Tim McSweeney

The Relationship between Legal Status, Perceived Pressure and Motivation in Treatment for Drug Dependence: Results from a European Study of Quasi-Compulsory Treatment

This paper reports on intake data from Quasi-Compulsory Treatment in Europe, a study of quasi-compulsory treatment (QCT) for drug dependent offenders. It explores the link between formal legal coercion, perceived pressure to be in treatment and motivation amongst a sample of 845 people who entered treatment for drug dependence in five European countries, half of them in quasi-compulsory treatment and half ‘voluntarily’. Using both quantitative and qualitative data, it suggests that those who enter treatment under QCT do perceive greater pressure to be in treatment, but that this does not necessarily lead to higher or lower motivation than ‘volunteers’. Many drug-dependent offenders value QCT as an opportunity to get treatment. Motivation is mutable and can be developed or diminished by the quality of support and services offered to drug-dependent offenders.

The Victimization of Dependent Drug Users Findings from a European Study, UK

This article contributes to the literature on drug users, victimization and offending using data on 545 dependent drug users entering treatment in four European countries. Members of the sample were exposed to high levels of criminal victimization. Sub-groups who were particularly vulnerable to crime were women (and especially sex workers), the homeless, recent offenders and those with a history of poor mental health. Multivariate analysis indicated that frequent drug use, recent offending and histories of depression and anxiety were significantly predictive of violent victimization, and only gender and a history of anxiety were significantly predictive of property victimization. The article discusses how these findings relate to theoretical approaches to victimization, in both positivist and critical frameworks.

Comparing outcomes of ‘voluntary’ and ‘quasi-compulsory’ treatment of substance dependence in Europe

Aim: This study evaluates quasi-compulsory drug treatment (QCT) arrangements for substance-dependent offenders receiving treatment instead of imprisonment in comparison to voluntary treatment within five European countries. Methods: Participants were interviewed with the European Addiction Severity Index, the ASI-crime module, questions on perception of pressure and self-efficacy, and the Readiness-to-Change Questionnaire at treatment entry and after 6, 12, and 18 months. Results: Reductions in substance use and crime as well as improvements in health and social integration were observed in QCT and voluntary treatment groups. After controlling for various factors, subjects in the QCT and the comparison group showed similar reductions in substance use and crime over time. Study retention was comparable in both groups. Conclusion: QCT is as effective as voluntary treatment provided in the same services in reducing substance use and crime.

Drug testing and court review hearings: uses and limitations

The ability of the UK criminal justice system to divert drug-dependent offenders into treatment has been enhanced during recent years. Despite the rapid expansion of such coercive measures, research findings to date are equivocal about their impact. This article draws on qualitative data from in-depth interviews with professionals and those mandated to treatment by the courts to assess the uses and limitations of two defining features of court-ordered drug treatment in Britain and elsewhere — drug testing and court review hearings — as a means of promoting and monitoring compliance with the conditions of these disposals.

Predictors of Retention in the ‘Voluntary’ and ‘Quasi-Compulsory’ Treatment of Substance Dependence in Europe

Background: Policies and practices related to the quasi-compulsory treatment (QCT) of substance-dependent offenders are currently implemented in many countries, despite the absence of reliable knowledge about significant predictors of treatment retention. This study aimed to identify such predictors in QCT and voluntary treatment. Methods: Participants were treated in one of 65 institutions in 5 European countries. They were interviewed at intake on substance use, crimes committed, perceived pressure for treatment, self-efficacy, stage of change, employment, and health-related variables. Binary logistic regression models were computed to identify predictors of treatment retention at an 18-month follow-up. Moderator analyses were computed to investigate whether these predictors vary by treatment condition (QCT vs. voluntary). Results: A higher number of working days in the previous month was positively associated with treatment retention, while use of heroin, crack, and multiple drugs, psychiatric problems in the previous month, and lifetime depression were negatively associated with treatment retention. Higher perceived medical pressure resulted in higher treatment retention rates only for participants in QCT. Conclusion:Predictors of substance abuse treatment retention are quite similar across both QCT and voluntary treatments. Perceived medical pressure is of higher relevance than the often-believed legal pressure for treatment retention in QCT.