title: Criminal justice referral and incentives in outpatient substance abuse treatment.
abstract: A substantial number of substance abusers entering outpatient psychosocial counseling treatment are referred from the criminal justice (CJ) system. This secondary analysis of previously published findings from a large (N=415) multi-site trial of a prize-based abstinence incentive intervention (Petry et al., 2005) examined the influence of CJ referral on usual care outcomes and response to the incentive procedure. CJ referrals (n=138) were more likely than those not CJ referred (n=277) to provide stimulant negative urine samples whether missing samples were counted as positive (50 versus 41%, p=.016) or as missing (96 versus 91%, p<.001). A significant interaction term was found only for percentage of treatment completers (p=.027). However, on that retention variable, and three additional drug use measures, significant incentive effects were confined to participants who entered treatment without referral from the criminal justice system. The study suggests that abstinence incentives should be offered as a first priority to stimulant users entering treatment without criminal justice referral. However, incentives can be considered for use with CJ-referred stimulant users based on the observation that best outcomes were obtained in CJ referrals who also received the abstinence incentive program.
authors: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore MD 21224, USA. defulio@jhmi.edu
authors: Anthony
authors: A
authors: DeFulio
authors: Maxine
authors: M
authors: Stitzer
authors: John
authors: J
authors: Roll
authors: Nancy
authors: N
authors: Petry
authors: Paul
authors: P
authors: Nuzzo
authors: Robert P
authors: RP
authors: Schwartz
authors: Patricia
authors: P
authors: Stabile
mesh_terms: D000553:Ambulatory Care / Q000379:methods; D003416:Criminal Law / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation; D010045:Outpatients / Q000706:statistics & numerical data; D012017:Referral and Consultation; D012054:Reinforcement, Psychology; D012201:Reward; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D016896:Treatment Outcome