Friday, 13 January 2006 - 11:00 AMIs Being Charged with a Crime a Catalyst for Involvement in Substance Abuse Treatment? Analysis of NSDUH 2002
Substance abuse treatment research with criminal justice populations has focused on later points in the criminal process such as imprisonment and community re-entry as opposed to earlier points such as arrest and arraignment. However, 60% of those under criminal justice supervision remain in the community (e.g. diversion, probation). Because there has been little assessment of how legal intervention may or may not motivate community treatment involvement for those with substance use disorders (SUD), we addressed this issue by analyzing data from the 2002 National Survey of Drug Use and Health (NSDUH) on individuals reporting at least one arrest in the past year. The NSDUH shows that approximately 6 million adults were arrested and charged with a criminal offense and 46% of those offenses were directly related to drugs or alcohol (e.g. drug offense, DUI). Only 15% of individuals charged received any formal substance abuse treatment within the same year as their legal involvement. Although not everyone involved in the criminal justice system needs treatment, 30% of those arrested and charged met criteria for drug and/or alcohol dependency (6 times that of the general population) but only 23.2% of those who met criteria received treatment. In contrast, 24.2% of those who received formal treatment did not meet criteria for any SUD. Overall, only 18% of those who felt they needed treatment actually received it. In multivariate logistic regression the highest odds ratios (OR) predicting treatment involvement were increasing age (OR=4.61 for those in the > 50 category), dependency (OR=4.23) and a drug related offense (OR=2.66). These results suggest that, similar to non-offending populations, that age and severity of the problem predict treatment. In addition, the type of offense triggers treatment, either through mandate or individual motivation. Surprisingly, this occurred even when the individual did not meet criteria for SUD (35% of those charged). Legal status did play some role in treatment involvement. Those further along the criminal justice continuum (e.g. probation) were more likely to be involved in treatment and the majority of those inappropriately placed in treatment were under more intensive levels of supervision (e.g. probation and parole). The criminal justice system holds tremendous potential for motivating treatment referral, entry and retention. Improved screening and assessment offer opportunities for more targeted substance abuse treatment and intervention at the front end of the criminal justice continuum. These targeted interventions are more cost effective and may prevent more restrictive sanctioning for non-compliance and hardship on families and communities. Social Workers have an opportunity to influence local and national policy development as well as practice initiatives.
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