Interventions for drug-using offenders with co-occurring mental illness

Area of Science:

• Criminal Justice
• Psychiatry
• Addiction Medicine

Background:

• This review updates a 2006 Cochrane review on interventions for drug-using offenders.
• It focuses on offenders with co-occurring mental illness, examining interventions for reducing drug use and criminal activity.

Purpose of the Study:

• To assess the effectiveness of interventions for drug-using offenders with co-occurring mental illness.
• To determine the impact on criminal activity and drug use.

Main Methods:

• Searched 14 electronic databases and 5 internet resources up to May 2014.
• Included randomized controlled trials (RCTs) evaluating interventions for drug-using offenders with co-occurring mental illness.
• Narrative synthesis due to heterogeneity of interventions and outcomes.

Main Results:

• Eight RCTs with 2058 participants were included; methodological quality was often unclear.
• Interventions showed limited success in reducing self-reported drug use.
• Therapeutic communities demonstrated moderate-quality evidence for reducing re-incarceration but not re-arrest.
• Other interventions like case management and motivational interviewing showed low to very low-quality evidence for reducing criminal activity or drug use.

Conclusions:

• Two trials indicated promising results for therapeutic communities and aftercare in reducing re-incarceration.
• High variation in study results necessitates caution in interpreting treatment outcome effectiveness.
• Further evaluations are required to establish effective interventions for this population.