sociology and Social Research, University of Kent, Medway, United Kingdom.
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Schaub M, Stevens A, Haug S, Berto D, Hunt N, Kerschl V, McSweeney T, Oeuvray K, Puppo I, Santa Maria A, Trinkl B, Werdenich W, Uchtenhagen A. Predictors of retention in the 'voluntary' and 'quasi-compulsory' treatment of substance dependence in europe. Eur Addict Res 2011; 17:97-105. [PMID: 21228594 DOI: 10.1159/000322574] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Accepted: 11/08/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND Policies and practices related to the quasi-compulsory treatment (QCT) of substance-dependent offenders are currently implemented in many countries, despite the absence of reliable knowledge about significant predictors of treatment retention. This study aimed to identify such predictors in QCT and voluntary treatment. METHODS Participants were treated in one of 65 institutions in 5 European countries. They were interviewed at intake on substance use, crimes committed, perceived pressure for treatment, self-efficacy, stage of change, employment, and health-related variables. Binary logistic regression models were computed to identify predictors of treatment retention at an 18-month follow-up. Moderator analyses were computed to investigate whether these predictors vary by treatment condition (QCT vs. voluntary). RESULTS A higher number of working days in the previous month was positively associated with treatment retention, while use of heroin, crack, and multiple drugs, psychiatric problems in the previous month, and lifetime depression were negatively associated with treatment retention. Higher perceived medical pressure resulted in higher treatment retention rates only for participants in QCT. CONCLUSION Predictors of substance abuse treatment retention are quite similar across both QCT and voluntary treatments. Perceived medical pressure is of higher relevance than the often-believed legal pressure for treatment retention in QCT.
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Affiliation(s)
- Michael Schaub
- Research Institute for Public Health and Addiction, Zürich, Switzerland.
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