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© 2003 by the Journal of Drug Issues Online access is available to paid subscribers. Online content is not to be distributed in digital form. The Utility of Debriefing Questions in a Household Survey on Drug Abuse Michael Fendrich, Joseph S. Wislar, Timothy P. Johnson Since subjects are often uncomfortable disclosing sensitive information, questions gauging respondent reaction to survey questions about drug abuse may aid in the interpretation of responses. Such debriefing questions can be worded subjectively, i.e., asking subjects about their own reactions to questions, or projectively, i.e., asking subjects about their perceptions of the reactions of others to questions. Using data from a study employing both types of debriefing questions, we examined whether question wording made any difference. We evaluated the extent to which drug reporting was associated with respondent reaction to the survey and whether reactions varied by type of debriefing question. A factor analysis of debriefing questions appended to an experimental household survey on drug abuse yielded factors reflecting distinct subjective and projective dimensions. Analyses suggested that debriefing question wording does make a difference with respect to respondent reaction. Contrary to expectations, analyses suggested that those reporting drug use expressed more discomfort on subjectively worded items and less discomfort on projectively worded items. Subjects who self-administered their survey also reported higher levels of subjective discomfort, as did those with lower levels of education. The projective measures derived from analyses were associated with three demographic variables: Younger subjects reported higher levels of projective ease than older subjects. Those with some college reported higher levels of projective ease than those with the least amount of formal education. African-Americans reported lower levels of projective ease than White/Other subjects. Implications for the design, interpretation, and analysis of drug use surveys are considered.
Martha A. Jessup, Janice C. Humphreys, Claire D. Brindis, Kathryn A. Lee The objective of this qualitative study was to examine extrinsic barriers to substance abuse treatment among pregnant and parenting women enrolled in residential perinatal substance abuse treatment programs in Northern California. Life history interviews were conducted with 36 women to examine help-seeking behaviors before treatment enrollment. Data analysis used the analytic framework of Mandelbaum (1973) to describe dimensions, turnings, and adaptations of participants. Results indicated that the majority (n = 34) of participants sought prenatal care but identified fear of punitive actions from helping institutions and individuals as a major barrier. Other extrinsic barriers included substance abuse treatment program barriers, partners, the status of opiate dependency, and the status of pregnancy. Biological, socio-cultural, and psychosocial dimensions of participants’ care-seeking experiences were identified. The turning was pregnancy and adaptations included preserving the family, managing fear and manifesting faith. Findings describe the transformation of the therapeutic alliance and the gendered impact of two decades of the War on Drugs in the United States. Participants’ coping strategies suggest that the desire for child custody and concern for fetal and child well-being was a priority and motivated care seeking despite extrinsic barriers perceived to be threatening to the woman’s safety and autonomy. Danica Kalling Knight, Gail Wallace Although providing child care and family residency options has become central to substance abuse treatment for women with dependent children, research documenting status of child coresidence prior to, during, and following treatment is currently unavailable. The purpose of this study is to examine the degree to which mothers are successful in maintaining or reestablishing their role as parents during the course of treatment. The sample included 152 female clients admitted to a residential drug treatment program for women with dependent children. Findings document an increase in child coresidency from admission to follow-up. Women who entered treatment with all children or who were reunited with children previously in others’ care at admission were over five times more likely to coreside with all children at follow-up. At follow-up, mothers who reported complete coresidence were more likely to be 30 years old or younger, live independently, and have fewer than two parenting challenges.
Ross Coomber, Michael Oliver, Craig Morris Thirty-three therapeutic cannabis users in England were interviewed about their experiences using an illegal drug for therapeutic purposes. Interviews were semi-structured, and responses highly qualitative. Particular issues included how and why cannabis was used therapeutically; what problems its illegality posed in terms of access, cost, reliability of supply, and quality of the product; the perceived beneficial effects of its use; and unwanted effects (problems in relation to family, friends, partners, the criminal justice system, and the health care system). The study did not seek to prove or disprove the efficacy of cannabis used as a therapeutic agent merely to report the experiences of those who use it in that way. It was found that users perceived cannabis to be highly effective in treating their symptoms, to complement existing medication, and to carry fewer unwanted effects. Smoking was the preferred method of administration, permitting greater control over dose and administration. Problems related to prescribed medication were motivational for many to use cannabis therapeutically. Few problems were experienced with friends, family, partners, and the criminal justice or health care systems, although other concerns apropos of cannabis’s illegality were reported. Although most were relatively unconcerned about the risk involved and were determined to continue use, many resented that they felt they were being forced to break the law. Problems relating to access to the drug (in an illegal context) and managing its administration were reported. A brief discussion of the continued prohibition of cannabis for this group is undertaken, and a harm reduction approach is suggested. Evaluating
a Prison-based Drug Treatment Program in Taiwan Using data collected from pre-release and 12-month follow-up interviews with drug-using offenders, this article evaluates the efficacy of the first prison-based drug treatment program in Taiwan. A quasi-experimental design matching drug-abusing offenders into treatment and nontreatment groups was adopted. Program outcomes were measured in five domains: criminal recidivism, post-release drug use patterns, improved family and social relationships, problems adjusting to community life, and mental health after release. Logistic and OLS regression were employed to identify possible correlates of program outcomes. The results generally failed to confirm positive outcomes generated by the compulsory drug treatment program. Program participants reported higher rates of recidivism and post-release illicit drug use than nonprogram participants. Program participants also reported more problems adjusting to community life after release. Post-release living arrangements, friends or family members abusing illicit drugs, and problems adjusting to community life after release were also found to be significant correlates of recidivism and post-treatment drug use. Post-release employment status and mental health status were significantly related to post-treatment drug use, but not to recidivism. Since multiple factors lead to drug addiction, the article concludes that the structure and implementation of Taiwan’s prison-based drug treatment program needs reform to effect positive behavioral change on drug-abusing offenders. Duren Banks, Denise C. Gottfredson Past research has generally shown that drug courts are reaching their target offenders and that program participants are rearrested at a lower or equivalent rate than comparison offenders. Few analyses have been conducted to test the relative effects of different drug court elements, however. The current research takes a closer look at the two main components of the drug court, supervision and treatment, to determine whether one is more effective at preventing failure, or whether the combination of both is necessary to observe a decreased risk of failure. Attending treatment significantly decreased the risk of failure over a two-year follow-up period, while receiving supervision did not. Offenders who received both supervision and treatment had the longest survival times, but not significantly longer than those who received treatment only. Implications for drug courts in general are discussed, as well as avenues for future research in this field. Perry N. Halkitis, Jeffrey T. Parsons, Leo Wilton This exploratory investigation describes methamphetamine use among a convenience sample of gay and bisexual men in New York City. A total of 49 participants reported using methamphetamines, on average, 12 days over the past three months, and 63.1% of the participants reporting use with the majority of their sexual encounters. Poly-substance use was high in this sample of methamphetamine users. Methamphetamine use was more frequent among those men who reported using the drug in bathhouses and bars, and frequency of use was associated with a need to escape unpleasant emotions and physical discomfort, avoid social conflict, and enjoy pleasant times with others. The data suggest a contextual understanding of methamphetamine use in New York City that is similar to that of gay communities of the Western United States. Limited Rationality and the Limits of Supply Reduction Jonathan P. Caulkins, Robert MacCoun Drug markets have been targeted for increasingly tough enforcement, yet retail prices for cocaine and heroin have fallen by 70-80%. No research has explained adequately why prices have fallen. This paper explores the possibility that part of the explanation may lie in the failure of drug dealers to respond to risks the way the simplest rational actor models might predict.
Andrew D. Hathaway, Patricia G. Erickson Contrasting the official harm reduction aims of Canada’s 10-year national drug strategy with the actual evolution of the Controlled Drugs and Substances Act, the authors find little evidence of harm reduction, and much of sustained and punitive prohibition. The example of the criminal sanctions currently being applied to cannabis possession offences serves to illustrate the limits of what can be achieved in reducing the impact of criminalization when the fundamental ban on personal use and access is retained. Theoretically informed by constructionist analyses of the styles and strategies of social problems discourse, a moral basis of drug use entitlement is expounded from which rational reform might be more fruitfully argued. Despite its official mandate in Canada to develop more pragmatic drug policy alternatives, the harm reduction movement, posing public health solutions based on empirical analysis, is nonetheless needful of a rhetorical foundation by which to denounce prohibition as a morally objectionable intervention in the private lives of individuals. Elizabeth M. Ginexi, Mark A. Foss, Christy K. Scott This investigation involved a first-attempt at modeling long-term treatment and work trajectories in a large, urban sample of individuals in publicly funded substance abuse treatment: (a) determining the demographic factors that predicted work patterns and (b) examining the longitudinal relationship between work status and continued treatment, persistent drug use, and psychological problems investigated work status across three years. Mixed-effects regression models revealed that significantly more participants were working and looking for work at each follow-up. Gains in labor force participation were greatest at six months while gains in employment were greatest at 24 months. Several demographic variables predicted later work status including age, gender, living arrangement, occupational skills, and having children in foster care. Participants who continued treatment, continued to use drugs, or reported psychological problems were most likely to be out of the labor force. By far, the greatest barrier to long-term employment was continued drug use. Grace E. Macalino, Rachel S. Weston, Francis A. Wolf, Stephanie L. Sanford-Colby, Michell M. McKenzie, Josiah D. Rich Efforts to prevent the spread of HIV and hepatitis among injection drug users (IDUs) by improving access to sterile syringes can raise questions about syringe disposal. This study sought to evaluate the acceptability and utility of the Voyager, a newly approved, hand-held syringe disposal device for active injection drug users (IDUs). We offered the Voyager to active IDUs (n = 97), and interviewed them upon receiving the device and one month later. Almost all (90%) accepted the device. At follow-up, 78% had used the Voyager and 44% reported using it all the time; 65% reported they would like to continue using the Voyager and 77% rated the device “somewhat better” or “much better” than other methods of syringe disposal. Many IDUs care about safe syringe disposal and are willing and able to use a convenient disposal device such as the Voyager. Communities concerned about needlestick injuries and re-use of contaminated syringes should explore increasing the availability of such a device for IDUs as part of an overall approach to prevent improperly discarded syringes.
JDI is a publication of the School of Criminology & Criminal Justice.
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