Predictors of retention in a drug-free unit/substance abuse treatment in prison.

The high rate of dropout from treatment programs is a recurring problem in the field of drug dependence. The purpose of this study was to identify the predictors of retention in a prison-based drug-free unit (DFU). The relationships among subscales of the Addiction Severity Index (ASI) as well as motivation and personality profiles and length of stay in a DFU, of 57 prisoners admitted for the first time to the program were analyzed. The mean dropout rates were 52.9% at six months and 67.8% at one year. The mean length of stay was 195.05 days. Predictors of retention at six months included the ASI Family Composite Score, the motivation subscale Taking Steps, and Narcissistic personality trait score. Predictors of retention at one year included lower ASI Psychological Composite Score, higher scores on the motivation subscale Ambivalence, and higher number of charges pending at the time of admission to the program. Identification of these predictor variables may be useful for developing strategies to increase retention in the context of in-prison substance abuse treatment.

What predicts retention on an in-prison drug treatment program?

UNLABELLED: The effectiveness of treatments for substance use disorders is strongly related to retention, since early dropout from treatment is associated with greater likelihood of relapse. The purpose of this prospective, ex post facto study is to analyze the effect of individual variables on retention in a treatment program carried out in a prison drug-free unit. The Addiction Severity Index, motivation and personality profile of fifty inmates were assessed on entry to the prison. Inmates were monitored for a year to identify length of stay. RESULTS: Motivation variables at intake play a vital role in the prediction of retention in a prison drug-free unit; scores on the Aggressive-Sadistic and Narcissistic scales are also strong predictors of treatment retention.

What predicts retention on an in-prison drug treatment program?

The effectiveness of treatments for substance use disorders is strongly related to retention, since early dropout from treatment is associated with greater likelihood of relapse. The purpose of this prospective, ex post facto study is to analyze the effect of individual variables on retention in a treatment program carried out in a prison drug-free unit. The Addiction Severity Index, motivation and personality profile of fifty inmates were assessed on entry to the prison. Inmates were monitored for a year to identify length of stay. Results: Motivation variables at intake play a vital role in the prediction of retention in a prison drug-free unit; scores on the Aggressive-Sadistic and narcissistic scales are also strong predictors of treatment retention (AU)

La eficacia de los tratamientos para los trastornos por uso de sustancias está altamente relacionada con la retention, pues entre otras cosas el abandono del tratamiento se vincula con una mayor probabilidad de recaída. El propósito de este estudio prospectivo ex post facto es analizar el efecto de distintas variables individuales sobre la retención en el tratamiento dispensado en una unidad libre de drogas intrapenitenciaria. Cincuenta internos de este programa fueron evaluados al ingreso en variables relacionadas con el perfil de gravedad de la adicción, la motivación y la personalidad. Resultados: La motivación inicial es una variable fuertemente predictora de la retención en el tratamiento, tanto a los seis meses como al año de estancia. Asimismo, las escalas Narcisista y Agresivo-Sádica evaluadas por el instrumento MCMI-II también tuvieron capacidad pronóstica en la retención (AU)

Evaluación de la eficacia de un tratamiento libre de drogas intrapenitenciario / Evaluation of the effectiveness of a prison-based drug treatment

El presente estudio evalúa la eficacia de una unidad libre de drogas intrapenitenciaria en la reducción del consumo de sustancias, y analiza los cambios en el perfil de gravedad de la adicción, la motivación y el perfil de personalidad provocados por la intervención. Se trata de una evaluación externa, con un diseño ex post facto de medidas repetidas. Se evalúan 87 reclusos a lo largo de un año de estancia en el programa. La mayoría son varones jóvenes y policonsumidores que cumplen condena por delitos contra la salud pública y contra la propiedad. Muchos presentan necesidad de tratamiento psiquiátrico al ingreso, con una comorbilidad del 85% con trastornos de personalidad. La motivación para el tratamiento es baja, y se mantiene estable a lo largo de los 12 meses que dura el estudio. La unidad libre de drogas consigue disminuir el consumo de drogas, y mejorar las áreas de consumo, de relaciones familiares y el perfil de personalidad. Sin embargo, no se logran cambios en las áreas médica y psiquiátrica, por lo que se resalta la necesidad de intervención en estos ámbitos (AU)

The present study evaluated the effectiveness of a drug-free unit (DFU) in reducing the use of substances by incarcerated adult offenders, and to analyze changes in the addiction severity index, motivation, and personality caused by the program. This is an external evaluation, with an ex post facto design with repeated measures. Eighty-seven prisoners from the DFU were evaluated during the first year of residence in the program. Most are young men, polydrug addicts and mainly serving sentences for public health crimes and property offenses. There is need of psychiatric treatment at the baseline, with 85% comorbid personality disorders. Motivation for treatment is low, and remains stable over 12 month’s duration of the study. The DFU was found to have a significant effect in reducing the use of drugs by offenders and to improve the drug and family composite scores, also reducing scores on personality scales. However, it fails to change medical and psychiatric scores, so that the need for intervention in these areas is underscored (AU)

[Evaluation of the effectiveness of a prison-based drug treatment]. / Evaluación de la efi cacia de un tratamiento libre de drogas intrapenitenciario.

The present study evaluated the effectiveness of a drug-free unit (DFU) in reducing the use of substances by incarcerated adult offenders, and to analyze changes in the addiction severity index, motivation, and personality caused by the program. This is an external evaluation, with an ex post facto design with repeated measures. Eighty-seven prisoners from the DFU were evaluated during the first year of residence in the program. Most are young men, polydrug addicts and mainly serving sentences for public health crimes and property offenses. There is need of psychiatric treatment at the baseline, with 85% comorbid personality disorders. Motivation for treatment is low, and remains stable over 12 month's duration of the study. The DFU was found to have a significant effect in reducing the use of drugs by offenders and to improve the drug and family composite scores, also reducing scores on personality scales. However, it fails to change medical and psychiatric scores, so that the need for intervention in these areas is underscored.

[Need for the assessment of dual diagnosis in prisons]. / Necesidad de evaluación de la patología dual en contexto penitenciario.

INTRODUCTION: Data show that 92.5% of prison inmates report drug or alcohol use. In spite of this, only 2% of dual diagnosis research has been carried out in the prison context. Therefore, the aim of this descriptive cross-sectional study was to analyze the profiles of dual diagnosis in a Spanish prison and test the feasibility of two assessment instruments. METHOD: The sample was made up of 152 drug-addicts imprisoned in the Villabona Penitentiary Center (Asturias, Spain) who volunteered to be interviewed. The sixth version of the Addiction Severity Index and the International Neuropsychiatric Interview - MINI- were used for the assessment of inmates' psychopathological status and drug problems. RESULTS: The results show that, in general, the offender's profile is: male, 34 years old, unmarried, with children and with an average time spent in prison of approximately five years. Only 4.5% of respondents did not use drugs at the time of the study. In the remainder, the most widely used substances are cocaine (37.6%), heroin (29.9%) and alcohol (10.8%), with 52.7% reporting having used drugs in the last month. With regard to psychopathological state, only 12.9% have no associated disorders, and the most prevalent symptoms correspond to antisocial personality disorder (65.6%), risk of suicide (45.2%), depression (35.9%) and anxiety (25.5%). CONCLUSION: The instruments proposed (ASI-6 and MINI) are feasible tools for detecting addiction severity and associated psychopathology in this context.

Necesidad de evaluación de la patología dual en contexto penitenciario / Need for the assessment of dual diagnosis in prisons

Introducción: Los datos epidemiológicos recientes indican que un 92.5%de los internados en prisión declaran haber consumido sustancias psicoactivas. A pesar de ellos, solamente un 2% de las investigaciones en patología dual se han realizado en el contexto penitenciario. Por ello, el objetivo del presente estudio descriptivo de carácter transversal, fue analizarlos perfiles de patología dual en una prisión española y probar la factibilidad de dos instrumentos de evaluación. Método: Se cuenta con una muestra de 152 internos procedentes de los módulos ordinarios del Centro Penitenciario de Villabona que manifestaron consumos compatibles con los criterios de un Trastorno por Uso de Sustancias y accedieron a realizar la entrevista voluntariamente. Se administraron la sexta versión del Índice de Gravedad de la Adicción-ASI-6- y la Entrevista Neuropsiquiátrica Internacional-MINI-. Resultados: El perfil del entrevistado responde a un varón de 34 años, soltero, con hijos y con un tiempo medio de encarcelación que ronda los cinco años. Únicamente el 4.5% de los entrevistados declara no consumir drogas en la actualidad, llevando más de un año abstinente. De los consumidores en activo, la sustancia de consumo principal es mayoritariamente cocaína (37,6%), heroína (29,9%) o alcohol (10,8%). El 52,7%reconoce haber consumido en el último mes. Con respecto al estado psicopatológico, únicamente el 12,9% no presenta patologías asociadas. Entre ellos, la sintomatología más prevalente es el trastorno antisocial de la personalidad (TAP, 65,6%), riesgo de suicidio (45,2%), depresión (35,9%) y ansiedad (25,5%).Conclusión: Los instrumentos propuestos –ASI-6 y MINI- son pruebas factibles y recomendables para detectar la gravedad de la adicción y de la psicopatología asociada en este contexto (AU)

Introduction: Data show that 92.5% of prison inmates report drug or alcohol use. In spite of this, only 2% of dual diagnosis research has been carried out in the prison context. Therefore, the aim of this descriptive cross-sectional study was to analyze the profiles of dual diagnosis in a Spanish prison and test the feasibility of two assessment instruments. Method: The sample was made up of 152 drug addicts imprisoned in the Villabona Penitentiary Center (Asturias, Spain) who volunteered to be interviewed. The sixth version of the Addiction Severity Index and the International Neuropsychiatric Interview –MINI– were used for the assessment of inmates’ psychopathological status and drug problems. Results: The results show that, in general, the offender’s profile is: male, 34 years old, unmarried, with children and with an average time spent in prison of approximately five years. Only 4.5% of respondents did not use drugs at the time of the study. In the remainder, the most widely used substances are cocaine (37.6%), heroin (29.9%) and alcohol (10.8%), with 52.7% reporting having used drugs in the last month. With regard to psychopathological state, only 12.9% have no associated disorders, and the most prevalent symptoms correspond to antisocial personality disorder (65.6%), risk of suicide (45.2%), depression (35.9%) and anxiety (25.5%). Conclusion: The instruments proposed (ASI-6 and MINI) are feasible tools for detecting addiction severity and associated psychopathology in this context (AU)

La Universidad de Oviedo y los estudiantes con discapacidad / University of Oviedo and students with disability

Recientemente se ha llevado a cabo un estudio exhaustivo de la situación de los estudiantes con discapacidad de la Universidad de Oviedo. En el presente artículo se ofrece una síntesis del amplio informe que se elaboró, concretamente del procedimiento seguido, de los principales resultados obtenidos así como de las conclusiones y sugerencias a las que se ha llegado tras el análisis detallado de la entrevista que se pasó a los alumnos con discapacidad matriculados en la universidad asturiana

Recently an exhaustive study on the situation of students with disability of the University of Oviedo has been carried out. In this paper a summary of the complete report is offered, with information about the procedure, the main results, as well as the conclusions and suggestions obtained after a detailed analysis of the interview applied to the students with disability registered in the University of Asturias (AU)