Cochrane Database Syst Rev. 2019 Oct 07;10:CD010901. doi: 10.1002/14651858.CD010901.pub3. Epub 2019 Oct 07.
Interventions for drug-using offenders with co-occurring mental health problems.
The Cochrane database of systematic reviews
Amanda E Perry, Marrissa Martyn-St James, Lucy Burns, Catherine Hewitt, Julie M Glanville, Anne Aboaja, Pratish Thakkar, Keshava Murthy Santosh Kumar, Caroline Pearson, Kath Wright, Shilpi Swami
Affiliations
Affiliations
- Department of Health Sciences, University of York, Heslington, York, UK, YO105DD.
PMID: 31588993
PMCID: PMC6778977 DOI: 10.1002/14651858.CD010901.pub3
Abstract
BACKGROUND: This review represents one from a family of three reviews focusing on interventions for drug-using offenders. Many people under the care of the criminal justice system have co-occurring mental health problems and drug misuse problems; it is important to identify the most effective treatments for this vulnerable population.
OBJECTIVES: To assess the effectiveness of interventions for drug-using offenders with co-occurring mental health problems in reducing criminal activity or drug use, or both.This review addresses the following questions.• Does any treatment for drug-using offenders with co-occurring mental health problems reduce drug use?• Does any treatment for drug-using offenders with co-occurring mental health problems reduce criminal activity?• Does the treatment setting (court, community, prison/secure establishment) affect intervention outcome(s)?• Does the type of treatment affect treatment outcome(s)?
SEARCH METHODS: We searched 12 databases up to February 2019 and checked the reference lists of included studies. We contacted experts in the field for further information.
SELECTION CRITERIA: We included randomised controlled trials designed to prevent relapse of drug use and/or criminal activity among drug-using offenders with co-occurring mental health problems.
DATA COLLECTION AND ANALYSIS: We used standard methodological procedures as expected by Cochrane .
MAIN RESULTS: We included 13 studies with a total of 2606 participants. Interventions were delivered in prison (eight studies; 61%), in court (two studies; 15%), in the community (two studies; 15%), or at a medium secure hospital (one study; 8%). Main sources of bias were unclear risk of selection bias and high risk of detection bias.Four studies compared a therapeutic community intervention versus (1) treatment as usual (two studies; 266 participants), providing moderate-certainty evidence that participants who received the intervention were less likely to be involved in subsequent criminal activity (risk ratio (RR) 0.67, 95% confidence interval (CI) 0.53 to 0.84) or returned to prison (RR 0.40, 95% CI 0.24 to 0.67); (2) a cognitive-behavioural therapy (one study; 314 participants), reporting no significant reduction in self-reported drug use (RR 0.78, 95% CI 0.46 to 1.32), re-arrest for any type of crime (RR 0.69, 95% CI 0.44 to 1.09), criminal activity (RR 0.74, 95% CI 0.52 to 1.05), or drug-related crime (RR 0.87, 95% CI 0.56 to 1.36), yielding low-certainty evidence; and (3) a waiting list control (one study; 478 participants), showing a significant reduction in return to prison for those people engaging in the therapeutic community (RR 0.60, 95% CI 0.46 to 0.79), providing moderate-certainty evidence.One study (235 participants) compared a mental health treatment court with an assertive case management model versus treatment as usual, showing no significant reduction at 12 months' follow-up on an Addictive Severity Index (ASI) self-report of drug use (mean difference (MD) 0.00, 95% CI -0.03 to 0.03), conviction for a new crime (RR 1.05, 95% CI 0.90 to 1.22), or re-incarceration to jail (RR 0.79, 95% CI 0.62 to 1.01), providing low-certainty evidence.Four studies compared motivational interviewing/mindfulness and cognitive skills with relaxation therapy (one study), a waiting list control (one study), or treatment as usual (two studies). In comparison to relaxation training, one study reported narrative information on marijuana use at three-month follow-up assessment. Researchers reported a main effect < .007 with participants in the motivational interviewing group, showing fewer problems than participants in the relaxation training group, with moderate-certainty evidence. In comparison to a waiting list control, one study reported no significant reduction in self-reported drug use based on the ASI (MD -0.04, 95% CI -0.37 to 0.29) and on abstinence from drug use (RR 2.89, 95% CI 0.73 to 11.43), presenting low-certainty evidence at six months (31 participants). In comparison to treatment as usual, two studies (with 40 participants) found no significant reduction in frequency of marijuana use at three months post release (MD -1.05, 95% CI -2.39 to 0.29) nor time to first arrest (MD 0.87, 95% CI -0.12 to 1.86), along with a small reduction in frequency of re-arrest (MD -0.66, 95% CI -1.31 to -0.01) up to 36 months, yielding low-certainty evidence; the other study with 80 participants found no significant reduction in positive drug screens at 12 months (MD -0.7, 95% CI -3.5 to 2.1), providing very low-certainty evidence.Two studies reported on the use of multi-systemic therapy involving juveniles and families versus treatment as usual and adolescent substance abuse therapy. In comparing treatment as usual, researchers found no significant reduction up to seven months in drug dependence on the Drug Use Disorders Identification Test (DUDIT) score (MD -0.22, 95% CI -2.51 to 2.07) nor in arrests (RR 0.97, 95% CI 0.70 to 1.36), providing low-certainty evidence (156 participants). In comparison to an adolescent substance abuse therapy, one study (112 participants) found significant reduction in re-arrests up to 24 months (MD 0.24, 95% CI 0.76 to 0.28), based on low-certainty evidence.One study (38 participants) reported on the use of interpersonal psychotherapy in comparison to a psychoeducational intervention. Investigators found no significant reduction in self-reported drug use at three months (RR 0.67, 95% CI 0.30 to 1.50), providing very low-certainty evidence. The final study (29 participants) compared legal defence service and wrap-around social work services versus legal defence service only and found no significant reductions in the number of new offences committed at 12 months (RR 0.64, 95% CI 0.07 to 6.01), yielding very low-certainty evidence.
AUTHORS' CONCLUSIONS: Therapeutic community interventions and mental health treatment courts may help people to reduce subsequent drug use and/or criminal activity. For other interventions such as interpersonal psychotherapy, multi-systemic therapy, legal defence wrap-around services, and motivational interviewing, the evidence is more uncertain. Studies showed a high degree of variation, warranting a degree of caution in interpreting the magnitude of effect and the direction of benefit for treatment outcomes.
References
- Trials. 2007 Jan 08;8:1 - PubMed
- Am J Drug Alcohol Abuse. 2005;31(3):393-401 - PubMed
- Psychiatr Serv. 2016 Feb;67(2):169-75 - PubMed
- J Behav Health Serv Res. 2015 Oct;42(4):554 - PubMed
- Contemp Clin Trials. 2017 Aug;59:1-12 - PubMed
- Am J Addict. 2003 Jul-Sep;12(4):314-23 - PubMed
- Int J Drug Policy. 2018 Jan;51:42-51 - PubMed
- Psychiatr Serv. 2007 Jul;58(7):955-61 - PubMed
- J Am Acad Psychiatry Law. 2007;35(1):83-91 - PubMed
- Contemp Clin Trials. 2016 Jul;49:57-64 - PubMed
- AIDS Behav. 2013 Oct;17 Suppl 2:S156-70 - PubMed
- Child Youth Serv Rev. 2012 Apr 1;34(4):639-647 - PubMed
- J Subst Abuse Treat. 2017 Oct;81:25-34 - PubMed
- J Subst Abuse Treat. 1999 Dec;17(4):339-47 - PubMed
- J Urban Health. 2013 Oct;90(5):983-96 - PubMed
- Am J Addict. 2013 Sep-Oct;22(5):500-2 - PubMed
- Am J Public Health. 2005 Jan;95(1):131-7 - PubMed
- Cochrane Database Syst Rev. 2006 Jul 19;(3):CD005193 - PubMed
- Int Clin Psychopharmacol. 2005 Sep;20(5):253-6 - PubMed
- Am J Drug Alcohol Abuse. 2003;29(1):1-18 - PubMed
- Eval Rev. 2000 Apr;24(2):212-41 - PubMed
- J Clin Psychopharmacol. 2015 Oct;35(5):535-43 - PubMed
- Community Ment Health J. 2016 Feb;52(2):127-35 - PubMed
- J Subst Abuse Treat. 2015 Nov;58:25-32 - PubMed
- J Exp Criminol. 2011 Sep;7(3):225-253 - PubMed
- Curr Psychiatry Rep. 2009 Oct;11(5):370-6 - PubMed
- J Marital Fam Ther. 2018 Jul;44(3):483-498 - PubMed
- Psychiatr Serv. 1998 Apr;49(4):483-92 - PubMed
- Contemp Clin Trials. 2017 Feb;53:130-136 - PubMed
- Qual Manag Health Care. 2010 Jan-Mar;19(1):62-9 - PubMed
- Int J Offender Ther Comp Criminol. 2014 May;58(5):522-36 - PubMed
- AIDS. 2015 Apr 24;29(7):819-24 - PubMed
- Syst Rev. 2014 May 16;3:45 - PubMed
- Addiction. 2012 Sep;107(9):1650-9 - PubMed
- Hosp Community Psychiatry. 1989 Dec;40(12):1309-10 - PubMed
- Harm Reduct J. 2006 Sep 27;3:28 - PubMed
- Psychiatr Serv. 2014 Nov 1;65(11):1325-31 - PubMed
- J Subst Abuse Treat. 2017 Sep;80:59-66 - PubMed
- PLoS One. 2014 Mar 25;9(3):e92809 - PubMed
- Cochrane Database Syst Rev. 2015 Jun 02;(6):CD010901 - PubMed
- J Appl Behav Anal. 2008 Winter;41(4):565-77 - PubMed
- Addiction. 2005 Jun;100(6):820-8 - PubMed
- Behav Ther. 2009 Dec;40(4):325-36 - PubMed
- J Nerv Ment Dis. 1997 May;185(5):306-13 - PubMed
- Drug Alcohol Depend. 2017 Jun 1;175:164-170 - PubMed
- J Addict Dis. 2012;31(3):258-69 - PubMed
- BMC Public Health. 2017 Mar 11;17(1):246 - PubMed
- J Am Acad Psychiatry Law. 2008;36(3):354-9 - PubMed
- Behav Sci Law. 2004;22(4):477-501 - PubMed
- Eur Arch Psychiatry Clin Neurosci. 2012 Dec;262(8):705-24 - PubMed
- Int J Drug Policy. 2017 Jan;39:86-91 - PubMed
- J Subst Abuse Treat. 2013 Jan;44(1):78-83 - PubMed
- Addiction. 2002 Dec;97 Suppl 1:1-3 - PubMed
- Trials. 2013 Sep 24;14:309 - PubMed
- J Fam Psychol. 2015 Apr;29(2):232-41 - PubMed
- J Stud Alcohol Drugs. 2011 May;72(3):497-506 - PubMed
- Int J Addict. 1982 Feb;17(2):393-7 - PubMed
- Soc Work Public Health. 2015;30(3):225-35 - PubMed
- Addiction. 2014 Mar;109(3):440-9 - PubMed
- Lancet Psychiatry. 2015 May;2(5):422-430 - PubMed
- J Consult Clin Psychol. 2012 Dec;80(6):1114-20 - PubMed
- Int Pharmacopsychiatry. 1975;10(4):240-50 - PubMed
- NIDA Res Monogr. 1976 Sep;(9):93-8 - PubMed
- Addiction. 2017 Aug;112(8):1440-1450 - PubMed
- J Subst Abuse Treat. 2003 Sep;25(2):99-105 - PubMed
- Eval Rev. 2005 Feb;29(1):42-64 - PubMed
- J Behav Health Serv Res. 2015 Apr;42(2):172-90 - PubMed
- Implement Sci. 2016 Apr 29;11:57 - PubMed
- Drug Alcohol Depend. 2006 Jun 28;83(2):122-9 - PubMed
- Drug Alcohol Depend. 2017 Mar 01;172:34-42 - PubMed
- Psicothema. 2013;25(3):307-12 - PubMed
- Am J Drug Alcohol Abuse. 2007;33(6):823-32 - PubMed
- Crim Behav Ment Health. 2005;15(4):236-48 - PubMed
- Br J Psychiatry. 2012 May;200(5):364-73 - PubMed
- Cochrane Database Syst Rev. 2013 Dec 19;(12):CD010862 - PubMed
- Cochrane Database Syst Rev. 2014 Jan 02;(1):CD010901 - PubMed
- J Addict Dis. 2017 Jan-Mar;36(1):60-71 - PubMed
- J Exp Criminol. 2014;10:105-127 - PubMed
- Lancet HIV. 2017 Feb;4(2):e59-e66 - PubMed
- J Consult Clin Psychol. 2006 Oct;74(5):955-66 - PubMed
- Am J Community Psychol. 2013 Mar;51(1-2):114-22 - PubMed
- Addiction. 2015 Mar;110(3):479-90 - PubMed
- J Stud Alcohol Drugs. 2013 Sep;74(5):770-6 - PubMed
- J Subst Abuse Treat. 2016 Jun;65:13-9 - PubMed
- Lancet. 2002 Feb 16;359(9306):545-50 - PubMed
- Addict Behav. 2015 Dec;51:51-6 - PubMed
- Lancet. 2015 Jul 25;386(9991):350-9 - PubMed
- PLoS One. 2013 Sep 04;8(9):e72946 - PubMed
- Can HIV AIDS Policy Law Rev. 2003 Dec;8(3):48 - PubMed
- J Subst Abuse Treat. 2008 Mar;34(2):242-8 - PubMed
- J Subst Abuse Treat. 1996 Jan-Feb;13(1):3-11 - PubMed
- J Fam Psychol. 2008 Aug;22(4):550-60 - PubMed
- J Drug Issues. 2014 Jan;44(1):69-82 - PubMed
- J Drug Issues. 2015 Jan;45(1):53-68 - PubMed
- Alcohol Alcohol. 2006 May-Jun;41(3):328-35 - PubMed
- Psychiatr Serv. 2009 Jun;60(6):761-5 - PubMed
- Subst Use Misuse. 2014 Apr;49(5):560-70 - PubMed
- Behav Sci Law. 2003;21(4):415-27 - PubMed
- Crim Justice Behav. 2014 Apr;41(4):417-432 - PubMed
- N Engl J Med. 2016 Mar 31;374(13):1232-42 - PubMed
- Contemp Clin Trials. 2014 Nov;39(2):256-68 - PubMed
- J Subst Abuse Treat. 2013 Oct;45(4):370-5 - PubMed
- Nurs Res. 2015 May-Jun;64(3):177-89 - PubMed
- Evid Based Med. 2006 Aug;11(4):112 - PubMed
- Addiction. 1998 Apr;93(4):515-32 - PubMed
- J Psychiatr Res. 2012 Sep;46(9):1174-83 - PubMed
- Int Pharmacopsychiatry. 1975;10(3):157-68 - PubMed
- J Offender Rehabil. 2014 Feb 1;53(2):95-115 - PubMed
- Drug Alcohol Depend. 2007 Dec 1;91(2-3):220-7 - PubMed
- Am J Drug Alcohol Abuse. 2000 Nov;26(4):537-52 - PubMed
- J Subst Abuse Treat. 2013 Nov-Dec;45(5):400-8 - PubMed
- Addiction. 2017 Aug;112(8):1462-1469 - PubMed
- Drug Alcohol Depend. 2010 Sep 1;111(1-2):161-5 - PubMed
- Addict Res Theory. 2014 Dec;22(6):463-473 - PubMed
- J Correct Health Care. 2009 Jul;15(3):210-21 - PubMed
- N Engl J Med. 1969 Jun 19;280(25):1372-5 - PubMed
- Trials. 2017 Aug 4;18(1):365 - PubMed
- Br J Gen Pract. 2011 Dec;61(593):e772-80 - PubMed
- J Consult Clin Psychol. 2010 Dec;78(6):885-97 - PubMed
- J Subst Abuse Treat. 2004 Mar;26(2):95-102 - PubMed
- Contemp Clin Trials. 2016 May;48:166-72 - PubMed
- Drug Alcohol Depend. 2013 Mar 1;128(3):222-9 - PubMed
- J Clin Psychol. 2014 Jul;70(7):644-57 - PubMed
- Eur Addict Res. 2015;21(4):179-87 - PubMed
- Nihon Arukoru Yakubutsu Igakkai Zasshi. 2012 Dec;47(6):298-307 - PubMed
- Am J Psychiatry. 2009 Nov;166(11):1269-77 - PubMed
- Br J Psychiatry. 2014 Feb;204(2):98-107 - PubMed
- Drug Alcohol Depend. 2006 Sep 15;84(2):160-6 - PubMed
- Drug Alcohol Rev. 2018 May;37(4):487-498 - PubMed
- Addiction. 2003 Aug;98(8):1137-41 - PubMed
- BMC Health Serv Res. 2011 Apr 18;11:80 - PubMed
- Trials. 2009 Jul 14;10:53 - PubMed
- PLoS One. 2011;6(9):e25127 - PubMed
- J Subst Abuse Treat. 2016 Sep;68:1-10 - PubMed
- Contemp Clin Trials. 2016 Jul;49:21-8 - PubMed
- Psychol Rep. 1993 Dec;73(3 Pt 2):1089-90 - PubMed
- J Psychoactive Drugs. 1990 Apr-Jun;22(2):197-209 - PubMed
- Pers Soc Psychol Bull. 2014 Mar;40(3):334-47 - PubMed
- J Consult Clin Psychol. 2016 Mar;84(3):248-58 - PubMed
- J Subst Abuse Treat. 2018 Feb;85:45-48 - PubMed
- J Consult Clin Psychol. 2006 Feb;74(1):42-54 - PubMed
- Lancet Psychiatry. 2016 Sep;3(9):871-81 - PubMed
- Addiction. 2000 Nov;95(11):1631-45 - PubMed
- J Subst Abuse Treat. 2006 Sep;31(2):203-11 - PubMed
- J Exp Criminol. 2017 Mar;13(1):53-77 - PubMed
- Addiction. 2017 Mar;112(3):502-515 - PubMed
- J Subst Abuse Treat. 2017 Oct;81:66-72 - PubMed
- J Clin Psychiatry. 2013 Dec;74(12):1249-55 - PubMed
- Drug Alcohol Depend. 2011 Dec 1;119(1-2):64-71 - PubMed
- J Clin Psychol. 2017 Oct;73(10):1226-1246 - PubMed
- Eval Program Plann. 2012 Feb;35(1):47-53 - PubMed
- J Correct Health Care. 2011 Jul;17(3):226-32 - PubMed
- J Subst Abuse Treat. 2009 Oct;37(3):277-85 - PubMed
- Addiction. 2007 Jul;102(7):1114-21 - PubMed
- Drug Alcohol Depend. 2003 Oct 24;72(1):59-65 - PubMed
- Crim Justice Behav. 2015 Oct;42(10):1008-1031 - PubMed
- Accid Anal Prev. 2013 Apr;53:89-99 - PubMed
- J Anxiety Disord. 2012 Oct;26(7):703-10 - PubMed
- J Subst Abuse Treat. 2014 Feb;46(2):134-43 - PubMed
- Drug Alcohol Depend. 2017 May 1;174:181-191 - PubMed
- J Subst Abuse Treat. 2017 Mar;74:54-64 - PubMed
- Int J Drug Policy. 2016 Jun;32:70-6 - PubMed
- Addiction. 2015 Jun;110(6):1008-14 - PubMed
- J Subst Abuse Treat. 2015 Dec;59:52-8 - PubMed
- Mindfulness (N Y). 2017 Jun;8(3):603-614 - PubMed
- Int J Drug Policy. 2010 Jul;21(4):296-301 - PubMed
- Int J Addict. 1994 Aug;29(10):1315-45 - PubMed
- BMC Psychiatry. 2016 Dec 7;16(1):436 - PubMed
- J Subst Abuse Treat. 1998 Nov-Dec;15(6):535-43 - PubMed
- Int J Offender Ther Comp Criminol. 2011 Jun;55(4):587-604 - PubMed
- Subst Abuse Treat Prev Policy. 2009 Feb 05;4:1 - PubMed
- Nurs Res. 2016 May-Jun;65(3):179-90 - PubMed
- Subst Use Misuse. 2014 Apr;49(5):536-46 - PubMed
- J Subst Abuse Treat. 2003 Oct;25(3):213-21 - PubMed
- J Subst Abuse Treat. 2017 Jun;77:44 - PubMed
- Contemp Clin Trials. 2017 Jun;57:98 - PubMed
- Contemp Clin Trials. 2016 Nov;51:97 - PubMed
- Subst Abus. 2016;37(1):248-54 - PubMed
- Drug Alcohol Depend. 2009 Jan 1;99(1-3):222-30 - PubMed
- Subst Use Misuse. 2000 Oct-Dec;35(12-14):1967-2009 - PubMed
- Psychiatr Serv. 1995 Mar;46(3):233-8 - PubMed
- J Consult Clin Psychol. 2016 Mar;84(3):210 - PubMed
- J Case Manag. 1997 Fall;6(3):119-26 - PubMed
- Subst Use Misuse. 2016 Jun 6;51(7):902-11 - PubMed
- AIDS Care. 2014;26(9):1071-9 - PubMed
- Subst Abus. 2012;33(1):19-29 - PubMed
- J Rural Health. 2017 Jun;33(3):250-256 - PubMed
- J Subst Abuse Treat. 2010 Apr;38(3):263-74 - PubMed
- Compr Psychiatry. 1977 May-Jun;18(3):211-9 - PubMed
- J Subst Abuse Treat. 2014 Mar;46(3):306-14 - PubMed
- J Offender Rehabil. 2014;53(7):543-561 - PubMed
- Addiction. 2006 Feb;101(2):241-51 - PubMed
- Am J Addict. 2016 Apr;25(3):233-40 - PubMed
- Addiction. 2015 Dec;110(12):1975-84 - PubMed
- Alcohol Treat Q. 2016;34(4):415-424 - PubMed
- Contemp Clin Trials. 2015 Mar;41:110-7 - PubMed
- Drug Alcohol Depend. 2016 Jan 1;158:38-44 - PubMed
- J Subst Abuse Treat. 2012 Apr;42(3):247-59 - PubMed
- Psicothema. 2006 Aug;18(3):620-9 - PubMed
- Drug Alcohol Rev. 2011 Mar;30(2):188-94 - PubMed
- Drug Alcohol Depend. 2014 Sep 1;142:33-40 - PubMed
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