Substance abuse treatment and pressures from the criminal justice system: data from a provincial client monitoring system.
OBJECTIVE
Compulsory treatment is discussed increasingly as a way to reduce the population burden of addictive behaviours. This study explores the extent to which social control strategies exercised through the criminal justice system are used to bring people into substance abuse treatment at a system level. We also assessed whether particular subgroups may be more or less likely to be brought into treatment in this manner.


METHODS
We employed a secondary analysis of data from a client-based information system which captured demographic, referral and substance use characteristics from people seeking treatment for substance abuse.


METHODS
A census of clients (n = 45123) entering specialized Ontario addiction treatment programmes between 1 April 1999 and 31 March 2000.


RESULTS
Some 28.9% of clients reported legal problems at treatment intake, and 13.9% had an explicit corrections-related condition of treatment contact. Logistic regression analyses indicated that legal problems and corrections-related conditions of treatment were more prevalent among younger, unmarried and unemployed males, who had not completed high school. A number of important interactions were identified between these factors and substance of abuse.


CONCLUSIONS
Implications for equity, accessibility and effectiveness of substance abuse treatment are discussed in relation to the tendency of treatment mandates from criminal justice system to disproportionately affect the entry of this segment of substance-abusing clients.
Rush
Brian R
BR
Health Systems Research, Centre for Addiction and Mental Health, Toronto, Canada. Brian_Rush@camh.net
Wild
T Cameron
TC
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D004651:Employment; D005260:Female; D006801:Humans; D035846:Law Enforcement; D008297:Male; D008393:Marriage; D008875:Middle Aged; D009864:Ontario; D012044:Regression Analysis; D019966:Substance-Related Disorders / Q000534:rehabilitation*