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A one of the newest developments in research literature that has gained much trend and acceptance in the recent past is the idea which postulates that substance abuse treatment is more effective when competent issues such as culture and gender-specific considerations are taken into account. VanderWaal et. al (2001), for instance, argues that consideration of ethnicity and culture is vital for the treatment of young addicts or offenders. Juvenile drug courts are also considering the cultural and ethnic backgrounds of the young offenders for the effective rehabilitation and treatments (Drug Court Clearinghouse, 1997)
As a matter of tradition, gender-based issues were never considered in the juvenile justice system, and female juveniles were meant to fit into the programs that were meant for the delinquent boy-child. This was revised after some research indicated that the girls were more difficult to work with than the delinquent boys (Covington, 1988; Bloom and Covington,2001). The reason behind this could be that in most cases, delinquent girls were three times likely to be victims of sexual abuse than the boys. An approximate percentage of 70% of the girls in correctional facilities have been sexually abused making their correction issue intricate (Green et al, 1998).
Early 1990s saw an increase in the arrests, delinquency and incarcerations of girls than boys (Prescott, 1997). The part of this tendency was because the there was a higher probability of girls being arrested for less violent crimes than boys with the detention lasting up to about five times longer than for boys (Bloom and Covington, 2001). Girls are also observed to be more likely to commit offences related to substance-abuse and to be arrested (Covington, 1998). He also observed that therapeutic Center women lowered the use of amphetamines and heroin when they were followed up but abused more marijuana and cocaine than the women who were in the control group in prisons. Federal Bureau of prisons study showed that out of the 547 women under study, therapeutic centre treatment proved to be ineffective in reducing relapse or recidivism.
Farrell (2000) researched on 41 women who were undergoing a therapeutic center program and who were in transition in a community set-up and when he compared them to 37 women who had in work release programs, he found out that the therapeutic center women showed a lower rate in alcohol relapse but not for the other hard drugs like cocaine and heroin. The therapeutic center groups found it easier to get some social support from their communities but were unlikely to hold down jobs, take care of the children or have meaningful relationships with the other members of the society outside the support network program.
Women in the two groups reported that they felt discriminated against by the larger communities. While there was no difference in the rate of recidivism for the drugs by any group, the responsibility for their children was a significant predictor for women in either group for the sake of staying out of trouble. However, no information was available as to whether Therapeutic Center program provided programming that are gender-specific such as attention that was paid to earlier abusive exposures. Schinka et al (1999) had reported on the changes in moods and personality characteristics in the women who had been admitted to the therapeutic centers one year later, the women reported fewer depression tendencies and were less avoidant, dependent and self-defeating; however, therapeutic treatment had no effect on their antisocial behavior.
Strickland et al (2008) asserts that Community Correction is a general term that includes everything from pre-trial diversion up to intermediate punishment. This definition includes any non-incarcerative, but a well supervised manner of dealing with culprits who are facing conviction in the justice system or those who have already been convicted to serve their terms. Parole and Probation are the most utilized forms of community corrections exploited so far, but the term may also connote electronic monitoring, home confinement, work release, day fine programs, curfews, halfway houses, community services, restitution, community-based correctional facilities, and so on. A correction facility qualifies to be called community-based when the state provides the funds and the operation is done by the local communities. The community programs provide residential sessions that are intermediate at the end of a system between prison and probation
Community Corrections in Ohio refers to a system of specific facilities that provide residential and non-residential services to a convicted offender. These facilities receive state funds but are based in and operated by local communities. These programs provide an intermediate residential sanction at the front end of the system between probation and custodial sentence, called diversion, and re-integration of the services at the end of the system between parole and prison, often called transition (Burrell and English 2006).
Volkow (2008) says that studies that have been done are consistent in confirming that drug treatment works in that it has a multi-pronged approach; apart from reducing the drug use, the initiative also suppresses criminal behavior and recidivism. For drug-abusing persons, that underwent treatment, it facilitates successful acceptance and re entry into the society.
Grella et al (1999) asserts that women in the system of criminal justice have very different patterns of relationships as opposed to women who are free and are much more likely to been single at the rate of 46% of them. About 20% are currently married and about a third is either separated or divorced. However, about 70% of these women have at least one minor aged child and most of them usually retain custody of their children while they are incarceration. When it comes to a father being incarcerated, about 90% of their childrenââ‚¬â„¢s time, the mother will take care leading to little disruption in the normal upbringing of the child.
Ross and Lightfoot (1985) clearly point the main aim of detoxification is not rehabilitative but to obtain social and economic goals by getting intoxicated. It defines and gives new meaning to drunkenness as a medical condition that requires attention as opposed to a criminal justice problem that warrants incarceration thereby helps in reducing criminal justice costs to the state. Critics however fault the detoxification process that it lacks rehabilitation and follow-up services that they lead to the revolving door phenomenon (Addiction Research Foundation: 1994). This research evidence shows that detoxification procedures may be helpful in the short period but not a long term to help individuals to withdraw temporarily from alcohol. It may be considered as a first step towards the long-term treatment to produce along lasting behavior change this may only work in alcohol since most drug users resort to detoxification procedures just to bring down their tolerance levels in order not to use much money but not to exit drugs. The detoxification centers also have a small budget that may disable them from making effective referrals.
The relationship between the drug use and crime rate has driven many state and federal governments into coercive treatment programs within the United States. The National Institute on Drug Abuse and the National Institute of Justice have supported projects of coercive treatments since the mid-1970s, merely because there is a connection between drugs and crime. Prevalence of drugs in the streets enhances the criminal careers. A look at the correctional facilities reveal that 83% of the state prisoners had previous records of drug abuse and 57% reported using the drugs in the month before they committed the crimes BJS, 1998) ADAM ( Arrestee Drug Abuse Monitoring Program) has reliably reported that between about 50 ââ‚¬" 82 % of the males in major urban areas test positive for drugs, confirming beyond the shadow of doubt that drug and crime are related(ADAM annual Report, 1998). Coerced treatment, which was based on the relationship between the drug use and crime, did not escape controversy and as the court used authority to within the criminal justice system to force addicts to community centers. The National Institute on Drug Abuse director, when addressing Federal Bar Association in 1977 proposed setting a urine testing scheme for users those who had undergone probation and parole. That if one failed the test and seemed not to stop using heroine; he would be referred to compulsory drug abuse treatment center for re-incarceration. In spite of this controversy, Leukfield, (1985), supported this concept on the account of the number of crimes that were related to substance abusers.
During the incarceration in the community correction centers, education about adverse and long-term effects of alcohol and drug use should be given to the participants on the pretext that that they lack accurate knowledge about their deviant actions and effects (Marlatt et al, 1986). Although this is debatable, there is proof to insinuate that abusers are unknowledgeable about the negative repercussions of substance or alcohol use compared to non-users ( Senn, 1983). The assumption is that an increase in the awareness of problems that accompany alcohol and drug use may change their attitudes toward use of these substances.
The inclusion of alcohol and drug education is a vital component of most drug and alcohol abuse interventions, for both the users and non-user. (Montagne et al, 1992). This education can be offered as a preventive measure to beginners of abuse of substances of to the vulnerable group to save the future generations from the menace and the whole society from the drugââ‚¬â„¢s association with crime. Alternatively, it should be offered to be taught as part of the educational curriculum in schools
Recent literature reviews have not found enough evidence to convince many researchers that drug and alcohol awareness programs have great impact on changing substance and drug use, attitude and behavior (Eliany et al, 1993). Although it is of great effort, it has been observed that education alone is not enough to change the actual behavior of alcohol and drug use (Tobler et al1976), in the actual examination of the efficiency of education, the challenge is to establish change in knowledge, attitudes and actual behavior leaving us with treatment of substance abuse as the most effective way of reversing the effects of addiction as Montagne (1982) writes.
Leukefeld & Bukoski (1991) reiterate that most people still lack knowledge and understanding or appreciation for three domains and that research does not explain what, and how much of what, that the people learn in one domain that influences another domain and as Montagne et al (1993) and others have implied, the evaluation of the efficiency of a research process should be found to be coinciding with a program goal. Where it comes to drug and substance education, if the stated purpose is to impact on knowledge, skills and attitudes, then these are the domains to be evaluated and measured by the one who imparts education process but not drug and alcohol using behavior. Alternatively, if the goal of education is always to change behavior though reinforced practice, then actual use of drugs or alcohol should be the outcome to be examined through an empirical means that would be acceptable to most researchers.
Senn (1983) assessed the impact this type of education of abuse as a component of an aftercare program with a group of former substance abusers, half of whom had been incarcerated and undergone treatment in community correction centers. They participated in a university drug and substance abuse awareness and education program. Results, when evaluated showed a tremendous increase in the knowledge on effects of drug and alcohol, a significant decrease in drug and alcohol use attitudes, but not major reductions in actual drug use. It was therefore inferred by Senn that education should be offered to abusers of substances with the intention of changing their knowledge and attitudes, as opposed to attempting to influence drug and alcohol use using behavior.
In a prison Education Program offered by Simon Fraser university, Druguid (1987) reported that the beneficiaries of the program, who were the drug-involved offenders, received education whose content was not solely on drug and alcohol but included all on-campus activities that were offered at the liberal arts colleges. When evaluation was done, a comparison was done between 65 student inmates to 65 non-student inmates and it shoed that about 50 % of the non-student inmates returned to prison while only about 16% of the student inmates returned there within two years. Druguid says that although the return to drug and knowledge of on substance use were not analyzed, the educational program contributed to a notable impact on the post-release success for the inmates.
A literature on rural drug treatment utilization shows that few studies have illuminated this issue. For example Robertson and Donnermeyer( 1998) used data fro m the National Household Survey on Drug Abuse(HNSDA) and reported that about 5.6 % on non-metropolitan and rural illegal substance abusers presented themselves to seek treatments as opposed to 6.6 % of the other drug users in the HSDA. The other data from National Longitudinal Alcohol Epidemiologic survey suggests no differences between the urban and rural forks in terms of probability to seek treatment.
A literature by Frohling (1989) indicates that jail and prison populations have grown at an alarming rate in the past many years as result of new convicts. He goes ahead to give the statistical information that 62% of State and Federal prisoners report drug use prior confinement. He adds that the data available from Drug Use Forecasting ( DUF) indicates that over 70% of the arrestees in metropolitan areas test positive for illegal substances.( U.S Department for Justice, 1989)
Twentyman et al (1982) observe that in alcoholics that are usually in correctional centers, they usually have low assertive skills. Therefore in all those undergoing treatment for substance abuse related complications, assertion training is normally recommended to give the best results to help them respond in difficult situations. The argument that training will address the deficiencies in assertiveness to curb drinking tendencies in alcoholics and to help them reform is an observation also made by Brown et al (1986), but for the drug users, the investigations are lacking to prove the same issue of lack of assertiveness affects them. This kind of training has only been performed on sampled drinkers but has also not been done on for other drug users and it is included as part of the curriculum for the treatment of those with alcohol addiction in the community correctional centers with an intention of making them regain the power of assertion.
Ferrell and Galassi (1981) researched on the effects of either assertion training or human relations training, to the existing addicts in a normal correctional treatment program with view to reducing drinking and improvement of their interpersonal skills. Among those who were being studied had skill-deficiency or were chronic alcoholics. The Results pointed out that although the two types of treatments led to a comparable sobriety within a 6-week period, the group which was subjected to assertion training had demonstrated remarkable improvement in interpersonal skills as compared to the group which was subjected the human relations training procedure. When a follow-up was done two years later, the results indicated that assertion training group was sober significantly longer than their counterparts in human relations training.
Rist and Watzl (1983), while researching, took a sample of female alcoholics, before and after skills training, in social drinking situations , on how hard it would be for them not to accept a drink offered to them (relapse risk) and on how uncomfortable they would feel in such situations (specific assertiveness). The patients who experienced relapse after three months reported such the situations as difficult to deal with and more uncomfortable than those abstaining patients. Further analyses revealed that the relapse risk affected the two outcome groups than specific assertiveness, thereby creating a general efficiency expectation seen in relation to patients' belief in being able to abstain, that has already been stated at admission.
In a recent study by Pfost et al. (1992), he examined three results of the assertion training that most people consider to be relevant to alcohol addicts: assertive behavior in some negative situations and discomfort experienced in such negative situations which require for assertive behavior; and expectations of assertive tendencies in sober or intoxicated situation. these findings showed that most alcoholics had acquired assertive skills in negative scenarios but less discomfort in such situations, he then believed that intoxication led them to more assertiveness. He found it discouraging that assertion training did not considerably reduce discomfort on the sample alcoholics in negative situations. The training also failed to reduce discrepancy between the views of assertiveness in sober as compared to intoxicated states in a follow up after six weeks.
In summary, as (Chaney, 1989) puts it, assertion training has made considerable gains that improve the tendency of alcoholics to respond well to interpersonal challenges with assertiveness as opposed to drinking behavior. Although the debate as whether the training has impacted positively on increased assertiveness, it has been approved that assertive behavior is usefully critical in a chronic population whose profile can block recovery. Although similar information is lacking for the treatment of drug abusers, it is potential to argue that the same situations are faced by drug use and can be addressed through assertion training in the same way as alcohol training.
Darke et al (1998) content that correctional centers favor high risks regarding drugs use since overcrowding and high population concentrations promote violent behavior. The consequences of use of drugs in confinements include related drug deaths, suicide attempts and self harm. Drug use in prison or correctional centers if not checked may be more harmful as some drugs are sometimes sneaked in such facilities where there are unhygienic injecting equipment. In their study of 492 Injectible Drug Users (IDUs), 70.5 % reported to be sharing needles while in incarcerations compared to the 45.7% who shared needles before confinements. Of particular concern was the rate of human immune deficiency Virus (HIV) transmission. In another study taken in Australia, Hepatitis C virus infection that was through sharing of needles was reported. Drug use in treatment centers has always been associated with high rate of involvement with violence as the number of the inmates who were being subjected to disciplinary actions over violence rose. Even after facing long incarceration as a matter of discipline the inmates still elicited hostility towards the prison staff ( Kaye et al (1998).
According to Kastelic et al (2008), unless a confined patient receives elaborate treatment, drug use and dependence and their potential dangers persist even after the release of such patient from the correctional center into the community and are often associated with overdose and other harms. In overall, the major cause of deaths in drug dependent patients soon after release from the correctional centers is associated with the tolerance to opioids. He states that 90% of these deaths are drug related.