Curtis J VanderWaal

Does State Certification or Licensure Influence Outpatient Substance Abuse Treatment Program Practices

In the United States, state governments legally authorize outpatient substance abuse treatment programs. In some states, programs are certified or accredited (ideal standards). Other states license programs (minimal standards). Additionally, some states authorize programs through “deemed status”, which is afforded to programs attaining accreditation from a national accrediting body. Primary legal research and the National Survey of Substance Abuse Treatment Services’ (N-SSATS) data were used to examine the relationships between state authorization type (certification/accreditation vs licensure with and without deemed status) and outpatient treatment program practices. Programs in certification/accreditation (vs licensure) states had significantly higher odds of offering wrap-around and continuing care/after care services associated with better long-term treatment outcome. Programs in states that allowed for certification/accreditation with deemed status had significantly lower odds of infectious disease testing, but higher odds of providing group and family counseling. Results suggest that state authorization type may impact services offered by outpatient treatment programs.

Provision of drug treatment services in the juvenile justice system: a system reform.

This article proposes a systemic reform of the organizational structure and delivery of substance abuse services for adolescents within the juvenile justice system. It first discusses the impact of substance use on the juvenile justice system and then reviews which drug treatment programs and services are currently available. Following an evaluation of the most effective drug treatment programs and modalities, recommendations for system reform are given. The recommendations are based on a graduated sanctions framework, supported by systems collaboration and comprehensive case management. Systems collaboration between service providers must exist for juveniles to receive appropriate and comprehensive services. Case managers (CMs) both assess juveniles and help them move through and between judicial, drug treatment, and social service systems. In this way, juveniles receive the most suitable and complete services a community can offer while remaining firmly under juvenile justice system supervision.

Community and School Drug Prevention Strategy Prevalence: Differential Effects by Setting and Substance

This study used key informant interviews and student survey data in 508 U.S. communities to examine relationships between the prevalence of community and non-classroom-based school substance prevention strategies and teen substance use rates. After controlling for covariates, analyses indicated that: (1) adult-supervised after-school activities were significantly related to lower past 30-day cigarette smoking and both past 30-day alcohol use and binge drinking; (2) unsupervised after-school recreational facilities were significantly associated with both lower past 30-day cigarette smoking and current daily smoking; (3) community activities to reduce substance use were significantly related to lower binge drinking; and (4) student organizations to prevent alcohol abuse were significantly related to lower binge drinking. Communities need a broad spectrum of strategies to address variation in substance use among youth.Editors’ Strategic Implications: Policymakers at the school, community, state, and federal levels will benefit from knowing that after-school activities for teens typically result in reliable (though often modest) reductions in substance use in this large national sample. This is a strategy that works, but the effects are likely to vary by setting, level of supervision, substance, and program implementation.

State Drug Policy Reform Movement: The Use of Ballot Initiatives and Legislation to Promote Diversion to Drug Treatment

For most of the past 25 years, the federal government and many states have adopted a tough, punitive approach to drug offenses. In recent years, changes in public perception and state budget shortfalls have spurred a policy reform movement across the political spectrum that advocates diverting low-level, nonviolent drug offenders into treatment rather than incarcerating them. In nine of the 24 states where ballot initiatives are permitted, citizens have attempted or have successfully placed initiatives on the ballot since 1996. In an additional 12 states, drug policy reformers have successfully passed legislation that allows for diversion. In this paper we briefly trace the history of the diversion-to-treatment policy reform movement, identify the successful diversion-related ballot initiatives and enacted laws from each state, and, using a qualitative content analysis approach, describe the nature and extent of those laws. Finally, we discuss the implications of these differences for state criminal justice policies.

Day Reporting Centers as an Alternative for Drug Using Offenders

It is the purpose of this paper to examine the development, implementation, and effectiveness of a day reporting center (DRC) for drug- using offenders in Cook County, Illinois. At the time of the evaluation, the program primarily offered services to African Americans with limited education and job experience and extensive histories of opiate and cocaine use. The analysis showed that while in the program, participants reduced their drug use, significantly improved the rate of their appearance for court dates, and had a very low rate of arrests on new charges. It was also found that the program had difficulties in integrating its services with other community services after participants left the program. Conclusions support the use of day reporting programs for drug-using offenders as an effective means to reduce drug use. It was also concluded that it was crucial to integrate this type of pre-trial service with other needed community services.

State Methamphetamine Precursor Policies and Changes in Small Toxic Lab Methamphetamine Production

Domestic production of methamphetamine in small toxic labs (STLs) results in significant community safety and health consequences. This paper examines the effects of state-level policies implemented in the middle of the last decade in reaction to a rapid increase in STL labs. These policies focused on controlling access to the methamphetamine precursor chemicals ephedrine and pseudoephedrine and the relationship of such policies with actual STL seizure rates. Data include (a) primary legal research on state laws/regulations in all 50 states in effect as of October 1, 2005; and (b) STL seizure counts for 2004–2006. Results from random effects cross-sectional time-series regression models showed that states with the greatest reduction in STL seizures had comprehensive policies involving quantity limits on methamphetamine precursor purchases, clerk intervention requirements (such as requiring buyer identification) and regulatory agency specification for monitoring compliance and tracking multiple purchases. Criminalizing purchasing violations was not related to STL reductions.

Reforming Drug Treatment Services to Offenders: Cross-System Collaboration, Integrated Policies, and a Seamless Continuum of Care Model

ABSTRACT For the past 2 decades the U.S. “war on drugs” has contributed to soaring incarceration rates, prison overcrowding, and overly harsh and race-based sentencing. This article calls for reform of drug treatment services for drug-addicted offenders. This article introduces an integrated model for delivering drug treatment services by improving cross-system collaboration along a seamless continuum of care. We offer practical principles and policies for improving drug treatment services across criminal justice and drug treatment agency boundaries. Reforming drug treatment services for offenders may reduce illicit drug use in the United States because the majority of heavy drug users are involved in the criminal justice system.

African-American injection drug users: tensions and barriers in HIV/AIDS prevention.

This exploratory study utilized a focus group methodology to explore tensions and barriers in HIV/AIDS prevention among African-American injection drug users. Participants discussed HIV infection risks, national/community HIV prevention effectiveness, prevention barriers, ideas on barrier removal, and the tensions which exist between users and the larger African-American community. Recognizing the inevitability of continued drug use for many injectors, participants requested basic harm-reduction supplies including condoms, needle exchange programs, additional drug user treatment services, and the use of culturally- and gender-matched peer-led prevention and treatment outreach. Preliminary recommendations are made for consideration in HIV/AIDS prevention among African-American IDUs. [Translations are provided in the International Abstracts Section of this issue.]

Smurfing in Small Toxic Meth Labs: Impact of State Methamphetamine Precursor Policies

Over the past 12 years, 31 states have implemented a wide variety of policies to curb methamphetamine production in small toxic labs. This qualitative study explores the perceived impact of methamphetamine precursor laws in five states. Researchers conducted individual and focus group interviews with 77 key state policy makers and law enforcement personnel. Themes included barriers to development, perceived effectiveness and impact, effective provisions, and unintended consequences. Researchers suggest policy recommendations in light of renewed calls by policy makers and law enforcement personnel to address the recent rapid rise in small toxic lab seizures.

Parental influence on inhalant use

The purpose of this article is to examine the dynamics of the relationship between parents and their adolescent children and their association with lifetime and past-month inhalant usage. The population studied was seventh- through ninth-grade students in rural Idaho (N = 570). The authors found a small, but consistent, significant inverse correlation between parental bonding and monitoring of behavior and inhalant usage. There was also a significant positive correlation between verbally aggressive behavior in the family and inhalant use. The data imply that family interaction may play a significant role in the use of inhalants and that the family can play a major role in prevention.