Faculty Bibliography

During the past several years, a number of aggressive federal and state initiatives have been undertaken to expand substance abuse treatment within correctional settings. These efforts have been fueled by the high rates of substance involvement among offenders and the growing body of research literature suggesting that intensive, prison-based treatment efforts can significantly reduce postprison substance use and recidivism. However, the rapid expansion of these programs increases their vulnerability to common implementation problems that could lead to pessimistic, and erroneous, assumptions about their effectiveness. This article summarizes both the research literature and the experiences of the authors regarding six common barriers to developing effective correctional treatment programs and offers potential solutions for each. © 1999 Sage Publications, Inc.

This study examined the likelihood that drug users would receive HIV/ AIDS prevention information and supplies (e.g., condoms and bleach) in the rural state of Kentucky. Despite evidence of high HIV risk among criminal justice and substance-using populations, incarceration and substance-user treatment were only minimally associated with prior HIV prevention exposure or HIV testing. These data strongly support the use of criminal justice and treatment settings to provide AIDS prevention interventions for the high-risk drug-using populations they serve, and to target HIV prevention services in rural as well as urban areas.

Patient records were reviewed from an eighteen-month period of a private hospital adult addictive disease unit. Of 667 consecutive admissions, sixty-five (49 males, 16 females) were diagnosed with cocaine abuse or dependence; 38 percent were from rural areas. Although mean age of males and females was similar, males had a longer duration of use (8.2 years versus 5.8 years), however, females used an average of 14 grams per week versus 9.5 grams per week for males. African-American patients were over-represented among the cocaine using sample and also among the sample who chose smoking as their route of administration. A larger percentage of males had legal problems and admitted to "dealing," when compared to females. Those from rural areas were more likely to be married and less apt to have legal problems.

The literature suggests that important and contributing factors in the rise of HIV and AIDS among women are crack use and the exchange of sex for drugs or money. However, not all women who use crack report they are exchanging sex for drugs or money. Thus, women are at differential risk for HIV and AIDS. The purpose of this study is to compare and describe women crack users (n = 292) who reported exchanging sex for drugs and money with women crack users who did not report exchanging sex. Results indicated that both women crack users who exchanged sex (n = 162) and women crack users who did not exchange sex (n = 130) were likely to be African American, to be about the same age, to have had incomes below +500 during the previous month, to have had similar education and martial backgrounds, to have had unprotected sexual intercourse as often, to have had similar drug use patterns, and to have initiated drug use at similar ages. However, women who exchanged sex had more sexual partners, had unprotected oral sex more often, used drugs before and during sex more often, and had a higher rate of sexually transmitted diseases than women who did not exchange sex. In addition, women who exchanged sex were also twice as likely to be homeless, four times more likely to have been in treatment, and twice as likely to have been arrested and charged/booked two or more times in their lifetime than women who did not exchange sex.

Perceptions and consequences of co-worker substance use were assessed to (1) examine perceptions of co-worker use as supplemental measures of substance use problems in organizations, and (2) examine relationships with employee perceptions and attitudes. Support for the hypothesis that exposure to co-worker substance use is negatively associated with job performance and attitudes is presented. Results suggest the utility of evaluating perceptions of co-worker substance use in assessments of drug use in the workplace. These results have implications for training and education programs which should emphasize that employee substance use is a problem that extends beyond the substance-using employee.

This study was undertaken to examine differences in caffeine and nicotine use between the psychiatric population and the addicted population in a private psychiatric inpatient facility. Eighty-six patients on an adult addictive disease inpatient unit and 80 patients on an adult psychiatry unit in a private psychiatric hospital were interviewed with regard to their use of nicotine and caffeine. In addition, demographic information and primary diagnoses were obtained from the psychiatric admission assessment in the medical record as listed by the admitting psychiatrist. Although there was little difference in psychiatric patients vs. chemically dependent patients with regard to the percentage of caffeine users, the chemically dependent individuals drank more coffee, soft drinks, and tea. A much greater percentage of the chemically dependent individuals also smoked cigarettes, although not in a greater amount than the psychiatric patients who smoked. Because group assignment was not random, ordinary least squares (OLS) regression analyses were conducted to determine the independent associations of age, sex, education, and treatment population in predicting levels of caffeine and tobacco use. Even after controlling for demographic differences between the two samples, chemically dependent patients still reported higher levels of daily caffeine and tobacco use than patients on the general psychiatric unit.