Allison Mateyoke-Scrivner

Treatment Retention Predictors of Drug Court Participants in a Rural State

Factors distinguishing clients who complete drug court treatment from those who do not complete drug court have been documented, but differences between urban and rural drug court participants have not been examined. The present study focuses on examining mental health, drug use, criminal activity, and education/employment as factors that are associated with treatment retention, which is measured by graduation from a rural and urban drug court. Study findings indicate that for the urban drug court, marital status, employment, drug use, and criminal activity predicted graduation. For the rural drug court, however, graduation was only predicted by age and juvenile incarceration. Findings from this study suggest there are different factors associated with drug court retention/graduation between urban and rural drug court settings. It is suggested that drug court administrators and other could use this information to better assess potential participants and to target services.

Methamphetamine Use in Nonurban and Urban Drug Court Clients

Population-based surveys suggest that methamphetamine use and abuse may be rising in the United States. However, little is known about methamphetamine use in eastern sections of the United States, particularly nonurban areas. The purpose of the present study was (a) to explore reported methamphetamine use and its correlates among Kentucky drug court clients and(b) to determine whether differences exist between methamphetamine users by drug court location. Of the 500 drug court clients surveyed, approximately 32% n = 161) reported lifetime methamphetamine use. Methamphetamine users and nonusers differed in their drug-use profiles, self-reported criminal history, and number of criminal offenses. Nonurban and urban methamphetamine users differed in their drug-use profiles, psychological functioning, self-reported criminal history, and number of criminal offenses. These results suggest that differences exist between these populations and clinicians, and criminal justice officials may need to consider these differences when planning treatment and rehabilitation strategies.

Employment, employment-related problems, and Drug use at Drug Court entry

The literature indicates that employment may be an important factor for retaining substance misusing clients in treatment. Given the link between employment problems and treatment retention for Drug Court clients, the current project builds upon the existing services provided by Drug Courts in order to develop and implement an innovative model that focuses on obtaining, maintaining, and upgrading employment for Drug Court participants. The purpose of this article is to (1) describe the employment intervention used in Kentucky Drug Courts, which is grounded in established job readiness and life skill training approaches; and (2) profile those participants who were employed full-time prior to Drug Court and those who were not. Findings suggest that those employed full-time were more likely to have higher incomes and more earned income from legitimate job sources, although there were no differences in the types of employment (major jobs included food service and construction). In addition, study findings suggest that full-time employment was not “protective” since there were few differences in drug use and criminal activity by employment status. Employment interventions need to be examined to determine their utility for enhancing employment and keeping drug users in treatment. This article focuses on the initial 400 participants, who began entering the study in March, 2000.

Gender, Mental Health, and Treatment Motivation in a Drug Court Setting

Abstract The current study examined differences in motivation for drug treatment in a sample of 500 (327 males and 173 females) drug court participants. It was hypothesized that females would report higher levels of treatment motivation, as indicated by measures of problem recognition and desire for help, and that this difference would be moderated by mental health. After controlling for selected factors related to treatment motivation, females were found to have higher levels of problem recognition and desire for help. A signi ficant gender x mental health interaction was also found, suggesting that females with more mental health problems have the highest levels of desire for help.

Contextual differences in substance use for rural Appalachian treatment-seeking women.

Objective: To examine differences in substance use among a sample of women entering treatment from rural Appalachian and non-Appalachian areas. Participants: A total of 2,786 women participating in state-funded substance abuse treatment programs statewide. Measures: Substance use measures were based on the SAMHSA CSAT Government Performance and Results Act (GPRA) gathering information on lifetime and past 12-month use of alcohol, marijuana, opiates, sedatives/tranquilizers, cocaine, and stimulants. Results: Women entering treatment in rural Appalachia had disproportionately high rates of opiate and sedative/tranquilizer use while methamphetamine, cocaine, marijuana, and alcohol were more prevalent for women in non-Appalachian areas. Conclusions: Women entering treatment in rural Appalachia were significantly more likely to report opiate and sedative/tranquilizer use compared to non-Appalachian women. In order to begin to understand the elevated rates of prescription drug abuse in rural Appalachian Kentucky, substance use must be considered within the context of demographic, geographic, social, and economic conditions of the region.

PRESCRIPTION DRUG USE, HEALTH SERVICES UTILIZATION, AND HEALTH PROBLEMS IN RURAL APPALACHIAN KENTUCKY

Rural states like Kentucky now lead the nation in the illicit diversion of narcotic prescription drugs. In order to understand this phenomenon, we examine the currently popularly abused prescription drug OxyContin® by comparing differences in drug use, health services use, and criminality among a nontreatment group of rural Appalachian probationers who reported using OxyContin® (n = 101) with nonusers of OxyContin® (n = 194). Although OxyContin® users were younger, a number of differences emerged. OxyContin® users exhibited higher levels of use for 15 illicit drugs examined; used more detoxification services; attended more AA/NA meetings; reported more depression, anxiety, trouble concentrating, and violence; and reported more crime for 16 crimes. We discuss the implications of OxyContin® use including the possibility that it may be a marker for other illicit rural drug use.

Criminal History, Physical and Mental Health, Substance Abuse, and Services Use Among Incarcerated Substance Abusers

Recent research shows that drug-involved offenders engage in many health-risky behaviors, but relatively little is known about the impact of criminal history on the health of these individuals. In this study, criminal history and health information was collected from 661 male drug-abusing prisoners. Findings showed that having a more extensive criminal history was associated with higher rates of overall physical health problems but not mental health problems. Although no relationship between mental health and crime was observed, future research on the connection between psychological problems and criminal history is discussed. Years of lifetime use of five different drugs was positively related to criminal history. In terms of health services utilization, offenders with more serious criminal histories were more likely to have received previous medical treatment in a hospital emergency room and to have received treatment for drug or alcohol abuse.

Drug Use and Criminal Activity Among Rural Probationers With DUI Histories

The present study examined whether ever being arrested for driving under the influence (DUI) was associated with higher levels of substance use and criminal activity in a sample of 800 probationers. Lifetime and 30-day histories of substance use and criminal activity were compared across three groups of probationers from rural Kentucky: those with a single DUI arrest, those with two or more DUI arrests, and those with no DUI arrests. A larger percentage of probationers with a DUI arrest reported lifetime and 30-day substance use than non-DUI offenders in almost all drug and alcohol categories. Higher prevalence of criminal activity was limited primarily to the multiple DUI arrest group. Findings add to the literature on rural substance abusers and indicate that DUI may be used as a marker to help identify opportunities for targeted substance abuse interventions.

Kentucky Rural Stimulant Use: A Comparison of Methamphetamine and Other Stimulant Users

Abstract Population based surveys suggest that methamphetamine use is increasing. However, little is known about stimulant use in rural areas. Given the lack of data regarding rural stimulant use, particularly methamphetamine use, and the continuing problems associated with stimulant drug use, the purpose of this study was to examine rural stimulant use in Kentucky. Of 225 rural stimulant-using participants surveyed, 76% (n = 170) reported lifetime use of methamphetamine. Rural methamphetamine users differed from other rural stimulant users on demographic characteristics, health, and drug use histories. These results suggest that differences exist between rural stimulant users and that clinicians may need to consider these differences when planning treatment and rehabilitation strategies.

Rurality and Criminal History as Predictors of HIV Risk Among Drug-Involved Offenders

The current study examined rurality and criminality as predictors of the lifetime HIV risk behaviors of 661 male, drug-abusing state prisoners. HIV risk behaviors included the number of lifetime sex partners, the number of lifetime drug injections, the number of times had sex with an injection drug user, and the frequency with which a condom was used. Regression analyses showed that criminality was related to the number of lifetime injections, whereas rurality was related to fewer lifetime sex partners and less frequent condom use. A rurality by criminality interaction for sex with an injection drug user was found. Specifically, those from rural areas who had more extensive criminal histories reported relatively high numbers of sex partners who were IDUs. Results are discussed in the context of rural and criminal justice interventions for HIV risk behavior.