Spence Nicholas R, Crawford April, LePage James P
Dallas VA Research Corporation, USA.
VA North Texas Health Care System, USA.
Subst Abuse. 2020 Aug 31;14:1178221820947082. doi: 10.1177/1178221820947082. eCollection 2020.
Formerly incarcerated military veterans-comprising approximately 8% of the prison population-experience significant barriers to reentry including homelessness, mental illness, and mortality. One of the most consequential barriers is relapsing into substance use. Most justice-involved veterans (JIV) possess histories of substance abuse before imprisonment, and this rate continues upon release. Mental illness-depression in particular-is often comorbid with substance abuse. With high rates of depression and substance use in a JIV population, it is important to determine to what extent release from prison contributes to predicting substance use and negative clinical outcomes. This study compares rates of substance use and negative outcomes between two matched samples of JIV and general veterans, both with depression and a substance use disorder. It is hypothesized that JIV will have a higher rate of substance use and that use will be associated with higher negative outcomes in the JIV condition. Rates of use of veterans released from prison and general veterans were collected during six-year follow-up periods. Use was defined as the use of an illicit substance or alcohol, if an alcohol use disorder was present, and determined by urine drug tests or self-report recorded in medical notes. Results indicate that JIV used substances at a higher rate compared to those not recently incarcerated, and that such use is predictive of several other negative outcomes including homelessness, use of inpatient substance treatment, and reincarceration. Structured drug treatment programs and other interventions should cater to veterans recently released from prison to offer help in these areas.
曾经入狱的退伍军人约占监狱人口的8%，他们在重新融入社会时面临重大障碍，包括无家可归、精神疾病和死亡率。其中最严重的障碍之一是重新染上药物滥用问题。大多数涉及司法系统的退伍军人（JIV）在入狱前就有药物滥用史，而且出狱后这一比例仍在持续。精神疾病，尤其是抑郁症，往往与药物滥用并发。鉴于JIV人群中抑郁症和药物使用的高发生率，确定出狱在多大程度上有助于预测药物使用和负面临床结果非常重要。本研究比较了两组匹配的JIV和普通退伍军人样本中药物使用情况和负面结果，这两组样本均患有抑郁症和药物使用障碍。研究假设JIV的药物使用率会更高，并且在JIV情况下，药物使用将与更高的负面结果相关。在六年的随访期内收集了出狱退伍军人和普通退伍军人的药物使用率。如果存在酒精使用障碍，使用被定义为使用非法药物或酒精，并通过尿液药物检测或医疗记录中的自我报告来确定。结果表明，与最近未入狱的人相比，JIV的药物使用率更高，而且这种使用可预测其他几种负面结果，包括无家可归、住院药物治疗的使用和再次入狱。结构化药物治疗项目和其他干预措施应面向最近出狱的退伍军人，在这些方面提供帮助。
