Featured Review: Interventions for drug-using offenders

Can pharmacological and mental health interventions reduce drug use and criminal activity among drug-using offenders?

Offenders with co-occurring mental health or drug-use problems demonstrate significant subsequent health problems and make rehabilitation particularly challenging. The link between drug use, health, social and criminological consequences is well documented. Offenders have a high risk of death from opioid overdose within two weeks of release from incarceration. Approximately 30% of acquisitive crime is committed by individuals supporting drug use with the use of criminal acts. As well, a greater proportion of mentally ill people are arrested compared with the general population.

A team of Cochrane authors based in the United Kingdom worked with the Cochrane Drugs and Alcohol Group to determine whether pharmacological treatment for drug-using offenders and intervention for co-occurring mental illness reduces drug use and criminal activity of offenders. The authors chose interventions if they had outcome measures of crime and/or drug use and described the mental health aspects of the population; interventions did not necessarily have to be mental health interventions.

The team reviewed 14 trials with 2647 participants involving pharmacological interventions, as well as eight trials with 2058 participants focusing on mental illness interventions. When compared to non-pharmacological treatment, drug treatments did not seem effective in reducing drug use, but did significantly reduced criminal activity. When comparing the drugs to one another, researchers noted no significant differences between the drug comparisons. Overall, the mental health interventions reported limited success with reducing self-reported drug use; they did report some success with reducing re-incarceration rates, but not re-arrests.

 “The findings suggest that mental health programmes and pharmacological interventions can help reduce criminal activity and re-incarceration rates, but limited success with reducing drug use,” said Amanda Perry, a researcher at the University of York in the United Kingdom and lead author of both Cochrane Reviews. “Findings were limited to mainly to male adult offenders. It’s important that future research investigates a variety of possible intervention programmes, with varied offender populations.”

Read the full Cochrane Review on pharmacological interventions for drug-using offenders

Read the full Cochrane Review on interventions for drug-using offenders with co-occurring mental illness

Tuesday, June 2, 2015