The Roles of Family, Community, and Services in the Prevention of Illicit Drug Use: Findings From a Sample of Released Prisoners

Studies show that the deterioration of family bonds and financial difficulty are barriers to a successful reintegration after incarceration. However, how family, community, and correction agencies simultaneously affect individuals’ illicit drug use during reentry is rarely examined. This study draws insights from the systemic model of social disorganization and examines the joint effects of private, parochial, and public levels of social control on post-release drug use. We used a longitudinal data set that captured family relationships, community cohesiveness, and reentry program participation of released prisoners. Findings provide empirical support for the application of the systemic model of social disorganization on illicit drug during reentry. The various levels of social control defined by this theory were found to exhibit significant and inhibitory effects on individuals’ drug use after release. This study advances our understanding of individuals’ reentry outcomes by highlighting the joint influence of family, community, and correction agencies. Policy implications for addressing post-release drug use are presented.

An Investigation of the Impact of Childhood Trauma on Quality of Caregiving in High Risk Mothers: Does Maternal Substance Misuse Confer Additional Risk?

The quality of caregiving is often compromised when mothers have co-occurring difficulties such as substance misuse and problems associated with extreme emotional dysregulation. These, in turn, are associated with poor child outcomes. The aim of the current study was twofold. First, to investigate the potential differences in risk factors associated with poor child outcome by comparing three groups: substance misusing mothers (Substance Misusing Mothers; SMM); mothers matched on demographic characteristics (Matched Comparison Mothers; MCM) and mothers recruited from the community (Matched Control Comparison; MCC). Second, to investigate the underlying mechanisms which are associated with poor child outcome by testing a mediated moderation model to ascertain (i) whether environmental risk and borderline psychopathology was a mediator between maternal childhood trauma and quality of caregiving and (ii) maternal substance misuse status moderated outcome. There were no significant differences found between the SMM and MCM groups on the key variables, but significant differences on all variables for both SMM and MCM compared to CCM. The moderated mediation analysis found that while there was significant mediation of environmental risk and borderline pathology between maternal childhood trauma and child outcome, this was not moderated by maternal substance abuse status. The importance of environmental-risk as a mechanism leading to reduced caregiving quality suggest treatment programs need to consider targeting these factors in high risk families.

Neighbourhood structural characteristics and crack cocaine use: exploring the impact of perceived neighbourhood disorder on use among African Americans

BACKGROUND

Crack cocaine use and associated negative social and health consequences remain a significant public health problem. Research that expands beyond the individual by considering the environmental context as a determinant of cocaine use is growing. The main objectives of this paper are to examine the effects of perceived neighbourhood disorder as an independent correlate of the frequency of recent crack cocaine use and whether its impact is mediated by use-related practices and social context of use among an African American adult sample in Atlanta (GA).

METHODS

Cross-sectional data were collected from 461 respondents who were recruited through active and passive community outreach from 70 disadvantaged urban neighbourhoods across Atlanta. Multivariable negative binomial regression was performed to assess the independent association of perceived neighbourhood disorder with crack cocaine use frequency and to explore potential mediation by use-related practices and social context of use.

RESULTS

Perceived neighbourhood disorder did not remain statistically significant after accounting for use-related practices and social context of use. Involvement in drug distribution and having traded sex were associated with increases in frequency of drug use, while using in safer places and using alone were associated with decreases in frequency of use.

CONCLUSION

The results show that perceived neighbourhood disorder is associated with frequency of crack cocaine use independently of socio-demographics. However, its significance was eliminated when controlling for use-related practices and the social context of use. Such practices and the social context of use may mediate the relationship between neighbourhood disorder and crack cocaine use. Future research is needed to more fully elucidate the links between individual and neighbourhood characteristics that are related to crack cocaine use and strategies to reduce use must consider the salience of use-related practices and the social context of use.

Drug arrests and injection drug deterrence

OBJECTIVES

We tested the hypothesis that higher rates of previous hard drug-related arrests predict lower rates of injection drug use.

METHODS

We analyzed drug-related arrest data from the Federal Bureau of Investigation's Uniform Crime Reporting Program for 93 large US metropolitan statistical areas in 1992 to 2002 to predict previously published annual estimates of the number of injection drug users (IDUs) per 10,000 population.

RESULTS

In linear mixed-effects regression, hard drug-related arrest rates were positively associated (parameter = +1.59; SE = 0.57) with the population rate of IDUs in 1992 and were not associated with change in the IDU rate over time (parameter = -0.15; SE = 0.39).

CONCLUSIONS

Deterrence-based approaches to reducing drug use seem not to reduce IDU prevalence. Alternative approaches such as harm reduction, which prevents HIV transmission and increases referrals to treatment, may be a better foundation for policy.