Reductions In Criminal Behavior Research Articles

Randomised controlled trial of the short-term effects of OROS-methylphenidate on ADHD symptoms and behavioural outcomes in young male prisoners with attention-deficit/hyperactivity disorder (CIAO-II)

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is a highly prevalent disorder, seen in 20–30% of young adult prisoners. Pharmacoepidemiological studies, a small randomised controlled trial and open trial data of methylphenidate suggest clinically significant reductions in ADHD symptoms, emotional dysregulation, disruptive behaviour and increased engagement with educational activities. Yet, routine treatment of ADHD in offenders is not yet established clinical practice. There is continued uncertainty about the clinical response to methylphenidate (MPH), a first-line treatment for ADHD, in offenders, who often present with an array of complex mental health problems that may be better explained by states of inattentive, overactive, restless and impulsive behaviours. To address this problem, we will conduct an efficacy trial to establish the short-term effects of osmotic-controlled release oral delivery system (OROS)-methylphenidate (Concerta XL), an extended release formulation of MPH, on ADHD symptoms, emotional dysregulation and behaviour.MethodsThis study is a parallel-arm, randomised, placebo-controlled trial of OROS-MPH on ADHD symptoms, behaviour and functional outcomes in young male prisoners aged 16–25, meeting Diagnostic and Statistical Manual of Mental Disorders, fifth edition criteria for ADHD. Participants are randomised to 8 weeks of treatment with OROS-MPH or placebo, titrated over 5 weeks to balance ADHD symptom improvement against side effects. Two hundred participants will be recruited with a 1:1 ratio of drug to placebo. The primary outcome is change in level of ADHD symptoms after 8 weeks of trial medication.DiscussionPotential benefits include improvement in ADHD symptoms, emotional dysregulation, attitudes towards violence and critical incidents and increased engagement with educational and rehabilitation programmes. Demonstrating the efficacy and safety of MPH on ADHD symptoms and associated impairments may provide the data needed to develop effective healthcare pathways for a significant group of young offenders. Establishing efficacy of MPH in this population will provide the foundation needed to establish long-term effectiveness studies with the potential for demonstrating significant reductions in criminal behaviour and improved health-economic outcomes.Trial registrationISRCTN registry, ISRCTN16827947, 31st May 2016; EudraCT number, 2015-004271-78, 31st May 2016. Last particpant last visit 6 June 2019. Data lock 27 August 2019.

Different Social Influences and Desistance From Crime

Desistance from crime has been associated with numerous social influences. Although researchers have explored different theoretical rationales and underlying mechanisms between external social developments and individual changes in behavior, little focus has been given to the individual versus cumulative influences, and social complexities, of different informal controls influencing reduction in criminal behavior. The current study explores the individual and combined impact of marriage and employment on arrest using 17 years of monthly level data from the National Longitudinal Survey of Youth (1997). The results address isolated and cumulative influences of each social control on arrest and provide insight into the relevance of acknowledging the complexities of social events developing over time.

Mental Health Services and Public Safety: Substance Abuse Outpatient Visits Were Associated with Reduced Crime Rates in a Swedish Cohort.

Substance abuse is related to offending and substance abuse treatment has been associated with reductions in criminal behavior. This cohort study aimed to explore the relationship between participation in substance abuse interventions and general criminal recidivism among offenders with a combination of mental health problems and substance use problems. In total, 150 Swedish offenders with self-reported mental health and substance use problems were followed for approximately three years with regard to participation in substance abuse interventions and criminal recidivism. Participants with at least three planned visits to specialized outpatient substance abuse clinics had a substantially reduced risk of reoffending as compared to those with fewer than three such visits (HR = 0.47, 95% CI 0.29–0.77). For those with at least three planned visits, general criminal recidivism was reduced by 75% during periods of participation in outpatient visits, as compared to periods of non-participation (HR = 0.25, 95% CI 0.11–0.60). For offenders with mental health problems and substance use problems, outpatient substance abuse interventions could be regarded as important from a clinical risk management perspective, and be encouraged.

Exploring Outcomes to Consider in Economic Evaluations of Health Promotion Programs: What Broader Non-Health Outcomes Matter Most?

BackgroundAttention is increasing on the consideration of broader non-health outcomes in economic evaluations. It is unknown which non-health outcomes are valued as most relevant in the context of health promotion. The present study fills this gap by investigating the relative importance of non-health outcomes in a health promotion context.MethodWe investigated the relative importance of ten non-health outcomes of health promotion programs not commonly captured in QALYs. Preferences were elicited from a sample of the Dutch general public (N = 549) by means of a ranking task. These preferences were analyzed using Borda scores and rank-ordered logit models.ResultsThe relative order of preference (from most to least important) was: self-confidence, insights into own (un)healthy behavior, perceived life control, knowledge about a certain health problem, social support, relaxation, better educational achievements, increased labor participation and work productivity, social participation, and a reduction in criminal behavior. The weight given to a particular non-health outcome was affected by the demographic variables age, gender, income, and education. Furthermore, in an open question, respondents mentioned a number of other relevant non-health outcomes, which we classified into outcomes relevant for the individual, the direct social environment, and for society as a whole.ConclusionThe study provides valuable insights in the non-health outcomes that are considered as most important by the Dutch general population. Ideally, researchers should include the most important non-health outcomes in economic evaluations of health promotion.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-0908-y) contains supplementary material, which is available to authorized users.

The National Treatment Outcomes Research Study (NTORS) and its influence on addiction treatment policy in the United Kingdom.

This paper describes the political origins of the National Treatment Outcomes Research Study (NTORS) and the outputs and impacts of the study. NTORS was designed to meet the request of the Health Secretary and of a Government Task Force for evidence about the effectiveness of the national addiction treatment services. NTORS was a prospective cohort study which investigated outcomes over a 5-year period of drug users admitted to four major treatment modalities: in-patient treatment, residential rehabilitation, methadone reduction and methadone maintenance programmes. The study investigated treatments delivered under day-to-day operating conditions. Outcomes showed substantial reductions in illicit drug use and reduced injecting risk behaviours. These changes were accompanied by improved psychological and physical health and by reductions in criminal behaviour. However, not all outcomes were so positive. There was a continuing mortality rate in the cohort of about 1% per year, and many clients continued to drink heavily throughout the 5-year follow-up. NTORS findings informed and influenced UK addiction treatment policy both at the time and subsequently. The findings were influential in supporting an immediate increase in funding for treatment, and Government Ministers have repeatedly cited NTORS as evidence of the effectiveness of addiction treatment. One finding that received political attention was that of the cost savings provided by treatment through reductions in crime. This important finding led to an unanticipated consequence of NTORS; namely, the greater focus on crime reduction that has increasingly been promoted as a political and social priority for drug misuse treatment.

CHANGES IN CRIMINAL OFFENDING AROUND THE TIME OF JOB ENTRY: A STUDY OF EMPLOYMENT AND DESISTANCE

Does employment promote desistance from crime? Most perspectives assume that individuals who become employed are less likely to offend than those who do not. The critical issue has to do with the timing of employment transitions in the criminal trajectory. The turning point hypothesis expects reductions in offending after job entries, whereas the maturation perspective assumes desistance to have occurred ahead of successful transitions to legitimate work. Focusing on a sample of recidivist males who became employed during 2001–2006 (N = 783), smoothing spline regression techniques were used to model changes in criminal offending around the point of entry to stable employment. Consistent with the maturation perspective, the results showed that most offenders had desisted prior to the employment transition and that becoming employed was not associated with further reductions in criminal behavior. Consistent with the turning point hypothesis, we identified a subset of offenders who became employed during an active phase of the criminal career and experienced substantial reductions in criminal offending thereafter. However, this trajectory describes less than 2 percent of the sample. The patterns observed in this research suggest that transition to employment is best viewed as a consequence rather than as a cause of criminal desistance.

Criminal Behavior in Opioid‐Dependent Patients Before and During Maintenance Therapy: 6‐year Follow‐Up of a Nationally Representative Cohort Sample

Lifetime prevalence of opioid dependence is about 0.4% in western countries. Opioid-dependent patients have high morbidity and mortality and a high risk of criminal behavior. Few studies have addressed the long-term impact of opioid maintenance therapy on convictions and criminal behavior. The PREMOS study is a prospective, longitudinal, naturalistic clinical study of a nationally representative sample of 2694 opioid-dependent patients to investigate convictions and criminal behavior at baseline and after 6 years of maintenance treatment. At follow-up, 2284 patients still were eligible (84.7%). A comprehensive assessment including a patient and doctor questionnaire, and the EuropASI was completed at baseline and follow-up. Data on criminality at follow-up had been received for 1147 (70.6%) patients. A large number (84.5%) of them had been charged or convicted at any time before baseline assessment, most frequently with drug-related offenses (66.8%), acquisitive crime (49.1%), or acts of violence (22.0%). Reported charges and convictions had declined to 17.9% for the last 12 months before follow-up, which was also reflected by a significant decrease in the EuropASI subscore "legal problems" from 1.52 at baseline to 0.98 after 6 years. These data indicate a significant and clinically relevant reduction in criminal behavior in opioid-dependent patients in long-term maintenance treatment. Maintenance therapy is effective in the reduction in both narcotics-related and acquisition crime.

Parenthood and crime: The role of wantedness, relationships with partners, and ses

Purpose Parenthood may play a pivotal role in the criminal desistance process, but few studies have examined the conditions under which becoming a mother or father is most likely to lead to reductions in criminal behavior. Methods The current longitudinal study draws on four waves of adolescent and young adult interview data (N = 1,066) and HLM regression models to examine the impact of parenthood on criminal trajectories, as well as the degree to which the prosocial potential of parenthood is modified by socioeconomic factors, the nature of the relationship between the biological parents, and pregnancy wantedness. The analysis also draws on narrative life history accounts elicited from a subset of these respondents (N = 22). Results SES and the wantedness of the pregnancy condition the relationship between parenthood and criminal involvement, however some gender differences emerged. Status of the relationship (married or cohabiting and single) was in general not a strong predictor. Conclusions Highly disadvantaged young men and women are not as likely as more advantaged young adults to evidence lower levels of criminal behavior after becoming parents, however wanted pregnancies may reduce female involvement in crime regardless of socioeconomic status. In-depth qualitative data further elucidate the conditional nature of the parenthood-crime relationship.

Effects of drug substitution programs on offending among drug‐addicts

Drug abusers are generally more involved in crime, in particular property crime, than people who are not drug abusers. Substitution programs have been developed in order to improve drug users' quality of life and to decrease their criminal involvement. Several evaluations, but not all, have reported crime reductions following substitution therapies based on heroin and methadone prescription. This systematic review is aimed at gaining an overall picture on the respective effects of prescription of methadone vs. heroin and other substances.66 studies were considered, and 46 were selected for inclusion in the review. They separately assess the impact of methadone, buprenorphine, heroin, naltrexone, dihydrocodeine or Levo alpha‐acetylmethadone substitution on the criminal behaviour of opiates addicts. Meta‐analytic techniques were used to identify overall effects of several substances.Heroin maintenance has been found to significantly reduce criminal involvement among treated subjects, and it is more effective in crime reduction than methadone maintenance. Methadone maintenance greatly reduces criminal involvement, but apparently not significantly more so than other interventions. Buprenorphine and Naltrexone have been found to be promising, although few studies have been identified using these substances in maintenance treatment.Executive Summary/AbstractBACKGROUNDDrug abusers are generally more involved in crime, in particular property crime, than people who are not drug abusers. Substitution programs have been developed in order to improve drug users’ quality of life and to decrease their criminal involvement. Several evaluations, but not all, have reported crime reductions following substitution therapies based on heroin and methadone prescription.OBJECTIVESThis systematic review is aimed at gaining an overall picture on the respective effects of prescription of methadone vs. heroin and other substances.Search strategy: Six databases (Medline, Campbell Crime and Justice Group, National Criminal Justice Reference Service, National Treatment Agency for Substance Misuse, JSTOR and Criminal Justice Abstracts) as well as relevant journals and websites (Harm reduction Journal, Journal of Substance Abuse Treatment, Drug and Alcohol Dependence, Drug and Alcohol Review, Drug and Therapeutics Bulletin, International Journal of Drug Policy, Journal of Clinical Psychopharmacology, Déviance et Société, Criminal Justice and Behavior, Criminologie, www.heroinstudie.de and www.drugscope.org.uk) have been searched for relevant studies meeting the inclusion criteria.SELECTION CRITERIATo be eligible, studies had to assess the effects of any substitution therapy (using e.g. methadone and/or opiates as substitution drugs). Only effects on offending have been considered. Comparisons of competing treatments (substitution therapy vs. any other form of treatment, including placebo treatment or no treatment at all) were restricted to studies meeting level 4 or higher on the scale developed by Sherman et al. (1997). In addition, one‐group pre‐post evaluations of substitution therapies were included because changes in offending are substantial compared to pre‐treatment levels, while comparisons of treatment with several substances often show modest differences. Finally, studies that assessed the impact of drug substitution at the macro (i.e. city or regional) level were also included. The three different types of studies have been analyzed separately.DATA COLLECTION AND ANALYSIS66 studies were considered, and 46 were selected for inclusion in the review. They separately assess the impact of methadone, buprenorphine, heroin, naltrexone, dihydrocodeine or Levo‐alpha‐acetylmethadone substitution on the criminal behaviour of opiates addicts. Meta‐analytic techniques were used to identify overall effects of several substances. Comparisons of different treatments (i.e. substitution vs. any other treatment) were restricted to studies meeting levels 4 or 5 on the scale developed by Sherman et al. (1997).MAIN RESULTSHeroin maintenance reduces crime significantly more than Methadone maintenance. Methadone maintenance reduces offending more than treatments without substitution therapy, but the mean effect size is not significant (p >.1). However, very large (and significant) reductions in criminal behaviour are observed during methadone maintenance therapy with respect to pre‐treatment levels. Buprenorphine does not significantly reduce criminal behaviour, although effects are positive, be it with respect to methadone or a placebo. Naltrexone treatment reduces criminality significantly more than behaviour therapy or counselling.CONCLUSIONHeroin maintenance has been found to significantly reduce criminal involvement among treated subjects, and it is more effective in crime reduction than methadone maintenance. Methadone maintenance greatly reduces criminal involvement, but apparently not significantly more so than other interventions. Buprenorphine and Naltrexone have been found to be promising, although few studies have been identified using these substances in maintenance treatment.

Modified Therapeutic Community Treatment for Offenders with Co-Occurring Disorders

This paper examines outcomes 12 months post-prison release for offenders with co-occurring disorders (n = 185) randomly assigned to either a mental health control treatment (C) or a modified therapeutic community (E). Significant between-group differences were not found for mental health measures, although improvements were observed for each group. Reductions in criminal behavior were associated more with substance use than improvements in mental health symptoms, supporting the primacy of substance abuse treatment in affecting recidivism. Additional study of this population is needed to describe the relationships among diagnostic subgroups, as well as change in substance use and in mental health symptoms.

Evaluation of the Breaking the Cycle Demonstration Project: Jacksonville, FL and Tacoma, WA

This research presents the results of the evaluation of the Breaking the Cycle (BTC) demonstration project in Jacksonville, FL and Tacoma, WA. The BTC demonstration project tested the feasibility and impact of system-wide intervention designed to reduce drug use among offenders. Specifically, the BTC model was designed to identify drug using felony defendants and then apply a combination of drug testing linked to graduated sanctions and drug treatment to promote abstinence among these defendants. The evaluation of BTC revealed that certain elements of the intervention might not be feasible. However, the results of the quasi-experimental impact evaluation discovered that, in spite of partial program implementation, participation in BTC was associated with reductions in criminal behavior.

Walpole Study of the Transcendental Meditation Program in Maximum Security Prisoners III

Part III of the Walpole Prison Study builds on the earlier longitudinal and cross-sectional findings in Parts I and II that reported reduced psychopathology and accelerated psychological development in members of the Transcendental Meditation1 prison program. Part III is a retrospective investigation of recidivism among 286 inmates released from Walpole prison, who were followed for up to 59 months. The sample comprised all subjects from the following sources who had been released six months prior to data collection: (a) all inmates who had learned the TM program at Wal-pole; (b) random samples of four other prison programs at Walpole (counseling, drug rehabilitation, Christian, and Muslim); (c) a random sample of the Walpole inmate population; and (d) subjects who were tested longitudinally in the prior Walpole studies. The rate of return to prison for a stay of 30 days or more was 32% among inmates who practiced the TM technique compared to 48% for a combined control group comprised of members of four other prison programs. This represented a proportionate reduction in recidivism of 33%, which was statistically significant (p = .042). Separate comparisons showed that the TM group also had lower reincarceration rates than each of the four other programs, with proportionate reductions in recidivism ranging from 29% to 42% (p = .007 to .073). In addition, the TM group compared to all non-meditating subjects had a lower rate of reincarceration due to new convictions (47% lower, proportionately; p = .045) and a 27% proportionately lower rate of reincarceration/warrant for arrest (p = .069). The pattern of reduced recidivism for TM program members was maintained in multiple regression analyses, controlling for background and release variables (e.g., parole vs. full discharge, institution of release, drug history). These findings are consistent with the proposition that the reduced psychopathology and accelerated psychological development resulting from the TM program are responsible for reductions in criminal behavior.

An Examination of an Intensive Probation Program for Alcohol Offenders

Judicial treatment programs that surpass traditional forms of probated sentencing in punishment severity have received little attention in the correctional literature. Innovative diversion programs have relieved bloated numbers of inmates in state prisons, decreased the potential pool of community welfare recipients, and have reintegrated offenders into their respective neighborhoods. This article reports the results of a three-year longitudinal study of seventy-one (N= 71) criminal offenders assigned to Dougherty County, Georgia's Criminal Alcoholic Program (C.A.P.). The criminal histories of these offenders are compared two years before and after completing this judicial diversion program. Statistically, significant reductions in criminal behavior were observed between pre and post testing periods. The most significant reductions in criminal behavior were for traffic and alcohol-related offenses. Youthful felons experienced the greatest improvement in criminal behavior two years after entry into the C.A.P. and were more successful in adapting to the community than olderfelons.

Arrests before and during methadone maintenance.

The effect of methadone maintenance on criminal behavior remains ambiguous, in part because of major methodological problems with most studies. We attempted to approach the problem more precisely than previous studies by comparing official police arrest records of 100 heroin addicts for 1 year before admission with those for 1 year after admission. The total number of criminal charges decreased from 189 before admission to 129 after admission. Excluding vagrancy, because of a change in police arrest practice, we found only a 14% reduction in criminal charges. A statistically significant decrease of 40% occurred in one category, burglary and theft. Arrest frequencies were generally correlated with other outcome measures such as employment status and continuation in methadone treatment. The results suggest a modest reduction in criminal behavior as a result of methadone maintenance, with insignificant reduction in crime not directly related to narcotic addiction.

Methadone Maintenance: A Comparison of Methadone Treatment Subjects and Methadone Treatment Dropouts

Commonly agreed upon goals in conjunction with methadone maintenance have been (1) a return to legitimate employment, (2) cessation or substantial reduction in criminal behavior, (3) reduction in the amount of time spent in drug-seeking behavior, (4) involvement with a social system in which there is a positive reinforcement for relating to people, and (5) furnishing a motivation for healthy living. Furthermore, many methadone programs have reported high retention rates of addicts remaining in the program. Thus, as a result of these retention rates, methadone maintenance programs should have a higher degree of success in achieving the above-mentioned goals as compared to other alternative forms of treatment that do not have high retention rates (Senay and Renault, 1971). Indeed, the present findings reveal that for matched groups of addicts admitted to a methadone program, those addicts who remain in methadone treatment longer than 3 months showed improved behaviors in seeking and gaining meaningful employment, attitudes about themselves, reduction in time spent seeking illegal drugs, interpersonal relationships, and a higher motivation for carrying on a more useful and productive life. In addition, these same addicts in methadone treatment revealed a steady reduction in criminal behavior. These findings are similar to those reported by others (Rosenberg, Davidson, and Patch, 1972).Despite these findings, it should be pointed out that the success reported here involves a sample which reflects only 35% of the addicts remaining in methadone treatment out of all the addicts who originally applied for the program. As such, a substantial problem still remains. It appears that many addicts who do not accept treatment or who drop out of treatment early may be lost to treatment for a long period of time. Furthermore, dropouts appear to be a high risk to return to criminal behaviors to support their habit. There seems to be no one single reason why addicts drop out of treatment, but rather the problem is a multidimensional one. That is, addicts who do not accept treatment or drop out early may be more influenced by peer group dynamics, deprived physical and emotional family backgrounds, or find it easier to obtain “street” methadone, all of which encourage addiction rather than abstinence and treatment. Finally, although a large number of addicts remain a problem, there is hope that for those addicts who accept and remain in methadone treatment, the first critical steps are being taken toward providing themselves with a degree of stability whereby improved social, psychological, and personal growth can take place. Thus it seems imperative that meth-adone treatment programs continue research into gaining a better understanding of the complex forces and interaction of forces that contribute to the heroin addict not accepting or dropping out of treatment. Only through such understanding can better alternatives be offered to a larger segment of the addict population.