Kiluk Brian D, Serafini Kelly, Malin-Mayor Bo, Babuscio Theresa A, Nich Charla, Carroll Kathleen M
Yale University School of Medicine, New Haven, Connecticut.
Am J Addict. 2015 Apr;24(3):225-232. doi: 10.1111/ajad.12208. Epub 2015 Mar 24.
A substantial portion of individuals entering treatment for substance use have been referred by the criminal justice system, yet there are conflicting reports regarding treatment engagement and outcome differences compared to those not referred. This study examined baseline characteristic and treatment outcome differences among cocaine-dependent individuals participating in cocaine treatment randomized trials.
This secondary analysis pooled samples across five completed randomized controlled trials, resulting in 434 participants. Of these, 67 (15%) were prompted to treatment by the criminal justice system.
This subsample of criminal justice prompted (CJP) individuals did not differ from those not prompted by the criminal justice system in terms of gender, race/ethnicity, marital status, or age. However, the CJP group reported more years of regular cocaine use, more severe employment and legal problems, as well as less readiness to change prior to treatment. Treatment outcomes did not differ significantly from those without a criminal justice prompt, and on some measures the outcomes for CJP group were better (e.g., percentage of days cocaine abstinent, number of therapy sessions attended).
These findings suggest that being prompted to treatment by the criminal justice system may not lead to poorer treatment engagement or substance use outcomes for individuals participating in randomized controlled treatment trials.
Despite some baseline indicators of poorer treatment prognosis, individuals who have been prompted to treatment by the criminal justice system have similar treatment outcomes as those presenting to treatment voluntarily.
相当一部分接受物质使用治疗的人是由刑事司法系统转介而来的，但与未被转介的人相比，关于治疗参与度和结果差异的报告存在冲突。本研究调查了参与可卡因治疗随机试验的可卡因依赖个体的基线特征和治疗结果差异。
这项二次分析汇总了五项已完成的随机对照试验的样本，共有434名参与者。其中，67人（15%）是由刑事司法系统促使接受治疗的。
在性别、种族/民族、婚姻状况或年龄方面，这个由刑事司法系统促使接受治疗（CJP）的子样本与未被刑事司法系统促使接受治疗的个体没有差异。然而，CJP组报告有更长时间的定期使用可卡因情况、更严重的就业和法律问题，以及在治疗前改变的意愿较低。治疗结果与没有刑事司法系统促使的个体没有显著差异，并且在一些指标上CJP组的结果更好（例如，可卡因戒断天数的百分比、参加治疗课程的次数）。
这些发现表明，对于参与随机对照治疗试验的个体而言，由刑事司法系统促使接受治疗可能不会导致较差的治疗参与度或物质使用结果。
尽管有一些治疗预后较差的基线指标，但由刑事司法系统促使接受治疗的个体与自愿接受治疗的个体有相似的治疗结果。
