Substance abuse by offenders with mild intellectual disability

This study compared the rate of self-reported alcohol and other drug use in a sample of 30 young adults with mild intellectual disability whose offending behaviour had resulted in involvement in the criminal justice system, with a matched comparison group of 30 non-offenders. Performance on an alcohol and other drug knowledge test was also compared. The results indicated that many individuals with mild intellectual disability regularly consumed alcohol and used illicit drugs. Furthermore, the data suggest a possible link between substance abuse and offending behaviour in this population. Individuals who had offended reported greater use of both legal and illicit drugs than their non-offending counterparts and many reported that they had been under the influence of alcohol or illicit drugs at the time of committing the offence that had resulted in their current placement within the criminal justice system. Although deficits in knowledge were apparent in both groups, the offenders demonstrated greater overall knowledge about alcohol and other drugs.

Early impact of the BEST intervention for parents stressed by adolescent substance abuse.

Youth involvement in substance abuse can be a source of considerable distress for their parents. Unilateral family interventions have been advocated as one means by which concerned family members can be supported to assist substance-abusing family members. To date there has been little research examining the impact of unilateral family interventions on the directly participating family members. In this study the early impact of an 8-week parent-group programme known as Behavioural Exchange Systems Training (BEST) was evaluated using a quasi-experimental, waiting list control design. The professionally led programme had been developed to support and assist parents in their efforts to cope with adolescent substance abuse. Subjects were 66 parents (48 families) accepted for entry into the programme between 1997 and 1998. Comparison was made between 46 parents offered immediate entry into the programme and 20 parents whose entry to the programme was delayed by an 8-week waiting list. At the first assessment 87% of parents showed elevated mental health symptoms on the General Health Questionnaire. Evidence suggested exposure to the intervention had a positive impact on parents. Compared to parents on the waiting list, parents entered immediately into the intervention demonstrated greater reductions in mental health symptoms, increased parental satisfaction, and increased use of assertive parenting behaviours.

Mental health promotion and socio-economic disadvantage: lessons from substance abuse, violence and crime prevention and child health

Issue addressed: Mental health promotion aimed at populations with low socio-economic status (SES) may benefit by investigating prevention strategies that effectively address related child and adolescent problems.
Methods: Evidence from a number of literature reviews and program evaluations was synthesised. First, the impact of SES on development from childhood to adulthood is considered in light of research on substance
abuse, violence, crime, and child development problems. Second, evaluations of interventions are reviewed to identify those that have shown outcomes in research studies (efficacy) or in real-world settings (effectiveness) in reducing developmental problems associated with low SES. Low SES is measured in different ways including low levels of education and/or income or definitions that combine several variables into a new indicator of low SES.
Results: Factors associated with low SES are also associated to varying extent with the development of violence and crime, substance abuse and child health problems. Interventions that address underlying determinants of low SES show strong efficacy in decreasing adolescent crime and violence and effectiveness in improving child health outcomes. Although there is limited efficacy evidence that substance abuse prevention can be effectively addressed by targeting low SES, programs designed to improve educational pathways show some efficacy in reducing aspects of adolescent substance use.
Conclusion: Mental health promotion strategies can draw on the approaches outlined here that are associated with the prevention of child and adolescent problems within low SES communities. Alternatively, such interventions could be supported in mental health promotion policy as they may assist in preventing related problems that undermine mental health.

Change for the BEST: family changes for parents coping with youth substance abuse

This paper reports family changes for participants in a program for parents coping with youth substance abuse. The Behavioural Exchange Systems Training (BEST) program is a professionally-led, parent training intervention. During 1996 and 1997, six groups of parents participated in the program. High levels of depression were observed at intake and symptoms demonstrated a stable reduction in association with exposure to the program. Parents tended to achieve success in developing common strategies for assertively managing family problems, though couples from more complex blended families found this more difficult. Adolescent improvements were noted during the weeks observed. A two year follow up conducted with a subset of families revealed that parents continued to report that the intervention had helped them cope with youth drug abuse.

Importance of assessing family dysfunction in conjunction with standardised measures when treating substance abuse

In this thesis, the link between substance abuse and family dysfunction is examined, and an argument is made for the assessment of family dysfunction when treating clients with substance abuse issues. Family dysfunction has been associated with a broad range of problems in children (e.g., low self esteem, increased risk of child abuse) through to adolescence and adulthood (e.g., increased risk of mental disorders such as depressive disorders, substance abuse disorders, and personality disorders) (Kaplan & Sadock, 1998). It is not the purpose of this thesis to suggest that family dysfunction causes substance abuse but rather to highlight that family dysfunction can in some cases place the individual at greater risk of substance abuse. Therefore, in order to understand the reasons why substance abuse developed and how it is maintained in the present requires the assessment of family dysfunction. Further, the importance of assessing the role and impact that family dysfunction may have had on the client, may help to better understand the nature and extent of substance abuse so that relevant and appropriate treatment goals for change may be set, progress monitored, and risk of relapse reduced. Chapter 1 provides a brief introduction to this thesis, and Chapter 2 is a review of the literature on the impact of family dysfunction including poor parental attachment and supervision, neglect, physical and sexual abuse, in adolescence and adulthood. Four case studies are presented to illustrate how family dysfunction and substance abuse may be related, thus highlighting the importance of assessing family dysfunction when treating substance abuse clients. All of the case studies include an individual with a substance abuse disorder (namely heroin) but they are diverse in terms of the types and extent of family dysfunction. The final chapter discusses the case studies in relation to the literature reviewed. Lastly, it gives consideration to the implication of a history of family dysfunction, and how it may impact negatively on treatment and therefore prognosis.

Readiness for substance abuse treatment amongst Victorian prisoners

The thesis examined treatment readiness in offender rehabilitation. Findings empirically refuted the notion that treatment readiness occurs in sequential progression through stages. Instead the study offered two treatment readiness models based on concurrent states of thought and behaviour. Furthermore, the treatment readiness models were found to be significantly predicted by offenders' cognitive styles and self-efficacy. The portfolio seeks to demonstrate, through four case studies, how different variables within the three-part ecological framework can either promote or constrain the reintegration process of ex-prisoners and ex-offenders.

Is access to alcohol associated with alcohol/substance abuse among people diagnosed with anxiety/mood disorder?

To investigate the relationship between access to off-license alcohol outlets and areas with dual treatment for alcohol/drug abuse and anxiety/mood disorder compared to areas with anxiety/mood disorder only in an urban setting in New Zealand.

Children impacted by parental substance abuse: an evaluation of the supporting kids and their environment program

The deleterious impact of parental substance abuse on child development and family functioning is well established. However, evaluations of interventions designed to ameliorate such impacts are very limited. This paper presents the results of a service evaluation using a pre-post design of the Supporting Kids And Their Environment (SKATE) program; a child-focused group program run by Glastonbury Community Services from 2006 to 2010 in the Geelong region of Victoria, Australia. The intervention was an 8-week psycho-educative model that used family-based techniques. Outcomes are reported for child behavior problems, assessed on the Child Behavior Checklist, and family functioning, assessed on the Family Support Scale. A total of 89 children and families within 13 intervention groups were recruited via adult Drug and Alcohol Services (Mean age = 10.4 years; SD = 2.4). Results suggest reductions in emotional and behavioral problems in children as well as improving family functioning with small to moderate effect sizes after children’s participation in the SKATE program compared to pre-test. These preliminary findings suggest that children whose parents are substance abusing are a high-risk group but they may benefit from targeted intervention programs that are well integrated with the adult drug treatment system. Such interventions warrant further development and evaluation.

Sober assessment of the link between substance abuse and crime-eliminating drug and alcohol use from the sentencing calculus

The relevance of drug and alcohol involvement to sentencing law and practice is one of the most perplexing and unsettled areas of sentencing law and practice.1 It is also one of the most important issues in the criminal justice system. Most crimes are committed by offenders who are substance involved, and nearly half of all crimes that are committed are done so by offenders who are intoxicated at the time of the offense. Substance involved individuals are grossly over-represented in the criminal courts. Addiction and intoxication impair sound judgment, and hence, it intuitively appears that intoxicated offenders are less culpable for their crimes. Moreover, there is often a sense that addiction and intoxication causes aberrant behavior and that curing the substance involvement will lead to more prudent (law-abiding) conduct.

Puberty and the onset of substance use and abuse

Objective: Substance abuse remains one of the major threats to adolescent health in Western cultures. The study aim was to ascertain the extent of association between pubertal development and early adolescent substance use.

Methods: The design was a cross-sectional survey of 10- to 15-year-old subjects in the states of Washington, United States, and Victoria, Australia. Participants were 5769 students in grades 5, 7, and 9, drawn as a 2-stage cluster sample in each state, and the questionnaire was completed in the school classrooms. The main outcomes of the study were lifetime substance use (tobacco use, having been drunk, or cannabis use), recent substance use (tobacco, alcohol, or cannabis use in the previous month), and substance abuse (daily smoking, any binge drinking, drinking at least weekly, or cannabis use at least weekly).

Results: The odds of lifetime substance use were almost twofold higher (odds ratio [OR]: 1.7; 95% confidence interval [CI]: 1.4–2.1) in midpuberty (Tanner stage III) and were threefold higher (OR: 3.1; 95% CI: 2.4–4.2) in late puberty (Tanner stage IV/V), after adjustment for age and school grade level. Recent substance use was moderately higher (OR: 1.4; 95% CI: 1.0–1.9) in midpuberty and more than twofold higher (OR: 2.3; 95% CI: 1.7–3.3) in late puberty. The odds of substance abuse were twofold higher (OR: 2.0; 95% CI: 1.2–3.2) in midpuberty and more than threefold higher (OR: 3.5; 95% CI: 2.2–5.4) in late puberty. Reporting most friends as substance users was more likely in the later stages of pubertal development, a relationship that accounted in part for the association found between later pubertal stage and substance abuse.

Conclusions: Pubertal stage was associated with higher rates of substance use and abuse independent of age and school grade level. Early maturers had higher levels of substance use because they entered the risk period at an earlier point than did late maturers. The study findings support prevention strategies and policies that decrease recreational substance use within the peer social group in the early teens.